Behavioral aspects of intervention strategies to reduce dietary sodium.

This article addresses general and specific aspects of dietary sodium interventions from the perspective of behavioral change. Changing dietary behavior requires relearning a range of habitual behaviors involved in day-to-day eating situations in the context of a diverse and complex food supply and in consideration of numerous factors, other than health concerns, that influence habitual eating patterns. Potential obstacles to dietary sodium reduction relate to the wide distribution of sodium in foods, the strong cultural values for salt, and the difficulty of assessing success in sodium reduction. A review of sodium interventions reported in the literature suggests that state-of-the-art behavioral change strategies can be effective in achieving reductions in sodium intake to around 3,000 mg/day but that this level is achieved only with highly motivated individuals and when a high level of intervention (i.e., intensive and multifaceted) is provided. Thus, in regard to sodium reduction in the general population, either the goal will have to be modest or the food supply will have to change so that substantial decreases in sodium intake can be accomplished with less intensive and less costly interventions.