The aim of the present study was to evaluate the cost-effectiveness of two population strategies to reduce sodium intake, such as voluntary reduction of food sodium content by manufacturers or taxing sodium used for food production. They analyzed data from earlier research to measure several outcomes such as incremental costs, quality-adjusted life-years (QALYs), and myocardial infarction (MI) and strokes avoided. Both strategies showed an increase in QALYs and a reduction in medical costs among middle-aged and elderly adults. They calculated that a 9.5% reduction in mean population sodium intake, generated by the collaboration with the industry strategy, would probably prevent over 500,000 strokes and approximately 480,000 MIs and save more than $32 billion in medical expenses over the lifetime of adults aged 40 to 85 years who are alive today. Moreover, the collaboration with the industry strategy seemed to achieve greater health benefits and lower costs than the sodium tax strategy because it provided healthier food alternatives for the consumer and it would make the demand for salty foods more responsive to prices. Thus, these results showed that efforts to reduce population sodium intake through U.S. government policies are effective to prevent cardiovascular disease and reduce medical costs. In their comment, Frieden TR et al. supported the study of Smith-Spangler and colleagues. They underlined that the substantial changes in food production will be necessary but that the sodium reduction must be gradual to be more acceptable to consumers. Thus, they emphasized the necessity to provide healthier choices by reducing the sodium content of food which will generate health and economic benefits.
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