Public health practitioners and healthcare providers can use these resources as they work to reduce sodium consumption in their communities.
These resources were developed by or highlight the work of the CDC’s Division for Heart Disease and Stroke Prevention (DHDSP) and funded recipients of the Sodium Reduction in Communities Program (SRCP).
Key Messages on Sodium and Sodium Reduction pdf icon[PDF – 11 MB]
DHDSP and funded recipients of the SRCP worked collaboratively to develop this resource that includes key messages related to sodium, the importance of sodium reduction, and sodium reduction strategies. The document may be useful to pull content from when communicating about the impact of sodium on health and about the value of sodium reduction work.
Sodium Reduction in Communities Program (SRCP) Implementation Guide
This guide was crafted to assist food service staff and public health organizations in reducing sodium in food service organizations. The guide draws upon the experiences gained during the SRCP and provides information on how to implement activities related to four key strategies:
- Implementing food service guidelines and nutrition standards
- Changing procurement practices
- Making meal or menu modifications
- Implementing environmental strategies or behavioral economics approaches
The SRCP Implementation Guide can assist food service staff in planning, implementing, and maintaining sodium reduction activities. The guide can also help public health staff determine how to support partners in sustaining sodium reduction strategies to achieve lasting change.
Sodium Reduction in Communities Program: Outcome Evaluation Toolkit pdf icon[PDF – 1 MB]
This evaluation toolkit was developed using CDC’s Evaluation Framework to provide guidance and tools for anyone evaluating sodium reduction activities, especially Sodium Reduction in Communities Program recipients.
Sodium Reduction Partner Readiness Tool
DHDSP and funded recipients of the SRCP worked collaboratively to develop this tool. The purpose of this assessment tool is to help public health organizations that partner with food service, such as health departments, to determine the readiness of partners to implement sodium reduction strategies and then develop an action plan that outlines next steps for facilitating greater readiness.
The tool itself is a simple Microsoft Excel file excel icon[XLS – 15 KB], and the corresponding instruction document in PDF format pdf icon[PDF – 270 KB] provides details on how to use the tool.
Sodium Reduction: Assessment to Action Toolsexternal icon
The Sodium Reduction: Assessment to Action Tools are easy-to-use, online tools to help food service providers reduce sodium consumption among the people they serve. These tools can help food service managers, dietitians, and chefs—and the public health practitioners they may partner with—to meet goals to serve healthier foods to their customers and clients.
These tools help food service providers assess current practices that impact sodium content and consumption and identify actions to take to reduce sodium. They can be used in a variety of food service settings, including congregate meal settings, cafeterias, snack bars, and vending machines.
The two online tools work together.
- The Assessment Tool captures site background information and assesses current policy and practices in four areas: (1) food service guidelines/standards, (2) food purchasing, (3) food preparation, and (4) nutrition promotion.
- The Action Plan Tool helps turn assessment results into actions that sites can implement. Based on assessment results, the Action Plan Tool recommends policies and practices to help reduce sodium. Providers can then prioritize the strategies for immediate or later action.
Sites can also conduct a post-assessment after implementing their action plan to monitor progress in sodium reduction efforts.
The Assessment to Action Tools are digital versions of the Sodium Practices Assessment Tool (SPAT) 2.0 and Site Action Plan developed and used by the New York State Department of Healthexternal icon.
Health Resources in Actionexternal icon translated these tools into a digital format, in collaboration with the National Network of Public Health Institutesexternal icon through a cooperative agreement with the Centers for Disease Control and Prevention (CDC).
Partnering with Food Service to Reduce Sodium: A Toolkit for Public Health Practitioners pdf icon[PDF – 422 KB]external icon
CDC, the National Network of Public Health Institutes, and Health Resources in Action developed this toolkit for public health practitioners. The toolkit highlights a list of strategies, case studies, tools, and resources for building new or enhancing existing partnerships with food service providers to reduce sodium in foods prepared, served, and sold. It aims to help public health practitioners understand the context of food service settings as well as the language and drivers of food service providers to support effective partnerships.
Reducing Sodium and Added Sugar Through Partnershipsexternal icon
Read these issue briefs from the Association of State and Territorial Health Officials that provide insights and share strategies used by food service management companies and operators across the nation.
The Sodium Reduction in Food Service resource is a compilation of tip sheets for public health professionals partnering with food service providers. The tip sheets summarize key messages and strategies highlighted in the Culinary Institute of America webinar series.
- Download the Sodium Reduction in Food Service tip sheets pdf icon[PDF – 1 MB].
- Learn more about the Culinary Institute of America webinar seriesexternal icon.
Reducing Sodium with the World’s Premier Culinary College: Training Videos for Food Service Professionalsexternal icon
The National Network of Public Health Institutes, in collaboration with CDC and The Culinary Institute of America, released a video series featuring chefs from The Culinary Institute of America. Whether you are a food service provider managing an operation, food service staff responsible for preparing delicious and healthy foods, or a public health professional working with food service providers to improve the nutritional value of foods, these videos provide valuable techniques and recipes that will enhance flavor without the sodium.
