The Macronutrient Content of Sodium-Modified Foods Is Unchanged Compared with Regular Counterparts: An Evaluation of Select Categories of Packaged Foods in the United States, 2018

Lowering excess sodium in packaged foods is part of a public health strategy to reduce cardiovascular disease risk. Sales of foods with labeled sodium claims increased during the past decade. Yet, it is unclear whether sugars or fats were added during the reformulation of foods that might counter the benefits of sodium reduction.It was hypothesized that the nutrient content of packaged foods with lower sodium label claims (ie, sodium-modified) would differ from their regular (ie, unmodified) counterparts.This cross-sectional study compared label data of 153 sodium-modified foods and 141 regular, matched counterparts within four food categories: soups, processed meats, vegetables, and savory snacks. Foods were identified by searching manufacturer websites of the top-10 brands in each category. Sodium, calories, total carbohydrate, sugar, protein, total fat, saturated fat, and potassium (when reported) were compared by labeled serving and per 100 g food.The average amount in milligrams of sodium per serving in regular foods ranged from 162 mg for savory snacks to 782 mg for soups. Compared with regular foods, the matched lower sodium foods had significantly less sodium per serving (–95 to –387 mg) and per 100 g (–184 to –462 mg) (P<0.01 for all comparisons), except for soups per 100 g (P = 0.166), and were similar to their regular counterparts in calories, total carbohydrate, sugar, protein, total fat, and saturated fat (P>0.05 for all comparisons). Of the soups that reported potassium on the label, potassium was 244 mg/serving (P=0.004) and 139 mg/100 g (P=0.002) higher among matched lower sodium soups.The similarity in macronutrient contents on the labels for sodium-modified foods and their regular counterparts suggests that reformulation did not include the addition of significant amounts of sugars, fats, or other macronutrients among major food brands in the selected categories. Potassium content and additional food categories deserve further investigation.