CDC Sodium Reduction Initiative
Saving Lives and Money
Sodium reduction is a national priority for the Centers for Disease Control and Prevention (CDC). The agency is working with national, state, and local partners to gradually reduce sodium consumption, increase blood pressure control, and improve nutrition in the United States. Led by the agency’s Division for Heart Disease and Stroke Prevention, CDC is actively monitoring the following: (1) high blood pressure and cardiovascular disease (CVD) deaths, (2) sodium consumption, (3) sodium content in foods, and (4) consumer readiness to reduce sodium intake. In support of this effort, CDC publishes data and research about sodium, educates and provides technical assistance to funded programs and partners working to reduce sodium in communities, and engages the food industry to understand challenges and solutions to sodium reduction in the food supply. Additionally, CDC’s Sodium Reduction Initiative supports the Million Hearts® 2022 aim of preventing 1 million heart attacks and strokes by 2022. The Million Hearts® initiative has established the goal to reduce sodium intake by 20% to meet this aim. Below is a summary of select activities that support this work.
Monitoring cardiovascular health is critical for measuring the impact of public health policies and programs. CDC manages Data Trends & Maps, a national repository of resources that documents the public health burden of CVD and its risk factors at the national, state, and local levels. CDC also works collaboratively with private and public partners to enhance and expand surveillance of sodium and related nutrients in foods, sodium and related nutrient intake, and consumer readiness to reduce sodium consumption. Related nutrients are those that have the potential to be affected by food reformulation or changes in salt intake and include iodine, potassium, sugar, saturated fats, and trans fats. A general description of monitoring foods, intake, and consumer readiness includes the following:
- Using sales and label information to track the sodium and related nutrient content of commercially packaged foods.
- Collaborating with federal partners to conduct and report laboratory analyses of the nutrient content of selected packaged and restaurant foods.
- Enhancing the monitoring of nutrient intake by providing support for updating national food and nutrient databases used with the National Health and Nutrition Examination Survey (NHANES).
- Expanding monitoring of sodium and related nutrient intake through analysis of urine biomarkers in national surveys.
- Collecting data and reporting on U.S. consumer knowledge about and attitudes toward policies to reduce sodium in packaged and restaurant foods.
- Collecting and reporting state and local data on consumer action and health professional advice on sodium reduction through the Behavioral Risk Factor Surveillance System (BRFSS).
Why Is Eating Too Much Sodium Harmful?
- Eating too much sodium is associated with higher blood pressure.
- Having high blood pressure can raise the risk of heart attack, stroke, and other cardiovascular conditions.
- Reducing sodium intake can help lower blood pressure and improve heart health.
CDC conducts and supports applied research to understand correlates, determinants, and consequences of sodium intake; help improve measurement of sodium intake; design and test interventions to reduce sodium intake; and translate research to programs, policies, and the public.
Understand Correlates, Determinants, and Consequences
- Supporting collaborative efforts to update the Dietary Reference IntakeExternal for sodium and potassium.
- Describing the sources of sodium in the United States and variability across population subgroups that include race or ethnicity, income, weight, and hypertension status.
- Conducting analyses to understand the associations of sodium intake with blood pressure, diet quality, obesity, and cardiovascular risk factors.
- Determining the most accurate, low-cost, and feasible methods to measure sodium intake through urine biomarkers.
- Supporting the development and testing of mobile apps to capture nutrition and other data from packaged foods.
Design and Test Interventions
- Collaborating with partners to estimate the health impact and cost-effectiveness of sodium reduction strategies.
- Analyzing data from surveys to better understand consumer attitudes, behaviors, and use of specific strategies to reduce sodium intake.
CDC provides education for the general public and public health workforce about sodium reduction. Education and technical assistance are provided through collaborating with stakeholders, advancing and disseminating research, and providing technical assistance to funded programs and partners.
- Ongoing partnership activities with federal agencies, including the U.S. Department of Agriculture (USDA), the Food and Drug Administration (FDA), and the National Institutes of Health (NIH).
- Informing the public health and food industry communities about sodium through bimonthly communications, including the Salt in the News and Salt e-Update newsletters, which are sent to more than 475 stakeholders in the United States and are translated and disseminated to Chinese stakeholders.
- Partnering with nongovernmental public health organizations to exchange information and coordinate sodium reduction efforts.
Programs and Technical Assistance
- Funding eight states and localities to initiate voluntary sodium reduction strategies through the Sodium Reduction in Communities Program (SRCP).
- Contributing to the evidence base for community-based sodium reduction by conducting a national evaluation to assess how and to what extent SRCP communities are carrying out sodium reduction strategies.
- Supporting state and local sodium reduction activities, including the promotion and adoption of food service guidelines and nutrition standards that include sodium standards, and strengthening healthier food access and sales in retail venues to reduce sodium content in the food supplyExternal.
- Providing information to government agencies, public health organizations, and public health practitioners to support sodium reduction efforts through the Partnering with Food Service to Reduce Sodium: A Toolkit for Public Health Practitioners Cdc-pdf[PDF-7.7 MB]External.
- Publishing guides, resource documents, and stories of best practices for sodium reduction in settings such as schools, hospitals, work sites, and institutionalized environments as well as for congregate meals served to older adults.
Industry and Public Engagement
CDC is aligning efforts with industry to support voluntary sodium reduction strategies by:
- Collaborating with the National Network of Public Health Institutes (NNPHI), CDC helped to develop four culinary training videos and three series of technical assistance webinars related to sodium reduction. The culinary training videos showcased cooking techniques that reduced the sodium content in meals. The three series of webinars—Connecting Public Health and Food Sector Collaborators, Connecting Public Health and the Food Industry, and Connecting Public Health and Food Service Operators—featured speakers from the food sector that highlighted food service operators and public health practitioners reducing sodium in food service operations.
- Facilitating discussions among grantees, partners, and industry to better understand what can be and is being done to reformulate products to reduce sodium in the food supply and at the community level.