Transcript Nutrition by the Numbers

Nutrition by the Numbers
Sodium Reduction
By Monica H. San Miguel
cartoonstock.com
Objective
Gain a holistic understanding of the
challenges of sodium reduction from new
product development through consumer
consumption.
Agenda
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•
Sodium in the Eyes of the Consumer
Why Sodium Reduction?
Government Regulation.
- Potential Government Regulation in light of Health Risks
- Upcoming Meal Pattern Update in Schools with Sodium as a
target.
How are major food manufacturers responding?
- What are the proactive steps major food manufacturers are
taking?
How to partner with food manufacturers in the effort to reduce
sodium consumption
- Nutrition Education.
- Tips for Reducing Sodium in the kitchen.
Top Health & Wellness Claims
Product Label Claim
Fat Claim
Natural
Calorie Claim
Salt/Sodium Claim
Preservative Free
Cholesterol Free
Whole Grain
Sugar Claim
Calcium Presence
Caffeine Free
Organic (UPC-Coded)
Hormone/Antibiotic Free
52-Week
$ Sales
$44.7 Billion
$20.9 Billion
$17.0 Billion
$15.9 Billion
$11.4 Billion
$10.6 Billion
$10.1 Billion
$9.7 Billion
$9.4 Billion
$5.7 Billion
$4.3 Billion
$2.2 Billion
Source: Nielsen Label Trends, Total U.S. Food/Drug/Mass excluding Wal-Mart,52 Weeks Ending 2/23/08
Change
Vs.
Year Ago
+12%
+11%
+6%
+3%
+4%
+6%
+8%
+8%
+3%
-2%
+25%
+17%
Change
Vs. 4
Years Ago
+29%
+35%
+27%
+8%
+16%
+10%
+31%
+35%
+9%
-3%
+142%
+66%
But, Doctor, I Never Use A Salt Shaker
Yes, Mr.
Smith. You
don’t salt
anything,
but you do
eat a lot of
sodium!
Source: Nutrient Essentials
By: Penny Kris-Etherton, Ph.D., R.D.
Department of Nutritional Sciences
Pennsylvania State University
A little over half of Americans are
satisfied with their health status.
(n=1000)
2008 6%
18%
17%
46%
14%
60%
Not At All
Satisfied
Not Very
Satisfied
Neither Satisfied
Nor Unsatisfied
Somewhat
Satisfied
Extremely
Satisfied
How satisfied are you with your overall health status?
↑ Significant increase from year indicated
↓ Significant decrease from year indicated
IFIC Foundation Food & Health Survey 2008
Total does not add to 100 percent due to rounding
Health: Where consumers are and
where they want to be.
Where they ARE
Healthy
Unhealthy
Where they WANT to be
Source: Seeing Nutrition through the Consumer’s Eyes
Shelley Goldberg, MPH, RD, Senior Director,International Food Information Council (IFIC)
Foundation
Nutrient Essentials: Sodium and the Healthy Plate; July 10, 2008.
What’s healthy,
what’s not.
Unhealthy
Healthy
• Active
• Energetic
• Confident
• Smiling
• Good complexion
• Good posture
• Bright and wideeyed
• Works out/is fit
• Positive attitude
• Well-rested
 Overweight
vs.
Source: Seeing Nutrition through the Consumer’s Eyes
Shelley Goldberg, MPH, RD, Senior Director,International Food Information Council (IFIC)
Foundation
Nutrient Essentials: Sodium and the Healthy Plate; July 10, 2008.
 Unkempt
 Smokes/drinks/does drugs
 Walks slowly
 Dejected, holds head
down
 Bundle of nerves
 Lays on couch
 Out of breath
 Dull skin
 Depressed/negative
WELLNESS
Source: Iconoculture, 2008.
Types of foods and ingredients
consumers report avoiding.
