About the Sodium Reduction in Communities Program

The Sodium Reduction in Communities Program funds programs across the nation to increase the availability and access to lower-sodium foods.

Grantees in the Sodium Reduction in Communities Program (SRCP) partner with local organizations that serve or sell food, such as schools, hospitals, and worksites, to implement sodium reduction strategies. Learn more about why sodium reduction is important and what the funded sites are doing in their communities.

Why is sodium reduction important?

High blood pressure is a major risk factor for heart disease and stroke. Many studies support a direct and positive dose-response relationship between sodium reduction and lower blood pressure.^1–3 Many leading medical and public health organizations recommend reducing dietary sodium from current levels on the basis of evidence that indicates a public health benefit.^4–9 In science, conflicting evidence from studies with methods of different strengths is not uncommon. The totality of evidence supports reducing U.S. sodium intake from current high levels, which greatly exceeds the limit recommended in the Dietary Guidelines for Americans.¹⁰

In light of the overwhelming body of credible, high-quality scientific evidence, CDC strongly supports sodium reduction as an achievable and effective public health strategy to reduce blood pressure and prevent heart attacks and strokes. Reducing sodium intake to the Dietary Guidelines for Americans recommended limit of 2,300 mg per day could save 280,000 to 500,000 lives and nearly $100 billion in health care costs over the next 10 years.^11,12

What are the funded sites doing?

CDC currently funds eight communities to continue sodium reduction strategies and collaborations with food industry partners.

The approach of the current funding cycle is to do the following:

• Create sustainable, community-level interventions. SRCP targets venues that provide food service to large populations and focuses on health promotion and disease prevention activities that influence a community’s overall health profile. These venues include public and private sector worksites, hospitals, schools, early child education centers, higher learning institutions, emergency food services, elder care services, homeless shelters, and detention facilities.

Each awardee is tailoring their strategies based on availability of resources (e.g., partnerships, skills, and materials) and food sector partners that are most appropriate for their selected venues. Read highlights from each awardee’s project.

• Increase choice through access and availability. Awardees have proposed strategies that influence the supply and identification of lower sodium products. Because the majority of sodium consumed is already present in foods before purchase or preparation, reducing sodium intake requires better availability of lower sodium items. Grantees work with selected venues and food sector organizations and groups that have committed to carrying out voluntary strategies to increase the availability of lower sodium commercially processed and restaurant food options.
• Monitor and evaluate the results. Measured outcomes will allow CDC to evaluate whether these strategies are effective in specific venues. Evaluation is performed at the local level—by each community—as well as through a national cross-site analysis to address the following questions:
  1. How and to what extent have sodium reduction interventions been implemented in specific venues and entities?
  2. How and to what extent has the food environment changed since the implementation of sodium reduction interventions, specifically addressing availability of lower sodium food products?
  3. To what extent have lower sodium food products been purchased or selected by either consumers or large food service providers?
  4. What are examples of successful and innovative sodium reduction strategies that could be replicated by similar communities?

Each grantee is also addressing long-term sustainability, such as expansion of nutrition policies to encompass additional programs within the community; engagement of corporate-level distributors to scale product availability at the national or regional level; or testing innovative, lower sodium formulas at the manufacturing level to align with the priorities of public health and food industry.

Publications and Resources

• Partnering with Food Service to Reduce Sodium: A Toolkit for Public Health Practitioners [PDF-7M]
• Early Outcomes for Sodium Reduction in Communities Program [PDF-488K]
• Public Health Interventions to Reduce Sodium Intake
• Improving the Food Environment Through Nutrition Standards: A Guide for Government Procurement [PDF-653K]
• Institute of Medicine reports related to sodium
• Sodium Reduction Toolkit: A Global Opportunity to Reduce Population-Level Sodium Intake 

References

1. Mozaffarian D, Fahimi S, Singh GM, Micha R, Khatibzadeh S, Engell RE, et al. Global sodium consumption and death from cardiovascular causes. N Engl J Med. 2014;371:624-34.
2. He FJ, Li J, MacGregor GA. Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials. BMJ. 2013;346:f1325.
3. Aburto NJ, Ziolkovska A, Hooper L, Elliott P, Cappuccio FP, Meerpohl JJ. Effect of lower sodium intake on health: systematic review and meta-analyses. BMJ. 2013;346:f1326.
4. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015-2020 Dietary guidelines for Americans. 8th ed. Washington, DC: U.S. Department of Agriculture, U.S. Department of Health and Human Services; 2015 Dec. 144 p.
5. Eckel RH, Jakicic JM, Ard JD, de Jesus JM, Houston Miller N, Hubbard VS, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation.2014;129(25 Suppl 2):S76-99.
6. Legetic B, Campbell N. Reducing salt intake in the Americas: Pan American Health Organization actions. J Health Commun. 2011;16 Suppl 2:37-48.
7. World Health Organization. Guideline: sodium intake for adults and children [Internet]. Geneva: WHO Press; 2012 [cited 2016 Dec 23]. Available from: http://www.who.int/nutrition/publications/guidelines/sodium_intake_printversion.pdf [PDF-581K].
8. Dickinson BD, Havas S; Council on Science and Public Health, American Medical Association. Reducing the population burden of cardiovascular disease by reducing sodium intake: a report of the Council on Science and Public Health. Arch Intern Med. 2007;167:1460-8.
9. Institute of Medicine, Committee on the Consequences of Sodium Reduction in Populations. Sodium intake in populations: assessment of evidence. Washington, DC: National Academies Press; 2013. 224 p.
10. Jackson SL, Coleman King SM, Zhao L, Cogswell ME. Prevalence of excess sodium intake in the United States—NHANES, 2009-2012. MMWR Morb Mortal Wkly Rep. 2016;64:1393-7.
11. Coxson PG, Cook NR, Joffres M, Hong Y, Orenstein D, Schmidt SM, et al. Mortality benefits from US population-wide reduction in sodium consumption: projections from 3 modeling approaches. Hypertension.2013;61:564-70.
12. Bibbins-Domingo K, Chertow GM, Coxson PG, Moran A, Lightwood JM, Pletcher MJ, et al. Projected effect of dietary salt reductions on future cardiovascular disease. N Engl J Med. 2010;362:590-9.