Excess Sodium Intake Remains Common in the United States

Nearly all Americans – regardless of age, race, gender or whether they have high blood pressure (hypertension) – consume more sodium than is recommended for a healthy diet. That is the conclusion of a new report published by the Centers for Disease Control and Prevention (CDC) in today’sMorbidity and Mortality Weekly Report (MMWR).

According to the latest findings, more than 90 percent of children and 89 percent of adults aged 19 and older eat too much sodium, that is, more than the recommended limits in the 2015-2020 Dietary Guidelines for Americans, not including salt added at the table. The newly released guidelines – which are developed around current scientific evidence and released every five years – recommend limiting sodium to less than 2,300 mg per day for people over the age of 14 and less for those younger. Evidence links excess sodium intake to high blood pressure and other health problems.

“The finding that nine of ten adults and children still consume too much salt is alarming,” said CDC Director Tom Frieden, MD, MPH. “The evidence is clear: too much sodium in our foods leads to high blood pressure, a major risk factor for heart disease and stroke. Reducing sodium in manufactured and restaurant foods will give consumers more choice and save lives.”

CDC researchers analyzed dietary data from the 2009-2012 National Health and Nutrition Examination Surveys (NHANES) to calculate how much sodium Americans are eating. Nearly 15,000 people were included in this study.

Sodium consumption high among those at risk of heart disease

Excess sodium intake is a problem across gender, race, and health status. Some differences were seen:

• Among adults, a larger proportion of men (98 percent) than women (80 percent) consume too much sodium.
• About 90 percent of adult whites consume excess sodium compared with 85 percent of blacks.
• Estimated sodium and calorie consumption peaks between the ages of 19 and 50.
• Among people at greater risk of developing heart disease or stroke – such as people age 51 and older, African Americans and individuals with high blood pressure or pre-hypertension (blood pressure higher than normal but not in the “high” range) – more than three out of four exceed 2,300 mg per day.
• Adults with hypertension consume slightly less sodium than other adults, and may be trying to follow physicians’ advice to reduce sodium. However, 86 percent of adults with hypertension still consume too much.

These new findings show that little has changed in sodium consumption over the past decade. More than three quarters of sodium in the American diet is estimated to come from processed and restaurant food, which gives consumers little choice when it comes to lowering daily intake. A key strategy for lowering population-wide sodium intake is gradually reducing sodium in the food supply. Some food companies have begun to voluntarily reduce sodium in their products and others are being encouraged to take similar steps.

The report also highlights the important role healthcare professionals can play in advising patients on how to limit salt in the diet. About one in three U.S. adults – or about 70 million people – already have high blood pressure and only half have it under control. Heart disease, stroke, and other cardiovascular diseases kill more than 800,000 Americans each year and cost nearly $320 billion a year in health care and lost productivity.

“Sodium reduction is a key part of preventing heart disease and stroke,” said Sandra Jackson, an author of the report and an epidemiologist in CDC’s Division for Heart Disease and Stroke Prevention. “Reducing sodium is an achievable and effective strategy to improve heart health for everyone, but it’s going to take all of us working together to make it possible.”

Food Research: Cooking with chloraminated water and salt could create toxic molecules ♦Action needed to set legal limits on trans fats in food ,♦ Safety last?

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1/29/15 Health News: Measles outbreak up to 87 cases ♦ Pasture feeding improves nutritional of red meat ♦ Salt and hypertension ♦ Malignant melanoma

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Pasture feeding may improve nutritional benefits of red meat

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Excessive salt intake "reprograms" the brain, interfering with a natural safety mechanism that normally prevents the body's arterial blood pressure from rising, Continue Reading

3/30/14 Health News: Cancer Risk for Kids Living Near Busy Roads ♦ Salt and Obesity May Prematurely Age Cells ♦ More of the Infections Kids Get Are Resistant to Drugs

Salt and Obesity May Prematurely Age Young Cells

High sodium intake and obesity may act synergistically to accelerate cellular aging in adolescents, according to new research presented at the American Heart Association's EPI/NPAM Scientific Sessions 2014. The study examined the effect of a high salt diet on telomere length in normal weight and overweight/obese teens. After controlling for factors known to shorten telomeres, researchers observed a statistically significant interaction between weight and sodium intake.Continue Reading

More of the Infections Kids Get Are Resistant to Drugs

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Higher Cancer Risk for Kids Living Near Busy Roads

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3/20/14 Health News: Tumor DNA Detects Cancer Early ♦ Children's Diets 'Far Too Salty ♦ HIV Home Testing Kits ♦ Sugar Tax May Be Necessary

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Children's Diets 'Far Too Salty'

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Reducing Sodium in Restaurant Foods is an Opportunity for Choice

Communities reduce, replace, reformulate to offer lower-sodium options

Americans eat out at fast food or dine-in restaurants four or five times a week. Just one of those meals might contain more than an entire day’s recommended amount of sodium.  CDC has strategies for health departments and restaurants to work together to offer healthier choices for consumers who want to lower their sodium intake.  The report, “From Menu to Mouth: Opportunities for Sodium Reduction in Restaurants,” is published in today’s issue of CDC’s journal, Preventing Chronic Disease.

