Reducing dietary sodium intake: the Canadian context.

Sodium is a required nutrient; Adequate Intakes for adults range from 1200 to 1500 mg*day(-1), depending on age. The Tolerable Upper Intake Level (UL) for sodium is 2300 mg*day(-1) for adults, based on the relationship between sodium intake and increased blood pressure. Elevated blood pressure, which is prevalent among Canadians, is, in turn, a major risk factor for stroke, cardiovascular disease, and renal disease. Sodium intake is not the only determinant of blood pressure; other modifiable risk factors include relative mass, physical activity, overall dietary quality, and alcohol consumption. However, because >90% of adult Canadian men and two thirds of Canadian women have sodium intakes above the UL, Health Canada's Working Group on Dietary Sodium Reduction has been charged with developing, implementing, and overseeing a strategy to reduce Canadians' sodium intakes. It is estimated that approximately 75% of dietary sodium is added during food processing; in addition to taste and palatability, sodium also has functional roles in food manufacturing and preservation, although the amounts used often exceed those required. Because of the central role of processed foods in sodium intake, the strategy proposed by Health Canada's Working Group includes voluntary reduction of sodium in processed foods and foods sold in food service establishments. It will also include an education and awareness campaign, and research and surveillance. Initiatives to reduce sodium in other parts of the world have demonstrated that it will be challenging to reduce sodium intake to the recommended range and will likely require many years to accomplish.