The four instructional videos highlight simple culinary strategies and techniques to reduce sodium in food service settings:
- Salad Dressingsexternal icon
- Cooking and Seasoning Techniquesexternal icon
- Ready-to-Use Foodsexternal icon
- Tomato Saucesexternal icon
Sodium Reduction Web Forum Series
CDC and the National Network of Public Health Institutes have published three web forum series that share best practices, successes, and subject matter expertise for public health audiences collaborating with the food sector to reduce sodium. Watch the archived events.
Connecting Public Health and Food Sector Collaborators
- Healthy Menu Innovations in Schoolsexternal icon
- Reducing Sodium in Food Service Settingsexternal icon
- Reducing Sodium through Food Service Guidelines and Nutrition Standardsexternal icon
- Reducing Sodium through Meal and Menu Modificationsexternal icon
Connecting Public Health and the Food Industry
- Reducing Sodium in Partnership with Food Service Vendorsexternal icon
- Voluntary Commitments to Reduce Sodiumexternal icon
- Reducing Sodium through Public-Private Collaborationexternal icon
- Reducing Sodium Through Food Manufacturingexternal icon
Connecting Public Health and Food Service Operators
Kansas (Shawnee County)
- Welsh EM, Perveen G, Clayton P, Hedberg R. Sodium reduction in communities Shawnee County survey 2011: methods and baseline key findingsexternal icon. J Public Health Manag Pract. 2014 Jan-Feb;20(1 Suppl 1):S9-15.
Los Angeles County
- D’Addario L,Kuo T, Robles B. Do knowledge about sodium, health status by self-report, and having hypertension predict sodium consumption behaviors among Southern California hospital employees? external iconTransl Behav Med.2021 Mar 23:ibaa148.
- Wickramasekaran RN, Robles B, Dewey G, Kuo T. Evaluating the Potential Health and Revenue Outcomes of a 100% Healthy Vending Machine Nutrition Policy at a Large Agency in Los Angeles County, 2013-2015external icon. J Public Health Manag Pract. 2018 May/Jun;24(3):215-224.
- Dewey G, Wickramasekaran RN, Kuo T, Robles B. Does Sodium Knowledge Affect Dietary Choices and Health Behaviors? Results From a Survey of Los Angeles County Residentsexternal icon. Prev Chronic Dis. 2017 Nov 22;14:E120.
- Wickramasekaran RN, Gase LN, Green G, Wood M, Kuo T. Consumer Knowledge, Attitudes, and Behaviors of Sodium Intake and Reduction Strategies in Los Angeles Countyexternal icon. Calif J of Health Promot. 2016;14(2):35-44.
- Wickramasekaran RN, Robles B, Dewey G, Kuo T. Evaluating the Potential Health and Revenue Outcomes of a 100% Healthy Vending Machine Nutrition Policy at a Large Agency in Los Angeles County, 2013-2015external icon. J Public Health Manag Pract. 2018;24(3):215-224.
- Robles B, Wood M, Wickramasekaran R, Kwan A, Reyes M, Kuo T. Developing and Applying a Mixed-Methods Evaluation Framework to Build the Business Case for Healthy Food Procurement at the Local Levelexternal icon. SAGE Research Methods Cases. London: 2020.
- Gase LN, McCarthy W, Robles B, Kuo T. Student receptivity to new school meal offerings: Assessing fruit and vegetable waste among middle school students in the Los Angeles Unified School Districtexternal icon. Prev Med. 2014 Oct;67 Suppl 1(0 1):S28-33.
- Cummings PL, Kuo T, Gase LN, Mugavero K. Integrating sodium reduction strategies in the procurement process and contracting of food venues in the County of Los Angeles government, 2010-2012external icon. J Public Health Manag Pract. 2014 Jan-Feb;20(1 Suppl 1):S16-22.
- Cummings PL, Burbage L, Wood M, Butler RK, Kuo T. Evaluating changes to sodium content in school meals at a large, urban school district in Los Angeles County, Californiaexternal icon. J Public Health Manag Pract. 2014 Jan-Feb;20(1 Suppl 1):S43-9.
- Robles B, Wood M, Kimmons J, Kuo T. Comparison of nutrition standards and other recommended procurement practices for improving institutional food offerings in Los Angeles County, 2010-2012external icon. Adv Nutr. 2013 Mar 1;4(2):191-202.
New York City
- Centers for Disease Control and Prevention. Sodium Reduction New York: NYC Healthy Hospital Food Initiative. 2014. https://www.cdc.gov/salt/pdfs/success_story_ny.pdf pdf icon[PDF – 242 KB].
- Lederer A, Curtis CJ, Silver LD, Angell SY. Toward a healthier city: nutrition standards for the New York City governmentexternal icon. Am J Prev Med. 2014;46(4):423-428.
- Moran A, Krepp EM, Curtis CJ, Lederer A. An intervention to increase availability of healthy foods and beverages in New York City hospitals: the healthy hospital food initiative, 2010-2014external icon. Prev Chronic Dis. 2016;13(6):150541.