50%
54%
Sugar/carbs
33%
38%
Fats/oils/cholesterol
28%
Animal products
21%
12%
15%
Salt/sodium
Snack foods/fast
foods/soda
Artificial/additives
Spices
Processed/refined foods
Biotech
16%
14%
2%
4%
2006
2007
1%
2%
0%
2%
0%
0%
Other
11%
11%
[IF AVOIDED FOODS] What foods or ingredients have
you avoided? [OPEN END]
Source: Seeing Nutrition through the Consumer’s Eyes
Shelley Goldberg, MPH, RD, Senior Director,International Food Information Council (IFIC)
Foundation;Nutrient Essentials: Sodium and the Healthy Plate; July 10, 2008.
International Food Information Council, 2007
= Statistically
significant
Sodium & Health: Consumer
•
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52% of consumers say they're keeping an eye
on sodium in their diet.*
About in one in five (22%) cuts back on the
salt added to food but pays far more attention
to sodium levels in prepared foods and
beverages.*
Another 18% consider low-sodium foods and
beverages “one of the three most important
components of a healthy diet.”*
One-quarter (26%) of consumers say they
check labels for sodium and may be
influenced by what they see but do not follow
a set plan to monitor sodium in their diet.*
The Smart Choices Program was driven by
consumer demand for a single, trusted and
reliable front-of-pack nutrition labeling
program that food manufacturers and retailers
(≤ 480 mg per serving). It is currently on hold.
Source: Mintel, 2009
Informed Choices
– Learn from various sources
– Want detailed information on menu items
– Impacts food selection
Source: Technomic, Generational Consumer Trend Report (2008)
Nutrition Facts Terms
• "very low sodium" (35 mg or less per
serving)
• "low in sodium" (140 mg or less per
serving)
• "reduced sodium" (at least 25 percent
less sodium when compared with a similar
food).
Consumers See New York Nutritional
Disclosure Law as a Positive
“Do you consider this a
positive move?”*
No
14%
“Do you read nutritional
information on menus?”**
No
16%
Yes
86%
*Base: New York Consumers aware of the calorie disclosure ordinance
**Base: New York Consumers visiting a restaurant with posted nutritionals
Source: Technomic, Generational Consumer Trend Report (2008)
Yes
84%
Consumers Want Nutritional
Disclosure
Fat content should also be posted more
prominently
40%
46%
86%
Sodium content data should also be posted
more prominently
40%
45%
85%
Nutritional information on menus will have a
positive impact on overall health and nutrition
42%
42%
84%
Nutritional information on menus is helpful
when I am making ordering decisions
36%
39%
I know how many calories I need a day
I do not want to see prominent nutrition
information on menus or menu boards
Somewhat Agree
Base: 299 New York Consumers
4-point scale: Completely Agree (4) – Completely Disagree (1)
)
Source: Technomic, Generational Consumer Trend Report (2008
20%
11% 31%
Completely Agree
47%
35%
83%
74%
Nutrition Disclosure
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According a February 2009 Technomic survey: New York City restaurants with 15 or
more units have had mandated calorie disclosure since the city passed a regulation
last July. The Technomic survey revealed that 82 % of the city's restaurant diners said
calorie disclosure affects what they order, while 60 % said it affects what restaurant
they visit.
81% of consumers thought restaurants have a responsibility to respond more
aggressively to nutritional concerns by offering more low-calorie and small-portion
options. Research also showed a high level of consumer support for mandated
disclosure of fat and sodium content in restaurant foods.
New York City is not alone in its menu nutrition information legislation. Philadelphia
and Washington's King County have passed nutrition information laws and several
state legislatures have pending labeling laws, among them Indiana and
Massachusetts. In King County, which includes the greater Seattle area, disclosure of
calories, sodium, saturated fat and carbohydrates is required.
California was the first to pass statewide menu labeling legislation for the disclosure
of caloric information in the form of bill 1420 last fall that requires that California
restaurants with 20 units or more provide nutritional information to consumers either
on a menu or on a menu board. That bill will affect 100 Darden Restaurant units,
which includes the Red Lobster and Olive Garden brands. The company has
implemented calorie disclosure in seven restaurants in New York City and six in King
County.
