Debriefing on the consumer research findings central to this article sparked animated discussion among our staff – dietitians and veteran communicators who have long worked to effectively explain nutrition nuances to consumers, utilizing consumer insights.
Salt is special. Inextricably linked to taste, salt can impact all five taste sensations (yes, even bitterness, sweetness, sourness, and umami – depending on other ingredients and amount used!). Beyond taste, salt plays a functional role in food production as a binder, stabilizer, and food preservative.
Salt, also known as sodium chloride, is one of the “OG” dietary guidance recommendations (going back to the original 1977 “Dietary Goals for the United States”). Salt is 40% sodium, thus sodium has been a long-standing nutrient of public health concern, a mainstay recommendation for reduction in Dietary Guidelines, nutrition education, and food labeling circles, and fodder for food reformulation. However, American sodium intake remains consistently above the recommendation – with average consumption around 3,400 mg per day compared to the 2,300 mg daily limit.
While IFIC’s consumer research is designed to yield answers, our latest IFIC Spotlight Survey: American Consumer Perceptions of Sodium in the Diet raises questions about our approach to providing nutrition information to consumers. Consumer knowledge, feelings, and actions affect our ability to better align behaviors with recommendations and this survey indicated: 1) a dearth of will to restrict sodium; 2) a remarkable lack of consumer knowledge of quantitative sodium recommendations; and 3) inaction among the majority.
Is There A Lack of Will To Limit Sodium?
Nineteen consecutive years of data from the IFIC Food & Health Survey tell us taste is the number one driver of food purchase decisions. Every year, flavor has edged out price, sometimes by 15 percentage points or more. Healthfulness is next – but has only been a close third 3 times in the 19 iterations of the IFIC Food & Health Survey.
Hypertension is among several risk factors associated with cardiovascular disease – the leading U.S. cause of mortality. Sodium intake is the poster child typically associated with high blood pressure, yet overweight or obesity, alcohol consumption, as well as a lack of potassium consumption or physical activity also contribute to risk (consider these insights from NIH’s National Health, Lung, and Blood Institute).
Still, our latest IFIC Spotlight Survey found mixed concern among Americans about their sodium intake. Close to half (46%) say they are concerned. The remainder are split between ambivalence (25%) and not concerned (30%). As far as actions on sodium, 37% of consumers report that they are currently limiting their intake. Another 17% say they are interested in limiting sodium consumption but have not started yet. Among those interested in limiting sodium intake and have taken steps to address it, improving overall health is the top motivator (65%). Other motivators include “to manage a current health condition” (33%); “a healthcare provider recommended it” (31%); and “to reduce water retention” (30%).
Why Are So Many Americans Unaware Of Sodium Recommendations And Their Intake?
If Americans have been told to limit sodium intake since the 1970s, why, in 2024, do just under half of consumers (48%) say they do not know how much sodium they consume daily? Further, of the 52% of Americans who ventured a guess at their sodium intake, 20% say they consume less than 1,000 mg per day and only 6% of the sample say about or more than 3,000 mg.
In addition to nearly half of Americans not knowing how much sodium they consume, it is unlikely it would be helpful if they did. That’s because the same percentage of our survey respondents (48%) say they also do not know how much sodium an average, healthy adult should consume each day. Among the 52% who ventured a guess at daily sodium recommendations, nearly 1 in 3 (29%) believe daily sodium intake should be about 1,000 mg or less.
Are We Asking Too Much From Consumers? Are We Setting Them Up To Fail?
To many health professionals and nutrition communicators, the tenets of nutrition and dietary guidance are almost intuitive, consistent, and doable. To consumers, though, traditional nutrition education may sound something like this:
- Eat more fruits, vegetables, whole grains, low-fat dairy, lean protein, and healthy fats
- Avoid sodium, added sugars, and saturated fats
- Eat more soluble and insoluble fiber
- Don’t eat high glycemic index foods
- Replace saturated fats with monounsaturated and polyunsaturated fats – avoid trans fats for fear of your life
- Get the right balance of “macros”
- Avoid processed foods
This is actually A LOT – essentially the equivalent of trying to impart a semester’s worth of knowledge in a class AND teaching it in a foreign language with advanced math. On top of this, consumers hear about implementing lifestyle modifications (get adequate physical activity at the right intensity and duration; don’t smoke; don’t drink; manage stress; get good quality and quantity of sleep) as well as reducing the risk of diet-related health conditions (blood pressure, blood cholesterol, diabetes and prediabetes, belly fat, cancer…the list goes on!).
It’s human nature to be overwhelmed when presented with a long list of imperatives which, can in turn, precede analysis paralysis, followed by tuning out, and moving forward on the path of least resistance. Sadly, this is counter to our goals of informing, educating, coaching and supporting Americans in building healthy dietary patterns.
Is There a Better Way?
I think so and our survey provides some ‘grains’ of wisdom.
- Start with receptivity. It used to be that consumers shunned foods labeled “low” or “reduced” sodium assuming they would not taste good. Now, more than half of the survey respondents (56%) express positivity toward foods and beverages advertised as low in sodium.
- Prioritize simple, actionable behaviors – even with a little math. We can’t ask consumers to do everything at once, yet for those that desire to take action, we can ask them to consider a couple of nutrients to check on the Nutrition Facts label and then use the 5/20 rule to determine if the percent Daily Value (%DV) is high or low in those nutrients. According to the U.S. Food and Drug Administration (FDA), a %DV of 5% or less is considered “low” and a %DV of 20% or more is considered “high.” If comparing sodium content between two similar products, thirty-one percent say they would purchase the product lower in sodium and 26% say they would purchase the healthier option. Predictably, 13% say they would purchase the one they think tastes best.
- Lean into trusted, credentialled health professionals. More than 4 in 10 of our survey respondents say they trust medical or nursing professionals (44%) and health organizations (43%) such as the American Heart Association to provide them with information about sodium consumption. Approximately one-third of respondents say they trust registered dietitians/nutritionists (35%) and U.S. government agencies (30%) such as the Centers for Disease Control and Prevention or the FDA.