把公共卫生方面的努力和餐饮服务的艺术结合起来
《膳食指南咨询委员会2015年科学报告》，现已上线
成年高血压患者使用营养成分标签获取钠含量信息
纽约的一项研究通过使用“2010年纽约社区健康调查”项下“心脏跟踪研究”的数据，对高血压与使用营养成分标签获取钠含量信息的频繁程度之间的关联进行了评估。该研究还评估了高血压人群频繁使用营养成分标签这一做法是否与钠摄入减少有关系这一问题。该研究通过使用24小时尿样测算实际钠摄入量，并通过使用调查问卷的方式获取被调查者查看食品营养成分标签的频度。结果表明，患有高血压的人更有可能会频繁查看营养成分标签以获取食物钠含量的信息（调整后的比值比为1.71,95%可信区间1.07到2.73）。不过，在该研究的调查对象中，经常使用营养成分标签的患者，与那些不经常使用营养成分标签的患者相比，钠摄入量这一指标并无差别（7.7克盐/vs7.6克盐/天;P=0.92）。
全国膳食调查产品宣布发布
美国农业部食品调查研究小组公布了“美国国民健康及营养状况调查2011-2012”项目之“美国人吃什么”主题调查的汇总数据表。汇总数据中加入了“每1000千卡营养摄入表”，以及“餐馆饭店营养摄入表”。“餐馆饭店营养摄入表”提供了人口估算的百分比报告，以及人们从所有餐馆饭店、全服务餐厅和快餐店提供的食物和饮料中获取的某些营养素的平均摄入量及百分比的数据。根据这份数据报告，美国2岁及2岁以上的人群每人每消耗1000千卡的饮食中，平均钠含量达到1659毫克。那些说自己从“所有餐馆饭店”至少消费国一种食物或饮料的2岁及2岁以上的人，他们钠消耗量的49%来自于各种餐馆饭店。汇总表还根据家庭收入（联邦政府划定的贫困线百分比）、收入（美元）、种族和性别等因素对数据进行了深入分析。
2015年2月14日至27日
Chipotle墨西哥风味快捷连锁餐厅提供的大多数餐食每份含有高于1000卡路里的热量，而且所含的钠几乎相当于目前推荐的一整天的摄入量。比如，一份牛排卷饼配一份薯条的话，所含的钠就已经超过了每日推荐摄入限额的117%。各种调味品也会让钠摄入快速增加：新鲜番茄酱虽然仅有20卡路里的热量，但含钠却达到210毫克，这比一盎司包的乐事薯片所含的钠还要多。Chipotle连锁餐厅公司公关主管克里斯？阿诺德说，该公司知道其提供的食物配方中所含各种营养素，但不对每份点餐的信息进行跟踪。“我们没有围绕个别营养素的量来设计菜品，”他说。
即将发布的《美国人膳食指导方针报告》有何新内容
政府给出的不合理饮食建议
在华盛顿大学圣路易斯分校校园内出售的各种便利食品和其他食品包装的营养标签表明，这些食品中脂肪和钠的含量水平不同寻常地高。有几位学生已经对这一问题表达了担心。举例来说，水牛鸡肉卷是该校园内出售的一款非常受欢迎的高钠食物，而其中所含的钠超过了3000毫克---按照当前的推荐摄入量来看，比一整天的摄入县直还要多。该校营养总监康妮？迪克曼说，之所以那么多食品中的钠含量过高，是因为钠这种化学物质是保存面包等食品的主要方式，而且要想提高食物口味、延长保质期，就得用钠。不过，校园餐饮服务营销和沟通主管艾普瑞尔？鲍威尔说，“如果我们不能找到能够减少钠的使用同时还能保持食物质量的原料，那么我们就需要继续加油去研究、去寻找这种原料。”