But Taste is King
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Taste and sensory factors: “Salty” is known as
one of the five basic tastes, along with sweet,
sour, bitter, and umami.
Scientists have attempted to mimic this taste with
salt substitutes with limited success. While lower
sodium food products generally taste less salty,
they often require the use of other ingredients to
add or enhance flavor.
There is evidence that the level of sodium
preference is learned. In fact, early experiences
with low or high sodium diets may have a longterm impact on an individual’s preferred sodium
level.
Studies have demonstrated that a gradual
reduction in sodium intake over 8 to 12 weeks
can decrease preference for salty foods and
increase acceptance of foods with less sodium.
[Bertino et al., 1982; Mattes, 1997].*
http://www.ific.org/publications/reviews/sodiumir.cfm
Why Sodium Reduction?
• The prevalence of high blood
pressure in children is rising,
increasing their adult risk of heart
disease and stroke.
• The average American Adult
consumes 2,900 mg to 4,300 mg per
day (American Heart Association).
Sodium is a learned taste. Gradually taking sodium out of foods can
“un-learn” the appeal of salt. Great to do at the beginning of the school
year, after the summer away.
The cost of excess sodium
Lower Sodium Could Mean Lower Health-Care Costs
If Americans consumed the recommended daily maximum of 2,300 milligrams of sodium
a day, the country could trim almost $18 billion in health-care costs and reduce
hypertension cases by 11 million, according to a Rand Corporation study. Reducing
sodium even further, to 1,500 milligrams a day, could decrease health-care costs by $26
billion.
Average Sodium
Consumption
(milligrams per day)
3,400*
2,300
1,700
1,500
1,200
Direct Health-Care
Costs Saved
(in $ billions)
Hypertension
Cases Reduced
(in millions)
$17.8
$23.8
$26.2
$28.3
11.1
14.9
16.4
17.7
*Average sodium intake of representative sample of adults. Source: "Potential Societal
Savings from Reduced Sodium Consumption in the U.S. Adult Population," 2005, Rand
Corp.
Forms of Sodium
• 90% of sodium consumed as sodium
chloride (salt)
• Other forms:
– sodium bicarbonate
– sodium in processed foods, such as
sodium benzoate and sodium phosphate
Source: The Health Effects of Reducing Sodium and Improving
Overall Diet
By Lawrence J Appel, MD, MPH, Professor of Medicine, Epidemiology
and International Health (Human Nutrition); July 9, 2008.
Sources of Sodium in the Diet
Added at table
6%
Added during cooking 5%
Inherent in foods
12%
Food
Processing
77%
Source: Nutrient Essentials
By: Penny Kris-Etherton, Ph.D., R.D.
Department of Nutritional Sciences
Pennsylvania State University, July 2008
Primary effect of sodium that drives policy: Increased blood
pressure (and subsequent blood pressure related CVD renal
disease).
Magnitude of the Blood Pressure
Problem
• 62% of strokes and 49% of CHD events
attributed to elevated BP*
• 26% of adults worldwide (971 million)
have hypertension**
*WHO, World Health Report 2002: Reducing Risks, Promoting Healthy Life,
**Kearney Lancet 2005;305:217,
Source: The Health Effects of Reducing Sodium and Improving
Overall Diet
By Lawrence J Appel, MD, MPH, Professor of Medicine, Epidemiology
and International Health (Human Nutrition); July 9, 2008.
Factors Associated with Increased
Blood Pressure Response to Salt
• Fixed factors
–
–
–
–
Middle and older-aged persons
African-Americans
Genetic Factors
Individuals with:
• Hypertension
• Diabetes
• Chronic Renal Insufficiency
• Modifiable
– Low potassium intake
– Poor quality diet
Source: The Health Effects of Reducing Sodium and Improving
Overall Diet
By Lawrence J Appel, MD, MPH, Professor of Medicine, Epidemiology
and International Health (Human Nutrition); July 9, 2008.
