Recently, the topic of sodium has experienced resurgence in public consciousness. National, regional and local dialogue has raised sodium’s profile, and the time for self-examination has arrived.  From industry to the individual, all are being asked to reflect on issues surrounding food and public health, as the discussion over sodium in the food supply evolves. Consumers and industry alike have begun looking toward the future of food in the U.S. and the role sodium will play.

Since 2009, the International Food Information Council (IFIC) has monitored trends in consumer knowledge of, and attitudes towards, sodium. Although there is a general lack of consumer research on the subject, IFIC’s “Consumer Sodium Research: Concern, Perceptions and Action”1 does shed some much-needed light on the matter.  Here is some of what was learned.

More Context to Comprehend Sodium
Most participants in the study wanted to know more about sodium, with only 20% wanting to know “nothing” about it. The desire for more information may be a reflection of a widespread lack of knowledge on the subject of sodium and health. Nearly half (44%) of all respondents did not know the daily recommended sodium intake amount, and 48% did not know how much they personally should consume per day. Importantly, 40% of those who reported having high blood pressure and heart disease, among whom a higher awareness might be expected, did not know how much sodium the average, healthy individual should consume. (See chart “Consumer Knowledge on Advised Sodium Levels.”)

Consumers also struggle to identify appropriate amounts per serving. According to the report, 29% of respondents did not know how many milligrams of sodium a low-sodium product contains per serving. Perhaps more revealing, of those willing to quantify an amount, 12% said a low-sodium product contains 301-500mg per serving, 4% said 501-750mg and 1% said even a serving size with more than 750mg is still considered low-sodium. These numbers are surprising, considering the FDA has determined a product labeled “low-sodium” must contain 140mg or less of sodium per serving.

Such limited awareness of appropriate intake levels is not unique to sodium. Only 15% of Americans can accurately estimate how many calories they should consume each day. Furthermore, only one third correctly identify that “calories, in general, are most likely to cause weight gain.” 2 These figures are especially worrisome, as research has shown sodium consumption to be positively associated with caloric intake. The larger question remains whether reducing sodium in the food supply will directly result in a reduced-sodium diet, if many consumers fail to understand proper daily nutrient quantities and their contribution to a healthful lifestyle. Increasing education into the role diet plays in overall health is necessary, if a true reduction in sodium intake is to be realized.

Top Consumer Health Concerns
Consumers have always held dear their personal taste preferences and individual diets. Tellingly, IFIC research found that 6 in 10 consumers are not concerned about their own sodium intake, yet 85% feel that others should be. Although sodium reduction is becoming an important topic in the public health arena, Americans remain focused on other food and health issues, with the three biggest health concerns being heart disease, weight and cancer 3.

Consumers are not indifferent to the relationship between food and health. They do acknowledge the link between diet and health status; they just need help achieving a more healthful diet. Even without knowledge of the daily recommendation for sodium, consumers are taking steps to improve the healthfulness of their diets; limiting sodium is just rarely one of those steps. Many factors play a role in deciding not to limit sodium, but taste perception is a leading barrier, as 4 in 10 consumers believe low-sodium products do not taste as good as their original recipe counterparts.

In creating a healthful diet, consumers rank six strategies higher than reducing sodium: increasing fruits and vegetables; increasing fiber; limiting saturated fat; limiting sugar; limiting trans fat; and increasing vitamins and minerals.  Similarly, when contemplating successful implementation of high blood pressure-management strategies, three consumer strategies eclipsed reducing sodium intake: moderating alcohol intake; eating a balanced diet rich in fruits and vegetables, whole grains and low-fat dairy foods; and being physically active on a regular basis. In short, this survey showed consumers are more focused on total diet and healthful lifestyle practices than simply limiting sodium intake.

Digesting the Food Label
Labels and packaging are how 68% of consumers say they determine whether a food is high or low in sodium, but pin-pointing sodium content of an individual food product requires working knowledge of product labeling. Unfortunately, the tools developed to help consumers make their purchasing decisions are rendered futile, if their usefulness is not fully appreciated. So, to better assist those who are managing sodium intake, more emphasis should be placed on teaching effective food labeling interpretation and implementation skills.

Regardless of label-comprehension skill, consumers’ purchasing decisions are influenced by label claims. Although front-of-pack, nutrient-specific label content may compel people to choose one product over another, the most appealing nutrient varies among consumers. When asked which nutrient claims are most compelling in purchasing a product, “low-sodium” (13%) ranked fourth behind “low-fat” (19%), “low-calories” (19%) and “low-sugar” (14%).

In addition to the variety of opinions over which nutrient is most critical, there is also confusion about how to determine levels of sodium in food and the origin of sodium in the diet. Since people want to know the health impact of sodium and whether they should be concerned, it is imperative and likely that communication and education efforts will become more prevalent.

Focus on Consumers
Although there has been, and continues to be, a great deal of effort by food manufacturers and public health officials to reduce sodium in retail and restaurant foods, the consumer has the ultimate say-so in whether sodium intake will decrease. Understanding what consumers know, do and want, when it comes to sodium, is critical to any potential public health intervention, communication or product reformulation endeavor. The IFIC survey findings suggest continued efforts to educate consumers about sodium and health are a critical element in the overall effort to successfully reduce sodium in the American diet. While the reformulation process moves forward, people need help to adopt healthy lifestyle habits. The focus should be on actions that consumers can take on their own, such as looking at their total diet, increasing consumption of fruits and vegetables, and proper weight management to achieve blood pressure and cardiovascular health. In the end, these actions will have the biggest health impact.pf

Website Resources:
www.preparedfoods.com -- For an article on a Penn State College of Agricultural Sciences study of people’s differing salt preferences, type “Penn State” into the search field

References:
1 IFIC 2009 Consumer Sodium Research: Concern, Perceptions and Action available at http://www.foodinsight.org/Content/6/FINAL-IFIC-Sodium-Consumer-Research-Report-8-14-09.pdf.
2Data from the “IFIC Foundation 2009 Food & Health Survey” available at http://www.ific.org/research/foodandhealthsurvey.cfm.
3Data from the IFIC 2007 “Consumer Attitudes toward Functional Foods/Foods for Health” research available at http://www.ific.org/research/funcfoodsres07.cfm.