南卡罗来纳安德森市第一学区的学生们已经逐渐爱上吃全麦面包和新鲜水果蔬菜，但减少餐厅菜品中的食盐用量则更加困难。据学生营养服务总监黛比？乔伊介绍，自从新的联邦钠摄入指导方针于2014年秋季实施以来，该学区各学校提供的午餐数量每月减少了2000份。以前每份主菜通常平均含钠量为600至800毫克，但是现在被限制到480毫克。她说，造成这一问题的原因，部分是因为食品生产商们还没有开发出钠的可口的替代品。不过，该学区在减钠方面还是取得了一些进展：学生们对一款新的低钠炸薯条的反应积极，而且餐厅员工也已经找到一些办法，通过用香草和香料代替食盐让低钠肉汤依旧美味可口。
在美国，过高的钠摄入量是高血压的主要病因之一。西田纳西州心脏和血管中心的莎拉？克恩近日在杰克逊-麦迪逊县综合医院主持了一个关于高血压及其预防和治疗的研讨会。她说，美国有3700万人患有高血压，而他们却没有积极治疗。克恩女士说，加工食品和餐厅食物是最省事的，而要吃一顿低钠的饭菜，则需要费点功夫。她建议人们应当在家做饭，多吃新鲜事物，多吃水果蔬菜，从而降低钠的摄入。她还建议人们应当阅读食品标签上的钠含量信息，而且对蛋黄酱、沙拉酱之类的调味品中所含的钠要格外留意。
以色列的公共卫生项目试图减少食盐消费
以色列政府实施的一项名为“Efsharibari”（翻译为“健康是可能的”）公共卫生项目已经很快说服了食品生产商们，让他们在接下来五年当中逐渐减少产品中的钠含量水平。Efsharibari项目的重点在于宣传和教育人们，让他们获得更好更均衡的营养，进行更多的体育锻炼，并注重健康生活方式的其他方面。不过，虽然该项目取得了明显的成功，但之前有一个政府部门停止为该项目提供资金。现在，以色列卫生部还没有公布针对Efsharibari项目的新的预算，所以除非新一届政府决定为该项目提供资金支持，否则该项目将在几个月后终止。
三明治是美国人午餐的一道重要主食，几乎有一半成年美国人在任何一天都要吃一个三明治。但研究表明，三明治是美国人饮食中含盐量最高的食物之一，在美国人每日总的钠摄入量中贡献了五分之一的量。餐厅提供的三明治是所有三明治中含钠最多的。PaneraBread面包咖啡连锁店里售卖的一份土耳其培根超级三明治中含有高达3000毫克的钠，比2300毫克的一般人群每日钠摄入推荐限额还要高出许多。三明治中含盐过多，这一点不足为奇，因为几乎每层都有一种高钠的原料：每片面包提供100到200毫克的钠，而特制面包或面卷所含的钠则相当于4到5片标准面包片的量。每2盎司份的火腿、火鸡和香肠等冷食可以贡献高达700毫克的钠，而大多数的三明治中所含的冷食则至少有4盎司。再把奶酪算进来，每片奶酪含有120到250毫克不等的钠；还有如蛋黄酱，芥末和奶油酱之类的调味品，每一大汤勺的这些酱汁含钠高达300毫克。把这些都加起来，三明治中总的的钠含量就非常高了。
请注意：
本简讯英文版由美国疾病预防控制中心发布，中文版由骄阳翻译公司翻译，如有歧义，请以英文版本为准。
Hello–
Thisweek’sCDCSalte-Updateincludesanewwebinarseriesforpublichealthofficialsworkingwithfoodserviceproviders,anupdateontheDietaryGuidelinesAdvisoryCommittee’sScientificReport,anarticlethatassessedtheassociationofhypertensionandsodiumintaketotheuseofthenutritionfactslabelandthereleaseofnewsummarydatatablesfromWhatWeEatinAmerica,NHANES2011-2012.