Dietary Recommendation
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According to the American Heart
Association, the current Dietary Guidelines
recommendation of less than 2,300mg of
sodium per day is too high and it should
be changed to no more than 1,500mg of
sodium per day.*
In recent comments to the Food and Drug
Administration and the Institute of
Medicine, AHA recommended that the
daily value for sodium be lowered to
1,500mg by 2020 with an intermediate
goal of 2,000mg by 2013. This two-step
phase down should provide manufacturers
with time to reformulate products and
identify acceptable sodium substitutes, as
well as allow consumers to adapt their
taste sensitivities to the lower sodium
content in foods.
With processed foods accounting for 77%
of all sodium consumed, it will require the
cooperation of food manufacturers and
restaurants to reduce the sodium content
of the foods they make available to the
public. AHA would like to see food
manufacturers and restaurants reduce the
salt added to foods by 50% over the next
10 years.
Source: American Heart Association Dietary Guidelines 2010, January 23, 2009.
School Meal Pattern
• Focus on Nutrient Density: colorful nutrient dense vegetables.
• These Food Groups For Which Intakes were found inadequate by
Institutes of Medicine Phase I Study.
• These food groups likely to be targeted for increases/new median
levels.
• Proposed Method by Institutes of Medicine is to also follow
MyPyramid Guidelines.
New or stricter guidelines are likely to be included as part of the
updated School Meal Pattern. These nutrients were found as
excessive intakes in the Institutes of Medicine Phase I Study:
1.
2.
3.
4.
Source: National Academy of Sciences.
Sodium
Saturated Fat
Total Fat
Cholesterol
Potential Government Regulation
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The Center for Science in the Public
Interest has called for increased
government regulation of sodium in food
products since the 1970s (the U.S. Food
& Drug Administration currently regulates
salt as a “Generally Recognized As Safe”
substance).
Food manufacturers & Restaurant Chains
are willing and have been working
towards sodium reduction vouluntarily.
Mintel's Global New Products
Database charts a 115% increase
between 2005 and 2008 in the number
of food products making low-, no- or
reduced-sodium claims.*
*http://www.ific.org/publications/reviews/sodiumir.cfm
NRA Sodium & The Healthy
Plate Conference 2008


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
National Restaurant Association Conference with
focus on Sodium Reduction and Better For You:
Nestle, McDonald’s, Burger King, McCain
Foods, ConAgra, Sodexo, Compass, Denny’s,
Chick-fil-A, Arby’s, Kraft, General Mills, Subway,
Birds Eye Foods, Campbell Soup, KFC, IHOP,
Tyson, Chipotle, Chicago UNO, ARAMARK
attended.
Consensus: consumers prefer natural foods to
commercial/processed foods.
All Manufacturers/Retailers/Restaurant Chains
(except for Campbell Soup) that presented are
following a “stealth approach” gradually
decreasing levels of sodium without telling the
consumer.
Nestle FS has found that cleaner labels/Natural
is more important than price and “Low sodium,”
so they traded off to “Reduced Sodium.”
Source: www.restaurant.org/events/nutrition
What does salt do?
• Flavor
– Unique, Impact, Enhancement, Metallic
• Mouthfeel
• Reduces Water Activity
• Texture
Source: Technical Challenges in Sodium Reduction – A
Product Development Perspective
By Harlan Meinwald, Nestlé Professional, Culinary Product
Development Support;
July 10, 2008.
Developing a Reduced Sodium
Strategy: Manufacturer’s POV
Trade-offs
•Sodium – How low?
•Match / Preference / Acceptance
•Cost
•Other sensory / performance aspects
•Other label declarations
•Other technical aspects
•Handling
Source: Technical Challenges in Sodium Reduction – A
Product Development Perspective
By Harlan Meinwald, Nestlé Professional, Culinary Product
Development Support;
July 10, 2008.
Case Study #1
Marketing wants to reduce sodium content of a signature
frozen entrée by 200 mg.
