In the JournalsPerspective

High sodium levels persist in processed, restaurant foods

Despite the clinical implications of sodium intake on blood pressure levels, results from two recent studies suggest that sodium levels in popular processed and restaurant foods have not met satisfactory reductions in recent years. Both studies were published in JAMA Internal Medicine.

In one study, Michael F. Jacobson, PhD, co-founder and executive director of the nonprofit health advocacy organization Center for Science in the Public Interest, and colleagues from various research institutions examined the changes in sodium levels in processed and restaurant foods from 2005 to 2011.

According to data, smoked bacon had the greatest sodium content, followed by Caesar salad dressing. Overall, they found that the sodium content in 402 processed foods decreased by approximately 3.5% (or about 0.5% per year), whereas the sodium content in 78 fast-food restaurant products increased by 2.6%.

Despite some decreases of 30%, more products demonstrated increases of at least 30%, suggesting no statistically significant changes in sodium content during a 6-year period, researchers wrote.

In a similar study, Mary J. Scourboutakos, BSc, of the department of nutritional sciences at the University of Toronto, and colleagues wrote that sodium levels are “… alarmingly high in breakfast, lunch and dinner meals from multiple chain sit-down restaurants.”

Scourboutakos and colleagues included 3,507 variations of 685 meals and 156 desserts from 19 chain sit-down restaurants in their analysis.

According to data, these variations of meals and desserts contained 1,128 calories (56% of the average daily 2,000-calorie recommendation), 151% of the amount of sodium an adult is suggested to consume in 1 day (2,269 mg); 89% of the daily value for fat (58 g); 83% of the daily value for saturated (16 g) and trans fat (0.6 g); and 60% of the daily value for cholesterol (179 mg).

Furthermore, researchers reported that only 1% of meals displayed less than 600 mg of sodium, and almost 50% of the meals exceeded the daily value for fat (65 g).

“Therefore, addressing the nutritional profile of restaurant meals should be a major public health priority,” researchers wrote.

For more information:

Jacobson MF. JAMA Intern Med. 2013;doi:10.1001/jamaintermed.2013.6154.

Scourboutakos MJ. JAMA Intern Med. 2013;doi: 10.1001/jamaintermed.2013.6159.

Disclosure: The researchers report no relevant financial disclosures.

Despite the clinical implications of sodium intake on blood pressure levels, results from two recent studies suggest that sodium levels in popular processed and restaurant foods have not met satisfactory reductions in recent years. Both studies were published in JAMA Internal Medicine.

In one study, Michael F. Jacobson, PhD, co-founder and executive director of the nonprofit health advocacy organization Center for Science in the Public Interest, and colleagues from various research institutions examined the changes in sodium levels in processed and restaurant foods from 2005 to 2011.

According to data, smoked bacon had the greatest sodium content, followed by Caesar salad dressing. Overall, they found that the sodium content in 402 processed foods decreased by approximately 3.5% (or about 0.5% per year), whereas the sodium content in 78 fast-food restaurant products increased by 2.6%.

Despite some decreases of 30%, more products demonstrated increases of at least 30%, suggesting no statistically significant changes in sodium content during a 6-year period, researchers wrote.

In a similar study, Mary J. Scourboutakos, BSc, of the department of nutritional sciences at the University of Toronto, and colleagues wrote that sodium levels are “… alarmingly high in breakfast, lunch and dinner meals from multiple chain sit-down restaurants.”

Scourboutakos and colleagues included 3,507 variations of 685 meals and 156 desserts from 19 chain sit-down restaurants in their analysis.

According to data, these variations of meals and desserts contained 1,128 calories (56% of the average daily 2,000-calorie recommendation), 151% of the amount of sodium an adult is suggested to consume in 1 day (2,269 mg); 89% of the daily value for fat (58 g); 83% of the daily value for saturated (16 g) and trans fat (0.6 g); and 60% of the daily value for cholesterol (179 mg).

Furthermore, researchers reported that only 1% of meals displayed less than 600 mg of sodium, and almost 50% of the meals exceeded the daily value for fat (65 g).

“Therefore, addressing the nutritional profile of restaurant meals should be a major public health priority,” researchers wrote.

For more information:

Jacobson MF. JAMA Intern Med. 2013;doi:10.1001/jamaintermed.2013.6154.

Scourboutakos MJ. JAMA Intern Med. 2013;doi: 10.1001/jamaintermed.2013.6159.

Disclosure: The researchers report no relevant financial disclosures.

    Perspective
    Elliott M. Antman, MD

    Elliott M. Antman

    • The principal basis for the American Heart Association’s sodium reduction recommendation is the strength of the evidence relating excess sodium intake to hypertension, cardiovascular disease (CVD) and stroke.We also know that reducing sodium intake is helpful for preventing and treating hypertension and reducing the development of CVD and stroke events. The studies examining sodium intake and direct health outcomes were not designed for this purpose, and have substantial methodological concerns that limit their usefulness in setting public health recommendations.

      The average American eats far too much sodium at about 3,400 mg per day. The AHA has taken an aggressive posture and recommends a sodium intake of less than 1,500 mg per day. That’s difficult to do because about three-quarters of the sodium we eat comes from processed or restaurant food.

      We acknowledge and commend the food industry for making some efforts at reducing the sodium content for the foods that they offer, but as the report in JAMA Internal Medicine observed, the reductions in sodium in the available processed and restaurants foods are small and largely haven’t changed significantly in a decade.

      We continue to work with the food industry and urge them to reduce the sodium content of the food they offer more significantly and to do so more rapidly.

      • Elliott M. Antman, MD
      • Spokesman for the American Heart Association
        Cardiologist at Brigham and Women’s Hospital
        Professor of cardiovascular medicine at Harvard Medical School
    • Disclosures: Antman reports no relevant financial disclosures.