Abstract
IMPORTANCE: Initiatives to reduce sodium in packaged foods have been launched in the United States, yet corresponding changes in the amount of sodium that US households obtain from packaged foods have not been evaluated, to our knowledge. OBJECTIVE: To assess 15-year changes in the amount of sodium that US households acquire from packaged food purchases, the sodium content of purchases, and the proportion of households that have purchases with optimal sodium density. DESIGN, SETTING, AND PARTICIPANTS: Longitudinal study of US households in the 2000 to 2014 Nielsen Homescan Consumer Panel, a population-based sample of households that used barcode scanners to record all packaged foods purchased throughout the year. Time-varying brand- and product-specific nutrition information was used for 1 490 141 products. MAIN OUTCOMES AND MEASURES: Sociodemographic-adjusted changes in mean sodium per capita (mg/d) and sodium content (mg/100 g), overall and for top food group sources of sodium, and the proportion of households that have total purchases with sodium density of 1.1 mg/kcal or less. RESULTS: In a nationwide sample of 172 042 US households (754 608 year-level observations), the amount of sodium that households acquired from packaged food and beverage purchases decreased significantly between 2000 and 2014 by 396 mg/d (95% CI, -407 to -385 mg/d) per capita. The sodium content of households' packaged food purchases decreased significantly during this 15-year period by 49 mg/100 g (95% CI, -50 to -48 mg/100 g), a 12.0% decline; decreases began in 2005 and continued through 2014. Moreover, the sodium content of households' purchases decreased significantly for all top food sources of sodium between 2000 and 2014, including declines of more than 100 mg/100 g for condiments, sauces, and dips (-114 mg/100 g; 95% CI, -117 to -111 mg/100 g) and salty snacks (-142 mg/100 g; 95% CI, -144 to -141 mg/100 g). However, in all years, less than 2% of US households had packaged food and beverage purchases with sodium density of 1.1 mg/kcal or less. CONCLUSIONS AND RELEVANCE: In this nationwide study, significant reductions in sodium from packaged food purchases were achieved in the past 15 years. Nonetheless, most US households had food and beverage purchases with excessive sodium density. Findings suggest that more concerted sodium reduction efforts are needed in the United States.