LinkingPublicHealthEffortstotheArtofFoodService
TheCDC’sDivisionforHeartDiseaseandStrokePreventionandtheNationalNetworkofPublicHealthInstitutes,incollaborationwiththeCulinaryInstituteofAmerica,launchedanewseriesofwebinarsfocusingonworkingwithlargefoodserviceprovidersandindependentrestaurantstoimprovenutritionandreducesodiuminofferings.Thefirstevent,titledReducetheSalt,KeeptheFlavor:GettingStartedwithFoodServiceProviders,broadcastedonWednesday,February18andfocusedonhowchangehappensinavarietyofcommercialandnon-commercialfoodservicesettingsasitrelatestosodiumreduction.
The2015DietaryGuidelinesAdvisoryCommittee’sScientificReport,NowAvailable
HypertensiveAdultsUsetheNutritionFactsLabelforSodiumInformation
AstudyinNewYorkuseddatafromthe2010NewYorkCityCommunityHealthSurveyHeartFollow-UpStudytoexaminetheassociationbetweenhypertensionandfrequencyofuseoftheNutritionalFactslabelforsodiuminformation.ThestudyalsoassessedwhetherfrequentuseoftheNutritionFactslabelinpeoplewithhypertensionisassociatedwithlowersodiumintake.Actualsodiumintakewasassessedusing24-hoururinesamplesandinformationregardingtheuseoftheNutritionFactslabelwasobtainedthroughaquestionnaire.ResultsindicatedthatindividualswithhypertensionweremorelikelytofrequentlyrefertotheNutritionFactslabelforsodiuminformation(adjustedoddsratio1.71,95%CI1.07to2.73).However,sodiumintakedidnotdifferbetweenfrequentvsnon-frequentuseoftheNutritionFactslabelforsodiuminformation(7.7gmsalt/dayvs7.6gmsalt/day;P=0.92)forthisgroup.
AnnouncingReleaseofNationalDietarySurveyProducts
TheFoodSurveysResearchGroupoftheUnitedStatesDepartmentofAgriculturereleasednewsummarydatatablesfromWhatWeEatinAmerica,NHANES2011-2012.ThetableofNutrientIntakesper1000Kilocalorieswasadded,aswellastablesofNutrientIntakesfromRestaurants,whichprovidepopulationestimatesforpercentreporting,meanamountsandpercentagesofselectednutrientsfromfoodsandbeveragesobtainedfromallrestaurants,fullservicerestaurantsandquickservicerestaurants.Accordingtothedatareport,themeansodiumamount(mg)per1000kcalconsumedperindividual,ages2andover,intheUnitedStateswas1,659mg.Individualsages2andover,whoreportedatleastonefoodorbeverageitemfrom‘AllRestaurants’,consume49percentofsodiumintakefromallrestaurants.Datawasfurtheranalyzedbyfamilyincome(%Federalpovertythreshold),income(indollars),raceandgender.
