A three-year initiative to reduce sodium consumption at Eskenazi Health and the Family Development Services’ Head Start program in Marion County has resulted in a significant decrease in the amount of sodium offered in the food they serve.

The project was funded in part by a $250,000 grant awarded to the Marion County Public Health Department by the Centers for Disease for Disease Control and Prevention’s (CDC) Sodium Reduction in Communities Program. Through this program, Eskenazi Health and Head Start launched efforts to further improve the nutritional profile of foods served in each organization, specifically to reduce the sodium content.

As a result of these efforts, Eskenazi Health reports a 37 percent decrease in the amount of sodium ingested by visitors and staff at the hospital’s retail food outlets and vending. At Family Development Services’ Head Start sites in Marion County, the average daily sodium intake in snacks and meals it served to children was reduced by 35 percent with no significant increase in food cost or waste.

While sodium is an essential ingredient for a healthful diet, excessive sodium intake may lead to high blood pressure, heart failure, poor bone development, kidney stones, breathing difficulties and dehydration.

Eskenazi Health was the first hospital in the Midwest to receive this grant, which assisted Eskenazi Health Food & Nutrition Services in developing the “Choose Health” initiative.

“Eskenazi Health is committed to encouraging wellness for all, and we’re pleased that our sodium reduction initiative has contributed to a more healthful diet for our patients, staff and visitors,” said Dr. Lisa Harris, chief executive officer of Eskenazi Health.

Family Development Services, which coordinates nutrition services for Head Start in Marion and Hamilton counties, wanted to reduce the amount of sodium in meals served to about 2,000 young children who participate in the Head Start program. It made simple changes to its menu, such as removing cheese from hamburgers, gravy from meatloaf, and making recipe modifications. 

“Being able to serve children healthier, lower-sodium meals will help them have a healthier life,” said Karen Harmon, RD, nutrition and wellness dietician with Family Development Services. “Hopefully, this will lead to a decrease in early onset health problems such as hypertension and heart disease in the children we serve.”

The reduction in sodium was also due to changes in food preparation by replacing salt with herbs or salt substitutes, replacing canned vegetables with fresh or frozen produce, and using lower-sodium soup bases. Plus, other lower-sodium options were used for canned tomato products, salad dressings, deli meats, and poultry at prices similar to the higher-sodium options.    

Additionally, in just under three years, the four Eskenazi Health retail sites have seen an average 38 percent decrease in the sodium used to prepare food, which exceeded the 10 percent goal for each year. The initiative has also led to a 31 percent sodium reduction in vending snack items offered at Eskenazi Health.

This highly-successful initiative is changing the industry by influencing vendors to start looking for more healthful products.

“CDC research shows most Americans consume more sodium than is recommended for a healthy diet. With strong evidence linking excess sodium intake to high blood pressure and other potential health issues, these findings are a cause for concern,” said Dr. Cathleen Walsh, acting director of CDC’s Division for Heart Disease and Stroke Prevention. “Through the Sodium Reduction in Communities Program, grantees, like Eskenazi Health, are serving as an example of what can be done on a local level to lower sodium in the food supply.

Eskenazi Health’s “Choose Health” initiative includes a “Choose Health” meal of the day, making the healthful food choice the easy choice without sacrificing quality or flavor and without a price increase. The “Choose Health” meals have fewer than 600 calories, less than 10 percent of calories from saturated fat, 0 grams of trans fat and contain fewer than 800 milligrams of sodium.

“One successful strategy was to purchase lower sodium foods that would not be noticeable to consumers and that were used in multiple recipes,” said Margie Fougeron, registered dietitian nutritionist at Eskenazi Health. “For example, a chicken breast that was not frozen in a saline solution was purchased with 78 percent less sodium and with a 30 percent cost savings.”

The Eskenazi Health sodium reduction strategies have inspired a number of positive changes at the hospital’s retail sites and in vending, including:

•             Increasing availability of lower sodium foods with an increase in sales. 
•             Expansion of the Fresh Harvest Stand encouraging the purchase of more fresh fruits and vegetables for home use.
•             Encouraging a decrease in soda and an increase in water consumption by placing free water beverage stations in retail areas.
•             Grab and go snacks with a more healthful profile and smaller size for use in vending and placement of fruit and grab and go snacks near cash registers in retail areas for more healthful impulse purchases.
•             Adding red/yellow/green spirals and consumer messages to vending machines to encourage more healthful choices. 
To find out more details about “Choose Health” and other nutrition information about items offered in Eskenazi Health retail operations and vending, please visit www.EskenaziHealth.edu/ChooseHealth.

For more information about the CDC’s Sodium Reduction in Communities Program, visit www.cdc.gov/dhdsp/programs/sodium_reduction.htm.

Plus, learn how to reduce sodium in everyday eating at www.cdc.gov/salt/.

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