PD explores alternative concepts and recipes. Mktg
decides to keep current concept. PD reduces salt in
current recipe (no other changes). Reformulated product
passes preference panel.
Current Status: Preparing to launch.
Source: Technical Challenges in Sodium Reduction – A
Product Development Perspective
By Harlan Meinwald, Nestlé Professional, Culinary Product
Development Support;
July 10, 2008.
Case Study #2
Customer of frozen entrees wants to reduce sodium
content from 1100 mg per serving to 750 mg. They plan
to do this in 3 stages, ~10% at a time.
Current Status: All products have samples pending at 10%
sodium reduction. Customer is deciding whether to do
match, preference, or acceptability testing.
Source: Technical Challenges in Sodium Reduction – A
Product Development Perspective
By Harlan Meinwald, Nestlé Professional, Culinary Product
Development Support;
July 10, 2008.
Case Study #3
Customer of dry soups wants to reduce sodium content
15%, matching flavor as closely as possible.
PD develops match using potassium chloride, yeast
extract, and a natural flavor.
Current Status: Customer implementing reformulation.
Source: Technical Challenges in Sodium Reduction – A
Product Development Perspective
By Harlan Meinwald, Nestlé Professional, Culinary Product
Development Support;
July 10, 2008.
Case Study #4
Marketing wants to launch “natural” bases which are low
sodium, same price, same handling, and same flavor
profile as current bases.
PD works with several flavor companies and internal
resources to develop product and demonstrate trade-offs.
Current Status: Launching “natural” bases which are
reduced sodium (25%), slightly more expensive, same
handling, and a more home-made flavor profile versus
current bases.
Source: Technical Challenges in Sodium Reduction – A
Product Development Perspective
By Harlan Meinwald, Nestlé Professional, Culinary Product
Development Support;
July 10, 2008.
Case Study # 5
Part 1: Customer requested 25% sodium reduction and
flavor match of a concentrate. Product passed blind panel,
but customer felt it was not close enough in finished
recipes and had some (undefined) off notes.
Part 2: Customer requested 75% sodium reduction without
flavor match. Removing the salt changed the handling
from “Keep Refrigerated” to "Keep Frozen“, which did not
work as well in their kitchens.
Current Status: On Hold. Customer developing nutrition
strategy. Will then define limits and priorities for menu
items.
Source: Technical Challenges in Sodium Reduction – A
Product Development Perspective
By Harlan Meinwald, Nestlé Professional, Culinary Product
Development Support;
July 10, 2008.
Case Study #6
Customer purchasing and operations initiated project to
improve handling in the kitchen without raising cost or
changing the product.
Chef also requested 15% sodium reduction, smaller carbon
footprint, and a more “natural” ingredient statement.
Current Status: Development in process.
Source: Technical Challenges in Sodium Reduction – A
Product Development Perspective
By Harlan Meinwald, Nestlé Professional, Culinary Product
Development Support;
July 10, 2008.
Portions – Easy Way to Control,
not just fat, but Sodium
• Proactive approach to
reduce sodium.
• Smaller portions of
higher-sodium foods
(lunch meats, hot dogs,
bacon and pickles).
Source: TeamNutritionUSA.gov
Reducing Sodium – Before
Cooking
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•
Offer high-sodium foods less often – pizza, chicken nuggets, and hot
dogs as examples.
Use grilled chicken breast instead of luncheon meat, bacon, sausage, or
ham.
Modify recipes that use high-sodium ingredients such as cheese
sauces, canned foods, tomato sauce, paste, Use lower sodium versions
or use less.
Remove salt from recipes whenever possible.
Serve more fresh foods.
Ask vendors for lower sodium versions of popular foods.
Serve salted snacks such as pretzels in smaller amounts.
Serve smaller amounts of condiments such as catsup, relish, and salad
dressing.
Offer salt-free seasonings as an alternative.
Reducing Sodium – During
Cooking
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•
Use fresh or dried herbs, spices, lemon or orange zest, or fruit juices to
jazz up the flavors in foods without adding sodium!