February14–27,2015
MostmealsatChipotleMexicanGrillhavemorethan1,000caloriesandnearlyafullday’sworthofsodiumbasedoncurrentrecommendations.Asteakburritowithasideorderofchips,forexample,contains117%moresodiumthanthedailyrecommendedlimit.Variouscondimentscanalsoaddupquickly:Thefreshtomatosalsahasjust20calories,butcontains210milligramsofsodium—moresodiumthana1-ouncebagofLay’spotatochips.ChrisArnold,Chipotle’scommunicationsdirector,saidthecompanyisawareofthenutritionofallitsingredientsbutdoesnottrackinformationabouteachorder.“Wedon’tmanageourmenuaroundindividualnutrients,”hesaid.–NewYorkTimes
Fortwogenerations,Americansatefewereggsandotheranimalproductsbecausepolicymakerstoldthemthatfatandcholesterolwerebadfortheirhealth.Now,bothteachingshavebeendisprovedinquicksuccession.Themainproblem,accordingtoNinaTeicholz,authorofTheBigFatSurprise:WhyButter,MeatandCheeseBelonginaHealthyDiet,isthatnutritionpolicyhaslongreliedonaweakkindofscience:epidemiological,or“observational,”studies,inwhichresearchersfollowlargegroupsofpeopleovermanyyears.Teicholzexplainedthatinsteadofacceptingthisevidenceasaninadequatebasisforsoundadvice,strong-willedscientistsoverstatedthesignificanceoftheirstudies.–NewYorkTimes
Fordecades,mostoftheevidenceformanydietaryrecommendationshascomefromepidemiologicstudies.Accordingtothisarticle,suchstudiescanbeflawed,leadingtodietaryguidelinesthatmaynotbebasedonthebestavailableevidence.Butrecently,thegovernmenthasstartedtoaddressthatproblem,proposingnewguidelinesthatinsomecasesaremoreinlinewithevidencefromrandomizedcontrolledtrials,amorerigorousformofscientificresearch.Agrowingbodyofepidemiologicdataindicatesthatlowsaltdietsmightactuallybeunhealthy,buttherearerandomizedcontrolledtrialsonthistopic:A2008trialstudyingpatientswithcongestiveheartfailurefoundthatmovingfromalowsodiumdiettoanormaldietcouldimprovehealthoutcomes,andasystematicreviewofrandomizedcontrolledtrialsofsaltintakepublishedlastyearfoundthatadvisingpatientstocutdownonsalt,orreducingsodiumintake,didnotimprovemortalityoutcomes.–NewYorkTimes
Unusuallyhighlevelsofsodium,calories,andfatfoundonthenutritionlabelsofvarious“grab-n-go”andotherfooditemssoldonthecampusofWashingtonUniversityinSt.Louishavecausedseveralstudentstoexpressconcerns.Oneexampleofapopular,highsodiumfooditemoncampusisthebuffalochickenwrap,whichcontainsmorethan3,000milligramsofsodium—morethananentireday’sworthbasedoncurrentrecommendations.ConnieDiekman,directorofuniversitynutrition,saidthatthereasonthesodiumcontentissohighinmanyfooditemsisthatthechemicalisthemainwaytopreservebreadandisnecessaryfortasteandalongershelflife.However,directorofmarketingandcommunicationsfordiningservicesAprilPowellsaid,“Ifwecan’tfind[ingredients]thatreducetheamountofsodiumandstillmaintainthequalityofthefood,thenweneedtokeepdoingourresearch.”–StudentLife(WashingtonUniversityinSt.Louis)
StudentsatAndersonSchoolDistrict1inSouthCarolinahavelearnedtolovewholewheatandfreshfruitsandvegetables.Butreducingsaltinthecafeteriahasbeenmoredifficult.Thenumberofmealsservedindistrictschoolshasfallenbyabout2,000permonthsincenewfederalguidelinesonsodiumwentintoplaceduringfall2014,accordingtoDebbieJoye,directorofstudentnutritionservices.Previously,entreestypicallycontainedanaverageof600to800milligramsofsodium,Joyesaid,butentreesarenowlimitedto480milligrams.Shesaidthatpartoftheproblemhasbeenthatfoodmanufacturershavenotdevelopedpalatablealternatives.However,thedistrictismakingsomeprogress:StudentsreactedpositivelytoanewlowersodiumtypeofFrenchfry,andstaffhavefoundwaystoflavorlowsodiumbrothswithherbsandspicesinplaceofsalt.–GreenvilleOnline