On average, foods from fast food restaurants contain 1,848 mg of sodium per 1,000 calories and foods from dine-in restaurants contain 2,090 mg of sodium per 1,000 calories. The U. S. Dietary Guidelines recommend the general population limit sodium to less than 2,300 mg a day. Too much sodium can cause high blood pressure, one of the leading causes of heart disease and stroke.

“The bottom line is that it’s both possible and life-saving to reduce sodium, and this can be done by reducing, replacing and reformulating,” said CDC Director Tom Frieden, M.D., M.P.H. “When restaurants rethink how they prepare food and the ingredients they choose to use, healthier options become routine for customers.”

The report outlines several ways health departments and restaurants have worked together to offer lower-sodium choices:

• Health department dietitians help restaurants analyze the sodium content of their foods and recommend lower-sodium ingredients.
• Restaurants clearly post nutrition information, including sodium content, at the order counter and on menus or offer lower-sodium items at lower cost.
• Health departments and restaurants explain to food service staff why lower sodium foods are healthier and how to prepare them.

The report also features examples of sodium reduction successes.  In Philadelphia, the health department worked with 206 restaurants to create the “Philadelphia Healthy Chinese Take-out Initiative.”  After evaluating menus for sodium content, participating restaurants began choosing lower sodium ingredients and creating lower sodium recipes. After nine months, analyses of two popular dishes offered by 20 of the restaurants showed sodium was reduced by 20 percent.  

“The story in Philadelphia shows what can be done,” Dr. Frieden said. “It’s not about giving up the food you love, but providing lower sodium options that taste great.”

To learn more about sodium and how it affects health, visit www.cdc.gov/salt.  Reducing sodium is one way that Million Hearts, a national public-private initiative to prevent a million heart attacks and strokes by 2017, is working with communities to keep people healthier and less likely to need health care www.millionhearts.hhs.gov.

12/14/3013 Health News: Uzbekistan 100's sick with Hepititis, Trader Joe's 33 sick, Salt in Medicines Causes Health Risk

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Salt in Medicines 'Poses a Health Risk'

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Games are used to Affect Childrens Bad Food Choices

“Advergames,” or free online games designed to promote branded products, are an example of evolving food marketing tactics aimed at children. The primary objective was to classify foods marketed to children (aged 2–11 y) in advergames as those meeting or not meeting nutrition recommendations of the US Department of Agriculture (USDA), Food & Drug Administration (FDA), Center for Science in the Public Interest (CSPI), and the Institute of Medicine (IOM).

The study identified 143 websites that marketed foods to children aged 2 to 11 years through advergames. Foods were classified on the basis of each of the 4 agency criteria. Food nutrient labels provided information on serving size, calories, micronutrients, and macronutrients.

The websites advertised 254 meals, 101 snacks, and 84 beverages. Proportions of meals and snacks meeting USDA and FDA recommendations were low. Only a small proportion of meals and fewer snacks meet the recommendations of all the agencies. Beverage recommendations were also inconsistent across the 3 agencies that provide recommendations (USDA, IOM, and CSPI). Most beverages advertised in advergames did not meet some of these recommendations.

The findings indicate that a large number of foods with low nutritional value are being marketed to children via advergames. A standardized system of food marketing guidance is needed to better inform the public about healthfulness of foods advertised to children.

In the United States, 1 in 3 children and adolescents aged 2 to 19 years is overweight or obese.  Inappropriate high-calorie food choices and portions, relative to the amount of physical activity, contribute to childhood obesity.

Other diet-related health considerations include consumption of total fat, saturated fat, added sugars, cholesterol, and sodium. These nutrients when consumed in excess can cause cardiovascular disease, hypertension, and other obesity-related conditions. Time spent using the computer, watching television, or using game consoles displaces the time and energy spent in playing sports and engaging in physical activity. Simultaneously, high-calorie foods such as sweetened beverages and French fries can lead to displacement of nutrients from more healthful foods .

Among the 439 foods from the 19 brands, there were 254 meals, 101 snacks, and 84 beverages . Approximately 95% of the advertised meals and 78% of the snacks did not meet the USDA and FDA recommendations for total fat.

Only a few foods met the USDA recommendations for added sugar (13.4% of meals and 3% of snacks), while 90% of meals and 26.7% and 25.7% of snacks met CSPI and IOM criteria. The USDA and FDA had stringent recommendations for sodium; only 3% to 5% of meals and 46% (FDA) and 59% (USDA) of the snacks met the sodium recommendations.

The nutrition recommendations made by USDA, CSPI, and IOM (FDA does not provide recommendations for beverages) for beverages that were examined in this analysis were also inconsistent. Only the USDA and IOM recommend 100% fruit juice, and this was met by 10.7% of the beverages analyzed. The USDA and CSPI recommend no added sugars or sweeteners, and this criterion was met by 4 beverages analyzed for both agencies. The IOM recommends that beverages contain less than 22 g of sugar per 8 fluid ounces; 34.5% of beverages met this recommendation.

