Restaurant Meals Still Sky-High in Sodium
A single restaurant meal often contains more sodium than people should eat in an entire day - and this salty situation may only be getting worse.
By Johannah Sakimura, RD
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MONDAY, May 13, 2013 — Eating out could be costing your heart even more than your wallet. Restaurant meals are dangerously high in sodium, and the numbers may only be increasing, according to a pair of studies published today in the journal JAMA Internal Medicine.
“Our food supply is loaded with excess salt and it’s killing people,” said Stephen Havas, MD, MPH, a preventive medicine specialist at Northwestern University and an author of one of the new studies. A high-sodium diet can contribute to high blood pressure, a major risk factor for heart attack and stroke.
In one report, researchers at the University of Toronto analyzed more than 3,500 breakfast, lunch, and dinner combinations at 19 sit-down chain restaurants in Canada. The average meal clocked in at 2,269 milligrams of sodium, or 151 percent of the amount most U.S. adults are advised to consume in a full day of eating.
Though the report analyzed meals at Canadian establishments, experts say restaurant offerings in the U.S. are just as loaded with salt. A plate of lasagna at Olive Garden tops 2800 milligrams of sodium, for example, while the Chipotle Chicken Panini sandwich at Panera Bread delivers 2,140 milligrams before factoring in salty sides like potato chips.
The University of Toronto study also revealed that the restaurant meals contained more than 50 percent of the average daily calorie requirement and nearly a day’s worth of saturated fat, which can also harm heart health when consumed in excess.
People who are 51 and older, as well as those who are African American or have hypertension, diabetes, or chronic kidney disease — groups that together account for nearly two-thirds of U.S. adults — should consume no more than 1500 milligrams sodium per day, according to the USDA's 2010 Dietary Guidelines. Americans currently take in more than twice that amount — 3300 milligrams per day — and restaurant fare is a major contributor to our salt surplus.
Eating too much salt may contribute to 15 percent of all heart-disease deaths around the world, according to an analysis published earlier this year.
And sodium levels in restaurant meals may be rising, despite heavy pressure from health organizations to cut back on salt. In a second study, Dr. Havas and colleagues analyzed changes in the sodium content of seven common fast food menu items, including cheeseburgers, chicken sandwiches, and breakfast sandwiches, at Burger King, McDonald’s, KFC, and other chains between the years 2005 and 2011. Sodium increased by 2.6 percent on average in the 78 foods analyzed, with the largest jump seen in French fries.
The researchers also examined sodium levels in a selection of 402 processed foods, including sandwich bread, salad dressing, canned soup, cheese, and deli meat, over the same time period. The sodium content of packaged foods decreased by 3.5 percent on average during the six-year window.
The changes may not seem significant — and that’s just the point, according to Havas. “The fact is that during this time period, when there have been numerous calls for reduction in sodium, processed and restaurant foods haven’t been changing,” he said. “I think this has enormous significance for the health of the American public."
In the last five years, many food manufacturers and restaurant chains, including Campbell’s, ConAgra, General Mills, Hormel, McDonald’s, and Subway, have made voluntary commitments to reduce the sodium in their offerings. And in 2011, retail giant Walmart announced it would reformulate many of its grocery items, including deli meats, salad dressings, and frozen entrees, to reduce sodium by 25 percent by 2015, and called on suppliers to do the same.
Yet, at least in the sampling of food products and fast food items evaluated in the new analysis, the cuts have been slow and inconsistent. In response, Havas and his fellow study authors are urging the U.S. government to begin setting mandated targets for sodium reduction.
“As long as there’s no regulation at the federal level, there will be minimal progress,” Havas contended. “One company doesn’t want to do it if the other companies aren’t doing it. They think it might be a competitive disadvantage.”
“Restaurants have made significant progress in developing lower sodium menu options,” Joy Dubost, PhD, RD, the Director of Nutrition for the National Restaurant Association, said in a statement. “The industry is highly diverse, including restaurants that provide a wide range of dining options. On the whole, our members have evaluated their product lines to determine the areas in which sodium can be reduced, reformulated existing menu items when feasible, and considered sodium levels as part of new product development. The industry’s proactive and ongoing efforts will better enable the gradual reduction of sodium in the food supply.”
Dining Out Without the Salty Side Effects
It’s very difficult for people to keep their sodium below the recommended 1500 milligrams a day, even if they’re preparing most of their meals at home, said Bonnie Taub-Dix, a registered dietitian and author ofRead It Before You Eat It. “If you really want to follow a very low-sodium diet, you would need to eat out much less often,” she said.
However, dining out is an important part of most people’s social life, and you don’t have to give it up completely to comply with dietary restrictions, said Jessica Goldman Foung. Better known as “Sodium Girl,” Goldman Foung shares recipes and tips to help people limit sodium without sacrificing flavor on her popular health blog. Goldman Foung began following a very low-sodium diet after suffering kidney damage as complication of lupus, but the majority of her readers are looking to cut back on salt because of high blood pressure or other heart health concerns.
Chain restaurants may not offer much flexibility for those looking for , because the meals are often prepared in advance and can’t be adjusted to accommodate personal requests, Goldman Foung noted. For that reason, she suggests dining at local restaurants whenever possible, where it is often easier to speak with the chef and ask for meals to be prepared without added salt and high-sodium ingredients.
Follow these other suggestions to keep salt to a minimum when eating away from home:
- Eat just half of the portion served, advised Goldman Foung. You’ll automatically reduce the sodium by 50 percent.
- It’s difficult to accurately gauge the sodium content by reading a menu description or looking at a plate of food. Our experts suggest checking the nutrition stats on the restaurant’s website before leaving home or using a smart phone to identify lower-sodium choices.
- Avoid “red flag” menu descriptors like pickled, marinated, breaded, and fried, which indicate dishes are likely to be high in sodium. Look for dishes that are steamed, poached, or boiled, which are typically (but unfortunately not always) lower in salt.
- Round out your meal with an order of steamed or grilled vegetables, as opposed to a side dish that’s high in sodium. As a bonus, you’ll be eating more health-boosting produce, Taub-Dix said.
- Order sauces, which are often highly seasoned, on the side. “This way, you can add the amount you like or just occasionally dip your food in there,” recommended Taub-Dix.
- Carry your own low-sodium seasonings with you. Goldman Foung keeps a bottle of Mrs. Dash in her purse at all times for flavor emergencies. With a quick sprinkle, she can transform a plate of boring steamed veggies or plain poached fish into a tastier, more delightful entrée.
Video: Where do we get most of our sodium?
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