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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThis article discusses the recent Institute of Medicine (IOM) report on sodium reduction and obesity prevention. Specific topics include the implications for population-based sodium reduction strategies, as well as an evaluation of the progress on obesity prevention in local populations.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Eobesity\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Enutrition physiology\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EIn this special session, Cheryl Anderson, PhD, University of California, San Diego, La Jolla, California, USA, and Lawrence W. Green, DrPH, University of California, San Francisco, San Francisco, California, USA, discussed the recent Institute of Medicine (IOM) report on sodium reduction and obesity prevention.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-2\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003EREVIEW SUPPORTS LOWERING EXCESSIVE SODIUM INTAKE IN THE GENERAL POPULATION\u003C\/h2\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EThe \u003Cem\u003EDietary Guidelines for Americans, 2010\u003C\/em\u003E set a goal for the general population to reduce sodium intake to \u0026lt;2300 mg\/day [US Department of Agriculture (USDA) and US Department of Health and Human Services. \u003Cem\u003EDietary Guidelines for Americans\u003C\/em\u003E, Washington, DC: US Government Printing Office, December 2010]. For persons \u226551 years old, of African American race, or with hypertension, diabetes, or chronic kidney disease, the guidelines recommend a sodium intake of \u0026lt;1500 mg\/day. The recommendations and goals supported by the American Heart Association (\u0026lt; 1500 mg\/day), World Health Organization (\u0026lt;2000 mg\/day), and National Heart, Lung, and Blood Institute (\u0026lt; 2400 mg\/day) vary somewhat from the goals of the \u003Cem\u003EDietary Guidelines.\u003C\/em\u003E Some have expressed concern that low sodium intake might adversely affect blood lipids, insulin resistance, and cardiovascular disease (CVD) risk; thus, the IOM report was designed to objectively evaluate the evidence regarding sodium intake and health outcomes.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EDr. Anderson summarized the IOM report \u003Cem\u003ESodium Intake in Populations: Assessment of Evidence\u003C\/em\u003E [IOM. Washington, DC: The National Academies Press, 2013]. The purpose of the report was to consider the implications for population-based sodium reduction strategies. Studies published between January 2003 and December 2012 were evaluated for generalizability to the general population and subgroups defined in the USDA recommendations. Criteria for methodological appropriateness included study design, quantitative measures of dietary sodium intake, adjustment for potential confounders, and the number and consistency of available relevant studies. The abstracts and studies that failed to meet the criteria were removed, yielding 39 studies. The studies were stratified by the disease state that was studied.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EThe evaluation of the studies was influenced by several factors, including variability in the types and quality of measures used. The extreme variability in sodium intake levels between and among population groups precluded the committee from establishing a \u201chealthy\u201d intake range. Because of these factors, the committee was able to consider sodium intake levels only within individual studies.\u003C\/p\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EIn the general population, studies linking sodium intake with health outcomes had highly variable methods for measuring intake and collecting data. Evidence on direct health outcomes was insufficient and inconsistent regarding an association between sodium intake \u0026lt;2300 mg\/day and cardiovascular outcomes or all-cause mortality. Given these limitations, the evidence indicated a relationship between higher sodium intake and increased CVD risk, but the committee was not able to recommend lowering sodium intake to \u0026lt;2300 mg\/day.\u003C\/p\u003E\n         \u003Cp id=\u0022p-7\u0022\u003EData from 2 related studies of prehypertensive subjects suggested a benefit of reducing sodium intake to \u2264 2300 mg\/day. Sodium intakes of 1500 to 2300 mg\/day were not associated with benefit, and some evidence suggested adverse effects with sodium restriction in other disease states. No relevant evidence was found on health outcomes for persons \u226551 years old or in people of African American race.\u003C\/p\u003E\n         \u003Cp id=\u0022p-8\u0022\u003EThe IOM committee concluded that the available evidence on sodium intake and direct health outcomes is consistent with population-based efforts to lower excessive sodium intakes but is not consistent with reducing dietary sodium in the general population to 1500 mg\/day. The evidence also suggests that sodium intake may affect heart disease risk through effects on blood pressure as well as other pathways.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-3\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003EEVALUATING PROGRESS IN OBESITY PREVENTION\u003C\/h2\u003E\n         \u003Cp id=\u0022p-9\u0022\u003EDr. Green was chair of the IOM Committee on Evaluating Progress of Obesity Prevention Efforts, which produced the publication \u003Cem\u003EEvaluating Obesity Prevention Efforts: A Plan for Measuring Progress\u003C\/em\u003E [IOM. \u003Cem\u003EEvaluating Obesity Prevention Efforts: A Plan for Measuring Progress.\u003C\/em\u003E Washington, DC: The National Academies Press, 2013]. According to Dr. Green, more practice-based evidence is needed to achieve evidence-based practice. In addition to evaluating outcomes and surveillance of population trends, monitoring the implementation of interventions is necessary. A key question addressed by the IOM committee was how to evaluate local adaptations of evidence-based interventions from randomized controlled trials for implementation in other populations, particularly in controlling obesity with environmental and policy reforms.