Add lemon rind or juice, in place of salt, to water that is used to boil
spaghetti. pasta, rice, beans, and hot cereals.
Add a little dry mustard or a dash of Tabasco sauce to egg dishes instead
of salt.
Prepare and heat vegetables without adding salt or butter.
Avoid using baking soda to retain the bright color of green vegetables.
Instead, cook for the appropriate length of time.
Prepare soups, sauces from scratch with unsalted, defatted stocks.
Prepare food from scratch as is feasible to control added sodium.
Purchase herbs and seasoning powders, rather than salts (e.g., onion
powder instead of onion salt). Make your own herb blends, vinegar, and
spicy seasoning mixes.
Rinse canned vegetables in water before cooking.
Reduced Sodium –
On The Table
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•
Salt Shakers – off the table. Substitute for a squeeze of lemon or lime juice, a
splash of vinegar, or a shake of a salt-free seasoning blend.
Use herbs and spices in place of salt in recipes for casseroles, soups, stews, chili
and pasta sauces.
Condiments…if used, use portion packs, control amounts.
Education idea for education dining facilities– charge for
salt packets (5 cents). Tell students why.
Sodium Reduction: Partnership
• Sodium Reduction is a complex problem.
• Current dietary guidance targets sodium
reduction, and provides strategies for
implementation.
• Given the widespread distribution of sodium
in the food supply, there are many targets.
• The restaurant and food industry can play a
key role in decreasing sodium and helping
consumers adhere to dietary
recommendations
• The solution is partnerships between food
manufacturers and operators.
• Nutrition Education plays a key role.
• Integrate reduced sodium products with
sodium reduction in the kitchen.
Questions??
Sources
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•
•
•
•
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•
http://www.teamnutrition.usda.gov/Resources/roadtosuccess.html
http://www.teamnutrition.usda.gov/Resources/DGfactsheet_transfat.pdf
www.MyPyramid.gov
www.cfsan.fda.gov/~dms/transfat.html#whatis
www.cnpp.usda.gov/DietaryGuidelines.htm
www.teamnutrition.usda.gov/HealthierUS/index.html
http://www.scribd.com/doc/1428575/USDA-menuplanner-chapter1
http://dpi.wi.gov/fns/doc/factsheet_sodium.doc
Appendix
AHA Diet and Lifestyle Goals for Cardiovascular
Disease Risk Reduction
• Consume an overall healthy diet
• Aim for healthy body weight
• Aim for recommended levels of LDL-C, HDL-C and
triglycerides
• Aim for normal blood pressure
• Aim for normal blood glucose level
• Be physically active
• Avoid use of and exposure to tobacco products
Source: Nutrient Essentials
By: Penny Kris-Etherton, Ph.D., R.D.
Department of Nutritional Sciences
Pennsylvania State University
Lichtenstein et al., Circulation, 114, 82-96, 2006
AHA Diet and Lifestyle Recommendations for
Cardiovascular Disease Risk Reduction
•
•
•
•
•
Balance calorie intake and activity to achieve a healthy weight
Consume diet rich in fruits & vegetables
Choose whole-grain, high-fiber foods
Consume fish, especially oily fish, 2X per week
Limit intake of saturated fat to <7% of calories, trans fat to <1% of
calories and cholesterol to < 300 mg per day by:
– Choosing lean meats and vegetable alternatives
– Selecting fat-free, 1% or low-fat dairy products
– Minimizing intake of partially hydrogenated fats
•
•
•
•
Minimize intake of added sugars
Choose and prepare foods with little or no added salt
If you consume alcohol, do so in moderation
When you eat food outside the home, follow the AHA
Recommendations
Lichtenstein et al., Circulation, 114, 82-96, 2006
Source: Nutrient Essentials
By: Penny Kris-Etherton, Ph.D., R.D.