CSPI is the only agency that mentions caffeine in its recommendations and recommends that beverages contain none; most (86.9%) beverages met this recommendation. The only recommendation that was consistent across all 3 agencies was for milk. All 3 recommend nonfat or 1% milk, but these beverage types were not found advertised through advergames.

The evidence indicates that the nutrition recommendations of the USDA, FDA, IOM, and CSPI for foods marketed to children vary greatly. Companies that market foods to children should exercise social responsibility Clear criteria and enforcement of food advertising guidelines and regulations is warranted. in the absence of consistent and enforceable The voluntary standards we now have are inconsistent and unenforceable.

The tactic addressed in this study, the advergame, is new, and the rapid pace of technological innovation will continue to provide more new and unique advertising opportunities for food companies. For example, the expanding popularity of mobile technology such as smartphones and tablets provides another venue for advertisers to reach children. In our technology-driven society, highly interactive advergames engage the player in ways that traditional one-way media, such as television, cannot.

Food marketers, presumably recognizing the potential persuasive effect of advergames on children’s attitudes or behaviors, have used advergames to reach their target audience more frequently than have marketers of nonfood products . This reach is achieved by promotion of advergames on food product packages, on portal websites, and via television advertisements . As new techniques evolve, it becomes even more critical that parents and the public be provided with sound nutritional and health guidance through food marketers.

Advergames most often promote high-calorie food products, potentially blurring the lines between advertising and entertainment and compounding children’s inability to recognize and resist intent. Conversely, studies have also demonstrated that using advergames can be an effective method of increasing nutritious food choices  and can potentially be a positive alternative strategy for obesity interventions aimed at children.

Childhood obesity is a complex issue, and the food industry has the power of promoting foods that could positively affect children’s food preferences and consumption patterns . A multinational study of children aged 6 to 12 years in 10 countries (the United States, Australia, the United Kingdom, France, Germany, Denmark, Finland, Greece, the Netherlands, and Sweden) showed a positive association between the hours spent watching television advertisements promoting energy-dense (sweet, salty, or high-fat) foods and the prevalence of childhood overweight. This relationship was inverse when the advertisements promoted nutrient-dense foods (fruits, vegetables, bread, and fish products). This result could also occur with advergames. Regulation of advertising of foods high in calories, fat, salt, and sugar is imperative to protect the health of the younger generation.

If the Irish can do it Why Can’t We?

A Salt Reduction Programme seminar, hosted by the Food Safety Authority of Ireland (FSAI), today outlined the actions that must continue to be undertaken to drive further salt reductions in processed food and the nation’s diet.  Since 2003, the FSAI has coordinated a salt reduction programme working in partnership with the food industry, Food and Drink Industry Ireland (FDII), Retail Ireland, various State bodies and organisations to achieve voluntary, gradual and sustained reductions in the salt content of processed foods.

Since efforts to reduce salt in processed foods began in 2003, the average daily salt intake in adults has decreased by 1.1g.  However, the FSAI stated that while levels of salt have dropped in processed foods, the average dietary salt intakes in Irish adults continue to exceed the recommended daily intake of 6g salt per/day.  Addition of salt by consumers at the table and during cooking can represent up to 30% of total salt intake.  The FSAI reiterated its call on consumers to select low salt or salt free options when choosing products and to cut back on the discretionary salt added during cooking and at the table.

According to Prof. Alan Reilly, Chief Executive, FSAI in the ten years of the FSAI’s involvement in salt reduction, there have been substantial reductions across many food groups and sectors, in particular breads and breakfast cereals.

“The progressive voluntary programme of salt reduction undertaken with the FSAI has always emphasised the need for industry to take responsibility for reducing salt in food.  This partnership approach has yielded significant reductions.  The past ten years of salt reduction has provided us with important lessons in how best to broach the issues related to the overall nutrient profile of our food and the impact that it is having on public health”, stated Prof. Reilly.

“With the rising obesity epidemic there has been a move towards a more joined up approach at national, EU and international levels to not only reduce salt, but also unnecessary sugar and fats in our food.  It is therefore considered time for the food industry to drive its own programme of reformulation of all foods, with the FSAI maintaining its independent monitoring role and oversight of commitments and achievements by the industry”, continued Prof. Reilly.

Food and Drink Industry Ireland (FDII) is intending to launch a new ‘Livewell Platform’ which will drive this agenda forward and offers an opportunity to transfer responsibility for driving future salt reduction to the food industry.  Mr Shane Dempsey, Head of Consumer Foods, Food and Drink Industry Ireland (FDII) addressed delegates at the seminar and stated that the industry is continuing to reformulate its products, having already made substantial progress, across a number of nutrients on a scientific basis and where technically possible.

“FDII intends to monitor the impact of reformulation over the past five years and on an ongoing basis over the next five years.  This information will demonstrate the huge positive contribution the food industry has made and will make to population health issues. We hope this will inform future policy approaches to key population health issues.  It is intended that this work will be carried out in a collaborative initiative involving industry and the Government over the coming five years,” stated Mr Dempsey.