\u003C\/p\u003E\n         \u003Cp id=\u0022p-10\u0022\u003EWhile obesity is well studied, there is much to learn about the determinants of obesity and the efficacy of interventions to reduce its incidence, prevalence, and consequences. The IOM committee explored questions of assessment, monitoring and surveillance, effectiveness of population-based strategies, and the unintended consequences of prevention efforts. In a previous report, \u003Cem\u003EAccelerating Progress in Obesity Prevention: Solving the Weight of the Nation\u003C\/em\u003E [IOM. Washington, DC: The National Academies Press, 2012], a committee identified 5 areas of focus\u2014message and media, education, physical activity, food and beverage, and health care and work environments. From these areas, 5 solutions for changing communities were recommended: integrating physical activity into daily life, involving employers and health care professionals in the effort to reduce obesity, marketing a healthy diet and lifestyle, increasing the availability of healthy foods, and strengthening school-based programs. According to Dr. Green, any one of these solutions might help speed progress in preventing obesity, but together their effects could be synergistic. A call to action was made, urging engagement, leadership, and responsibility by individuals, families, communities, and society to address this epidemic. Environmental and policy changes were called for to support practitioners in addressing obesity. The report \u003Cem\u003EEvaluating Obesity Prevention Efforts\u003C\/em\u003E [IOM. Washington, DC: The National Academies Press, 2013] focused on assessment, monitoring, and summative evaluation of these efforts.\u003C\/p\u003E\n         \u003Cp id=\u0022p-11\u0022\u003ECurrent evaluation efforts were reviewed, including the evaluation of users\u0027 needs and interests, the strengths and limitations of the current monitoring and surveillance system, and the investments and systems science approach to the evaluation of national, state, and local monitoring and surveillance systems. Based on this review, national and community obesity plans were developed to implement the strategies recommended in the \u003Cem\u003EAccelerating Progress in Obesity Prevention\u003C\/em\u003E report [IOM. Washington, DC: The National Academies Press, 2012] and the \u003Cem\u003EEvaluating Obesity Prevention Efforts\u003C\/em\u003E report (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETables 1\u003C\/a\u003E and \u003Ca id=\u0022xref-table-wrap-2-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T2\u0022\u003E2\u003C\/a\u003E) [IOM. Washington, DC: The National Academies Press, 2013].\u003C\/p\u003E\n         \u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/16475\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/16475\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16475\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-12\u0022 class=\u0022first-child\u0022\u003ENational Obesity Evaluation Plan Activities\u003Csup\u003E\u003Csup\u003Ea\u003C\/sup\u003E\u003C\/sup\u003E\n               \u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cdiv id=\u0022T2\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/16476\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/16476\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16476\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 2.\u003C\/span\u003E \n               \u003Cp id=\u0022p-15\u0022 class=\u0022first-child\u0022\u003ECommunity-Level Obesity Assessment, Surveillance, Monitoring, and Summative Evaluation Plan Components\u003Csup\u003E\u003Csup\u003Ea\u003C\/sup\u003E\u003C\/sup\u003E\n               \u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-18\u0022\u003EFinally, the committee began development of a set of core indicators for measuring progress in obesity prevention at the national and community levels. Based on a review of some 400 currently available indicators, the committee recommended 83 indicators for possible use by program evaluators. From these, core indicators can be developed for incorporation into evaluation plans. Comprehensive information on the plan components and progress indicators can be found in the \u003Cem\u003EEvaluating Obesity Prevention Efforts: A Plan for Measuring Progress\u003C\/em\u003E report [IOM. Washington, DC: The National Academies Press, 2013; \u003Ca href=\u0022http:\/\/www.nap.edu\/catalog.php?record_id=18334\u0022\u003Ehttp:\/\/www.nap.edu\/catalog.php?record_id=18334\u003C\/a\u003E] or in related dissemination materials (eg, interactive indicator table, a pullout summary of the indicators, a report brief) [\u003Ca href=\u0022http:\/\/www.iom.edu\/evaluatingprogress\u0022\u003Ewww.iom.edu\/evaluatingprogress\u003C\/a\u003E].\u003C\/p\u003E\n         \u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/5\/27\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022The editors would like to thank the many members of the 2014 American Society of Nutrition presenting faculty who generously gave their time to ensure the accuracy and quality of the articles in this publication.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-483899929\u0022 data-figure-caption=\u0022The editors would like to thank the many members of the 2014 American Society of Nutrition presenting faculty who generously gave their time to ensure the accuracy and quality of the articles in this publication.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure1\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/5\/27\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/5\/27\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure1\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/5\/27\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16474\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\n               \u003Cp id=\u0022p-19\u0022 class=\u0022first-child\u0022\u003EThe editors would like to thank the many members of the 2014 American Society of Nutrition presenting faculty who generously gave their time to ensure the accuracy and quality of the articles in this publication.\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/5\/27.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzlxs2\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlxs2\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzlxs2\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}