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Good Healthy Diet Starts at the Restaurants: Salt Content

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Sometime ago, I wrote a post about Boston Market reducing salt content and moving the salt shaker:

http://chowhound.chow.com/topics/884725

This following article by CDC Director Tom Frieden discusses salt reduction in restaurants in general

"The city's (Philadelphia) Public Health Department worked with 206 restaurants, first evaluating their menus for sodium content and then helping them choose ingredients and develop recipes with less sodium. ....

After nine months, the initiative analyzed two popular dishes from 20 participating restaurants to see what changed. The result? A 20% reduction in sodium, more than the project's goal.

It's one thing to choose how much salt to add to your food when you eat. It's another to live with decisions made by those who prepare your food before it makes it to the table."

http://www.cnn.com/2014/01/23/health/...

What do you think?

A good public policy by reducing salt? Too much intervention from the government to dictate food content? What's next? Regulate sugar and fat?

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  1. Interesting. But it does strike me that restaurants wishing to reduce sodium would likely be forced to use more fresh ingredients than they were previously.

    1. It is good public policy that food should not have excessive salt, but restaurants are probably not the main part of the problem.

      2 Replies
      1. re: GH1618

        <restaurants are probably not the main part of the problem>

        Where?

        1. re: Chemicalkinetics

          Prepared foods for home use are too highly salted. Canned soup, for example.

      2. Ah, the sugar and fat....

        Restaurant food does tend to contain a lot of salt, compared to home cooked food. However, the reason restaurant food, particularly chain and fast food, is high in salt is because salt can cheaply make up for sub-par ingredients or cooking methods. Ditto for fat and sugar. Designing foods to have maximum appeal at a minimum cost is a very lucrative branch of science.

        I could easily see a backlash, where the salt content goes down, but the fat content or sugar content goes up to compensate, the way low fat versions of food tend to be high in one or more of starch/sugar/salt. If you regulate everything, you end up with food that is less appealing or more expensive, which hits the bottom line of the restaurant.

        Then you run into issues with things that are legitimately salty - dishes with pickled or fermented ingredients, or soy marinated stuff is going to be high in salt. That's not a problem if it is part of a varied diet, but reducing the salt content destroys the fundamentals of the dish.

        7 Replies
        1. re: tastesgoodwhatisit

          <but reducing the salt content destroys the fundamentals of the dish.>

          You bought up a very good point. I personally prefer to eat "less of something good", and I don't mean it the way how normally people say it here. Most people use it to mean eating at high end restaurants.

          Let use milk as an example, I am the kind of person who enjoy regular (full fat) milk. So I rather drink half glass of a regular milk, than 2-3 glasses of 1-2% low fat milk. Same for many other foods as well.

          Maybe our real problem is that we eat large portion. You can cut the salt by 20-30% or you can simply cut the portion by 20-30%. Maybe the latter makes more sense.

          1. re: Chemicalkinetics

            I don't think it's an either/or proposition. One should not overeat, so as to maintain a healthy weight. And the food should not be oversalted. Properly seasoned food should not taste salty, but balanced. There are exceptions — some things are inherently salty, but these should be a small part of the diet.

            1. re: GH1618

              <One should not overeat, so as to maintain a healthy weight. And the food should not be oversalted>

              Prioritization is important too. One should also find the "bottleneck", where will make the biggest gain with the least resistance.

              1. re: Chemicalkinetics

                Biggest gain in what, in this case?

              2. re: GH1618

                Why? Salt requirements vary hugely from person to person. When I don't eat enough salty food, I literally have to eat or drink some salt in water to maintain my low normal bp and avoid cramps/spasms.

                There is no health benefit of salt restriction for most folks, in fact, mortality risk is highest when salt intake is restricted substantially.

                I think the real issue is another one you pointed out; prepared and junky foods are loaded with stuff that's unhealthy and deficient in the minerals one needs in balance with sodium, like magnesium and potassium.

            2. re: tastesgoodwhatisit

              And on Top Chef and the like, it seems the ratio of "needs more salt" to "too salty" runs about 10 to 1. Does it really *need* more salt, or is it what we are used to getting?

              1. re: DGresh

                I have noticed a lot of inadquately sessoned food coming out of restaurants in the past year, increasingly, and find myself reaching for a salt shaker or having to request one.

                I can't recall ever having salted anything but eggs in a restaurant in decades til now. Bleah.

            3. Look at what Panera Bread has just unveiled:

              https://www.panerabread.com/en-us/art...

              This is revolutionary if all the fast casuals would adopt it.

              1 Reply
              1. re: smoledman

                Hidden menu?

              2. The only person that should be regulating salt in my food is me.

                3 Replies
                1. re: ipsedixit

                  but don't you want nanny Bloomberg to tell you what to eat?

                  1. re: smoledman

                    You'll have to find a new name for the nanny

                    1. re: smoledman

                      Like Bloomberg or not, I think his approach is different from this one. In the case of Bloomberg, he was trying to limit sugar intake directly to the consumers. In this article, it is more about limiting the chefs/restaurants.

                      You may say what is the difference. The endgame may be the same, but the argument is different.

                      "It's one thing to choose how much salt to add to your food when you eat. It's another to live with decisions made by those who prepare your food before it makes it to the table."

                      In other words, Bloomberg soda policy was protecting you from your own stupid decisions. This salt-reduction approach is to protect you from the restaurants' stupid actions.