- Moran A, Lederer A, Curtis CJ. Use of Nutrition Standards to Improve Nutritional Quality of Hospital Patient Meals: Findings from New York City’s Healthy Hospital Food Initiativeexternal icon. J Acad Nutr Diet. 2015;115(11):1847-1854.
- Lederer A, Toner C, Krepp EM, Curtis CJ. Understanding hospital cafeterias: results from cafeteria manager interviewsexternal icon. J Public Health Manag Pract. 2014 Jan-Feb;20(1 Suppl 1):S50-3.
New York State
- Lowenfels A, Pattison MJ, Martin AM, Ferrari C. Improving the Food Environment in Hospitals and Senior Meal Programsexternal icon. Prev Chronic Dis. 2018 Feb 15;15:E22.
- Schuldt J, Levings JL, Kahn-Marshall J, Hunt G, Mugavero K, Gunn JP. Reducing sodium across the board: a pilot program in Schenectady County independent restaurantsexternal icon. J Public Health Manag Pract. 2014 Jan-Feb;20(1 Suppl 1):S31-7.
- Johnston YA, McFadden M, Lamphere M, Buch K, Stark B, Salton JL. Working with grocers to reduce dietary sodium: lessons learned from the Broome County Sodium Reduction in Communities pilot projectexternal icon. J Public Health Manag Pract. 2014 Jan-Feb;20(1 Suppl 1):S54-8.
- Riordan M, Zeitz A, Fulton B, Holliday D, Bartoli C, Aquilante J, Spratt O, Miller L, Wilson A, Deutsch J. Culinary Scientists Collaborating with City Health Department and Manufacturers to Improve Public Heath: A Case from Philadelphia’s Sodium Reduction in Communities Programexternal icon, Journal of Culinary Science & Technology. 2019 27 Sep.
- Deutsch J, Zeitz A, Fulton B, Milliron B, Bartoli C. Chapter 6: From Navigating the Regulatory Environment to Designing a Good Food Supply for Institutions: Cases From Philadelphia. In: Thottathil S, Goger A, eds. Institutions as Conscious Food Consumers, Leveraging Purchasing Power to Drive Systems Changeexternal icon. 1st ed. Academic Press; 2018.
- Ma GX, Shive SE, Zhang G, Aquilante J, Tan Y, Pharis M, Bettigole C, Lawman H, Wagner A, Zhu L, Zeng Q, Wang MQ. Evaluation of a Healthy Chinese Take-Out Sodium-Reduction Initiative in Philadelphia Low-Income Communities and Neighborhoodsexternal icon. Public Health Rep. 2018 Jul/Aug;133(4):472-480.
- Ma GX, Shive S, Zhang Y, Aquilante J, Tan Y, Zhao M, Solomon S, Zhu S, Toubbeh J, Colby L, Mallya G, Zeng Q. Knowledge, perceptions, and behaviors related to salt use among Philadelphia Chinese take-out restaurant owners and chefsexternal icon. Health Promot Pract. 2014 Sep;15(5):638-45.
- Quinn EL, Ortiz K, Titzer L, Houston-Shimizu B, Jones-Smith J. Healthy Food Environments in Food Pantries: Lessons Learned from a Sodium Reduction Interventionexternal icon. Int J Environ Res Public Health. 2021;18(24):13206.
University of Arkansas for Medical Sciences
- Long CR, Rowland B, Langston K, Faitak B, Sparks K, Rowe V, McElfish PA. Reducing the Intake of Sodium in Community Settings: Evaluation of Year One Activities in the Sodium Reduction in Communities Program, Arkansas, 2016-2017external icon. Prev Chronic Dis. 2018 Dec 20;15:E160.
- Rowland B, Mayes K, Faitak B, Stephens RM, Long CR, Mcelfish PA. Improving health while Alleviating Hunger: Best Practices of a Successful Hunger Relief Organizationexternal icon. Curr Dev Nutr. 2018 Jun 22;2(9):nzy057.
Read the Journal of Public Health Management and Practice supplement, “Public Health Interventions to Reduce Sodium Intakeexternal icon,” which features articles from the 2010 SRCP sites.
- Yarnoff B, Teachout E, MacLeod K, Whitehill J, Jordan J, Tayebali Z, Bates L. Estimating the cost-effectiveness of the Sodium Reduction in Communities Programexternal icon. Public Health Nutr. 2021 Oct 25:1-11.
- Jordan J, Hickner H, Whitehill J, Yarnoff B. CDC’s Sodium Reduction in Communities Program: Evaluating Differential Effects in Food Service Settings, 2013-2016external icon. Prev Chronic Dis. 2020 Jul 30;17:E72.
- Mugavero KL, Gunn JP, Dunet DO, Bowman BA. Sodium reduction: an important public health strategy for heart healthexternal icon. J Public Health Manag Pract. 2014 Jan-Feb;20(1 Suppl 1):S1-5.
- Losby JL, Patel D, Schuldt J, Hunt GS, Stracuzzi JC, Johnston Y. Sodium-reduction strategies for meals prepared for older adultsexternal icon. J Public Health Manag Pract. 2014 Jan-Feb;20(1 Suppl 1):S23-30.