Implement Policies on Sodium Reduction

What is Sodium?

• NaCl (table salt)• Maintain balance

of fluids• Helps to transmit

nerve impulses• Aids in contraction

and relaxation of muscles

Dietary Recommendations

• Recommended levels of salt intake :Less than 2,300 mg/day

• Majority of adults’ actual salt intake:More than 3,400 mg/day

Where’s the salt?

77 percent of a person’s salt intake comes from restaurant or processed food.

High Salt Foods Serving size Sodium (milligrams)

1 teaspoon of salt 2,400 mginstant ramen noodles with flavoring 500-1500 mg2 oz Spam (1/6 can of Spam) 790 mg1 cup of corned beef hash 1,230 mg1 tablespoon of soy sauce 1,000 mg3 links of vienna sausage 410 mg½ cup of canned corn 360 mg¼ of a frozen pepperoni pizza 480-860 mg1 oz bag of regular potato chips (13-16 chips) 120-215 mg1 oz serving of dry roasted, salted peanuts (28-30 peanuts)

230 mg

1 fast food restaurant cheeseburger 710-1690 mg¼ cup of tomato sauce 340 mg

High Salt Intake’s Effect on Health• Heart diseases– High blood pressure / hypertension• about 68 million U.S. adults (1 in 3)

– Heart Disease– Stroke

• Only 46 of 100 of adults with hypertension had adequately controlled blood pressure

Did you know?

High blood pressure is known as the silent killer since usually it does not have warning signs or symptoms.

Salt Reduction Benefits on Health

• Evidence supports a strong, direct relationship between blood pressure and vascular (blood vessels) mortality

• Average blood pressure was in patients with resistant high blood pressure when switched from a high to low salt diet

• In most individuals, blood pressure is reduced within days reducing salt intake

What should we do?

• WHO states that population-wide reductions in dietary salt consumption are highly cost effective. There is a need to give priority to implement national strategies and policies aiming at the reduction of dietary salt consumption.

Law and Policy

• Food and Drug Administration–Nutrition labeling • Improve effectiveness of the Nutrition Facts Panel

through labeling

–Menu labeling/Salt Claims• Expand regulations under the Nutrition Labeling

Education Act of 1990 (NLEA) to cover sodium content claims on menu items

–Daily Value• Lower salt intake to 2,300mg or less

Program Examples

• USDA School Breakfast Program–National School Breakfast Program

guidelines• 3 step reduction plan• 25%-27% reduction in breakfast meals (2004-2005)• 430-500 mg of sodium per meal

Culinary Training Camp

29 Greenville County Schools in South Carolina • At the training camp, cafeteria workers learn

scratch cooking techniques such as roasting, use of herbs and seasonings in place of salt, and knife skills, so they can prepare foods fresh in the cafeteria rather than use highly processed foods.

• These schools are committed to adopting healthier menus.

State and Local Level

• Menu Labeling• Warning Labels• Procurement Policies• Licensing/Taxing

Labeling• Menu Labeling– Disclosure of salt

content on menus – FDA Waiver

• Warning Labeling– Under NLEA, state and

local authorities can mandate warnings related to safety of food

To reduce dietary salt intakePan American Health Organization & World Health Organization Regional Expert Group suggests:• Make salt substitutes (spices and herbs) readily

available at affordable prices, such as using basil, garlic and ginger.

• Institute reformulation schedules for a gradual and sustained reduction in the salt content of all existing salt-containing food products at restaurants and ready-made meals

Implement policies that reduce salt consumptionAn American Samoa Example

Target Population: All Department of Health employeesSummary: American Samoa Department of Health (DOH) Employee Wellness Policy #13-01

October 2013: DOH implemented a policy for all DOH employees relating to proper nutrition, physical activity and tobacco smoking

Employee Wellness Activities: restricts DOH employees from having incentives, fundraisings and activity vendors advertising and selling unhealthy foods, alcohol, tobacco and gift cards to fast food chains

Increased Access to Healthier Foods: prohibits DOH and its contracted food services from serving unhealthy foods

All DOH internal meetings, conferences, community meetings sponsored and funded by DOH must serve healthy and local options of food and drinks; no red meat, soda products and artificially flavored drinks are to be served

Implement policies that reduce salt consumptionA Guamanian Example

Target Population: All government of Guam employees Summary: PL31-141: Healthy Vending Machine Policy

Guam was awarded with the Communities Putting Prevention to Work Grant to have healthy foods more accessible to the community

PL31-141: mandates all vending machines in government of Guam facilities to be serving at least 50% healthier food options

The Guam Department of Public Health and Social Services (DPHSS) worked with all government agencies, and vending machine operators before the Healthy Vending Machine Policy could be passed

DPHSS took the law a step further by enforcing 100% of all vending machines in all DPHSS facilities to be selling healthy foods and water content only

Guam’s Non-Communicable Diseases (NCD) Consortium is looking towards having the Worksite Wellness Health Coaches in each of the participating government agencies to be the enforcing agency, to ensure vending machine vendors are in compliance to the standards set forth by Healthy Vending Machine Policy

Who can I contact for more information?

Adrian BaumanBoden Institute of Obesity, Nutrition and Exercise and Prevention Research CollaborationUniversity of SydneySydney, Australia Email: adrian.bauman@sydney.edu.au