HighsodiumintakeisoneoftheleadingcausesofhighbloodpressureintheUnitedStates.SaraKeenofWestTennesseeHeartandVascularCenterrecentlyledatalkatJackson-MadisonCountyGeneralHospitalabouthighbloodpressureandhowtomanageit.Shesaidthatmorethan37millionAmericanshavehighbloodpressureandarenottakingcareofit.Keensaidthatprocessedandrestaurantfoodsaretheeasiesttoprepareandeat,anditcantakeefforttoeatalowersodiumdiet.Sherecommendedcookingathome,eatingfreshfoods,andeatingmorefruitsandvegetablesaswaystocutbackonsodium.Shealsorecommendedreadingthesodiumcontentonfoodlabelsandbeingawareofsodiumincondimentslikemayonnaiseandsaladdressings.–JacksonSun
AnIsraeligovernmentprojectcalledEfsharibari—translatedas“HealthIsPossible”—hasquietlypersuadedfoodmanufacturerstograduallyreducesodiumintheirproductsoverthenext5years.Efsharibarihasbeenfocusedonawarenessandeducationalprojectstopromotebetternutrition,moreexercise,andotheraspectsofahealthylifestyle.However,despitetheprogram’sapparentsuccess,onegovernmentministrypreviouslystoppedfundingtheprogram,andnowtheHealthMinistryhasnotrenewedEfsharibari’sbudget,sotheprojectwillendinafewmonthsunlessanewgovernmentdecidestofundtheprogram.–JerusalemPost
Sandwichesareamealtimestaple—nearlyhalfofU.S.adultseatoneonanygivenday.ButresearchshowsthatsandwichesareoneofthesaltiestfoodsintheU.S.diet,contributingaboutone-fifthofAmericans’totaldailysodiumintake.Restaurantsandwichesaretheworstoffenders.ABaconTurkeyBravoSandwichatPaneraBreadhasalmost3,000milligramsofsodium,wellabovethe2,300-milligramdailysodiumlimitrecommendedforthegeneralpopulation.Itmakessensethatsandwichesareloadedwithsaltbecausenearlyeverylayerisahighsodiumingredient:Breadprovides100to200milligramsperslice,andspecialtybreadsandwrapscansupplythesodiumequivalentof4to5standardslices.Coldcutslikeham,turkey,andsalamicontributeupto700milligramsper2-ounceserving,andmostsandwicheshaveatleastdoublethatamount.Whencheeseisfactoredin,at120to250milligramsperslice,aswellascondimentslikemayo,mustard,andcreamysignaturesaucesatupto300milligramspertablespoon,thesodiumcanveryquicklyaddup.–EverydayHealth
Forthoseworkingtomaintainheart-healthydiets,itisnosecretthatloweringsodiumintakeisimportant.However,manypeopleremainunawareofexactlywhatsodiumisandhowitaffectsthebody.Theeasiestwayforpeopletoprotecttheirbodiesfromhealthconditionsrelatedtosodiumintakeistomanagewhichfoodstheybuyfromthegrocerystore.Oncepeopleareawareofwhattolookforinalowsodiumdiet,learninghowtocookbecomesaculinaryadventure.Addingmorenaturalspicesandherbstomealscancreatedelicious,heart-healthydishesrichinflavor.–Leaf-Chronicle
Recently,researchersinthejournalPediatricsreportedontheirexaminationofawiderangeoftoddlerfoodsavailableingrocerystoresintheUnitedStates.Resultsrevealedthatalmost75%oftoddlerdinnershadmorethan210milligramsofsodiumperserving.Parentsneedtoknowwhattolookforandwhattoavoidwhenitcomestoconveniencefoodsfortoddlers.SarahRemmer,aconsultingdietitianinCalgary,Canada,givesthesetipsforpreparingsnacksathomefortoddlers:Chopveggiesandfruitsassoonastheyarebroughthometohavethemreadyforquickserving;buyindividual-sizedcheese,yogurt,andcottagecheese;andofferfrozenpeas,homemadegranolabites,choppedhard-boiledeggs,andFrenchtoaststripswithyogurt.–GlobeandMail
Inthisvideo,registereddieticianWendyGregorsharesideasforeasy,heart-healthymeals,includinglowsodiumrecipes.Gregorrecommendseatingathomemostofthetimeandsavingrestaurantmealsforspecialoccasions.–KCRASacramento
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