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CANADA

The 2004 Canadian Community Health Survey, a self-reported dietary recall survey, showed that among people 19 to 70 years of age, more than 85 percent of men and more than 60 percent of women consumed more than 2,300 mg sodium daily (the maximum intake level recommended in Canada) (Garriguet, 2007). Among children, 77 percent ages 1 to 3 years and 93 percent ages 4 to 8 years exceeded Tolerable Upper Intake Levels (ULs) of 1,500 and 1,900 mg/d, respectively (as established by the Institute of Medicine). Average sodium intake for both genders combined was 3,236 mg for ages 9 to 13 years; 3,534 mg for ages 14 to 18 years; 3,430 for ages 19 to 30 years; 3,207 mg for ages 31 to 50 years; and 2,954 mg for ages 51 to 70 years.

In 2006, the first Chair in Hypertension Prevention and Control was appointed. The chair, with support from health-related and science organizations, works to lobby the government to implement policies aimed at reducing the addition of salt to food (Campbell, 2007). A year later, the Minister of Health established a working group tasked with developing and implementing a strategy for reducing sodium intake among Canadians.

The Multi-Stakeholder Working Group on Sodium Reduction

Health Canada oversees the sodium working group, which consists of 23 representatives from the following areas: government (6), scientific and health-professional community (5), health-focused and consumer nongovernmental organizations (5), and food manufacturing or foodservice industry (7). The strategy employed by the group is multistaged and based on a three-pronged approach (education, voluntary reduction of sodium levels [in processed foods and foods sold by foodservice operations], and research). The preparatory stage allowed the group to gather baseline data on sodium levels from sources of sodium in Canadian diets. Next, the group moved into the assessment stage, which focused on gathering data on the following: (1) current efforts to educate/inform consumers and health professionals about sodium consumption and health-related consequences; (2) voluntary efforts to reduce sodium in foods; (3) consumers’ perspectives on sodium and its relation to hypertension; (4) sodium, taste, and food choices; (5) functional uses of sodium; and (6) regulatory barriers or disincentives to reduce sodium in foods. During the third stage—development of a strategic framework—the working group used input from the wider stakeholder community to set goals and develop action plans and time lines for the implementation and assessment process. Currently, the working group is in the implementation stage (which



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