Department of Nutritional Sciences
Pennsylvania State University
High-priority Recommendations to Facilitate Adoption of
AHA Diet and Lifestyle Recommendations
• Groups included: Health Practitioners, Restaurants, Food Industry,
Schools, Local Government
• Specific Recommendations
– Restaurants
• Display calorie content or make information easily
accessible
• Reduce portion sizes
• Reformulate products to reduce calories, sodium, saturated
and trans fat
• Provide more vegetable options, and prepare them with
minimal added calories and salt
• Provide more fruit options, with minimal added sugar
• Develop creative marketing approaches for fruits &
vegetables
• Allow healthy substitutions
• Provide whole-grain options
Adapted from Lichtenstein et al., Circulation, 114, 82-96, 2006
Source: Nutrient Essentials
By: Penny Kris-Etherton, Ph.D., R.D.
Department of Nutritional Sciences
Pennsylvania State University
High-priority Recommendations to Facilitate Adoption of
AHA Diet and Lifestyle Recommendations
• Groups included: Health Practitioners, Restaurants, Food Industry,
Schools, Local Government
• Specific Recommendations
– Food Industry
• Reduce salt and sugar content of processed foods
• Replace saturated and trans fat in prepared foods with lowsaturated fat oils
• Increase proportion of whole grain foods available
• Package foods in smaller portion sizes
• Develop packaging that allows more stability, preservation
and palatability of fresh fruits & vegetables without added
sodium
Adapted from Lichtenstein et al., Circulation, 114, 82-96, 2006
Practical Tips to Implement AHA Diet and
Lifestyle Recommendations (Sodium Related)
• Food choices and preparation
– Use nutrition facts panel and ingredients list to choose food
purchases
• Eat fresh, frozen and canned vegetables and fruits
without high-calorie sauces, added salt and sugars
• Reduce salt intake by:
– Comparing sodium content of products and choosing ones with
less salt
– Choosing reduced sodium versions or foods, including cereals
and baked goods
– Limiting condiments (eg. soy sauce, ketchup)
• Limit processed meat intake, especially those high in
saturated fat and sodium
Lichtenstein et al., Circulation, 114, 82-96, 2006
Source: Nutrient Essentials
By: Penny Kris-Etherton, Ph.D., R.D.
Department of Nutritional Sciences
Pennsylvania State University
What is a "Healthy Diet"?
The Dietary Guidelines describe a
healthy diet as one that
•Emphasizes fruits, vegetables, whole
grains, and fat-free or low-fat milk and
milk products;
•Includes lean meats, poultry, fish,
beans, eggs, and nuts; and
•Is low in saturated fats, trans fats,
cholesterol, salt (sodium), and
added sugars.
Source: Nutrient Essentials
By: Penny Kris-Etherton, Ph.D., R.D.
Department of Nutritional Sciences
Pennsylvania State University
DASH PYRAMID
Low-Sodium Cookbooks
Source: Nutrient Essentials
By: Penny Kris-Etherton, Ph.D., R.D.
Department of Nutritional Sciences
Pennsylvania State University
Organizations and Countries Recommending
Major Reductions in Sodium
Organizations
Countries
National Research Council1
Finland1
National Institutes of Health1
United Kingdom3
National HBP Education Program CC1
Australia1
Joint National Committee 71
Ireland
U.S. Department of Health and Human Services1 New Zealand
U.S. Department of Agriculture1
National Academy of Sciences
American Medical Association3
American Heart Association1
American Public Health Association3
Center for Science in the Public Interest3
World Health Organization4
Source: The Health Effects of Reducing Sodium and Improving
Overall Diet
World Hypertension League
By Lawrence J Appel, MD, MPH, Professor of Medicine, Epidemiology
and International Health (Human Nutrition); July 9, 2008.
1
< 2300 mg/day; 2 < 2300 mg day under age 50; < 1500 mg/day for 50-70,
hypertensives, and blacks; < 1200 mg/day for age 70 and higher; 3 Minimum
50% reduction in processed and restaurant foods; 4 < 2000 mg/day