                  2. DH and I were in Philadelphia and were looking for a quick, casual dinner before an evening engagement. Right across the street was a Hard Rock Cafe and I went on my computer to look at their menu.
                    I was braced fro high calories and high sodium, but was floored when I saw the actual numbers, the salt in particular.
                    I really don't think that people in general realize just how much salt is in Chain foods! Not that many care, but it's en eye opener!

                    1. Robert Sietsema, the NY restaurant critic, spoke out about Mayor Bloomberg's salt jihad a few years ago:
                      ------------------------------------------------------------------
                      [Bloomberg's] campaign against salt exploits the easiest of targets, but does it rest on good science? We know that the prevalence of hypertension in the adult population (over 18) is approximately 20%.

                      Estimates of salt sensitivity among those suffering from hypertension range from 10 percent to 33 percent. So, let's assume the higher figure. If 75 percent of the city's population is over 18, and 20 percent of those are hypertensives, and 33 percent of that population is salt sensitive, that means the mayor is prepared to distort an entire food culture for the benefit of less than 5 percent of the population. And the figure is probably far smaller, since a large proportion of the hypertensives are medicated, and don't need to worry about their salt. Is it worth changing the eating habits of the entire population for the small percentage that might be affected?
                      ---------------------------------------------------------
                      Full article - http://blogs.villagevoice.com/forkint...

                      18 Replies
                      1. re: Bob Martinez

                        It isn't true that people who are medicated don't need to worry about their salt.

                        1. re: GH1618

                          I've been taking blood pressure meds for 10 years and my pressure is absolutely normal. I use as much salt as I like.

                          I have friends who do the same and they have no problems at all.

                          1. re: Bob Martinez

                            It is not valid to generalize from individual experience to everyone else. There is also the factor of whether one prefers to minimize medication dosages. Some of us who require and take medication nevertheless believe that good health begins with good eating habits.

                            1. re: GH1618

                              As much as I trust you I'm not in the habit of taking diet advice from anonymous posters on a food board.

                              Could you provide links to reputable sources (not cult sites) that describe the risks of salt other than those that are blood pressure related?

                              1. re: Bob Martinez

                                Possibly related to many other things, including gastro cancer.

                                http://www.sciencedaily.com/releases/...

                                http://www.ncbi.nlm.nih.gov/pmc/artic...

                                http://www.ncbi.nlm.nih.gov/pubmed/15...

                                1. re: Chemicalkinetics

                                  Oh, please, do not confuse associations/epidemiology for clinical outcomes. Most often, they are markers for something else and raise interesting avenues to explore, not answers about causation.

                                  1. re: Chemicalkinetics

                                    Thanks for doing that research. Those are legitimate sites.

                                    I've got for you from the NY Times
                                    ----------------------------------------------------

                                    No Benefit Seen in Sharp Limits on Salt in Diet
                                    Published: May 14, 2013

                                    In a report that undercuts years of public health warnings, a prestigious group convened by the government says there is no good reason based on health outcomes for many Americans to drive their sodium consumption down to the very low levels recommended in national dietary guidelines.

                                    Those levels, 1,500 milligrams of sodium a day, or a little more than half a teaspoon of salt, were supposed to prevent heart attacks and strokes in people at risk, including anyone older than 50, blacks and people with high blood pressure, diabetes or chronic kidney disease — groups that make up more than half of the American population.

                                    Some influential organizations, including the American Heart Association, have said that everyone, not just those at risk, should aim for that very low sodium level. The heart association reaffirmed that position in an interview with its spokesman on Monday, even in light of the new report.

                                    But the new expert committee, commissioned by the Institute of Medicine at the behest of the Centers for Disease Control and Prevention, said there was no rationale for anyone to aim for sodium levels below 2,300 milligrams a day. The group examined new evidence that had emerged since the last such report was issued, in 2005.

                                    “As you go below the 2,300 mark, there is an absence of data in terms of benefit and there begin to be suggestions in subgroup populations about potential harms,” said Dr. Brian L. Strom, chairman of the committee and a professor of public health at the University of Pennsylvania. He explained that the possible harms included increased rates of heart attacks and an increased risk of death.

                                    Full article here -
                                    http://www.nytimes.com/2013/05/15/hea...

                                    Government study here:
                                    http://books.nap.edu/openbook.php?rec...

                                    1. re: Bob Martinez

                                      I really don't have a dog in this fight, but is the average american *anywhere near* 2300 mg? I think getting below that level would take a lot more than some restaurants tweaking their recipes.

                                      1. re: DGresh

                                        I'm at the 23g level. And climbing.

                                      2. re: Bob Martinez

                                        I think we have some people eat too much salt and some people don't eat enough salt. The message of "lower your salt intake" advise tends to scare the people who are already eating normal or lower than normal.

                                        If you scream into a theater room and tell them that people should cut down their weight, then you end up motivating/scaring the ones who are already thin and lean more so than the ones who are actually overweight. What can you do, right?

                                    2. re: Bob Martinez

                                      Blood pressure is what I'm interested in right now, and I am not inclined to research other areas.

                                      In any case, I am not giving you or anyone else diet advice. Consume as much salt as you like.

                                      1. re: GH1618

                                        I am interested in bp, too. I had severe labile ht (210/190 frex) for years til a diet change, and now typically low normal or below normal, but it occasionally rises close to 140/90. At those times, Morton blended lite salt (NaCl and K) drops it like a rock. So does time released rx K with OTC magnesium glycinate.

                                        If those two don't work, taking plain salt does... it opens the channels for potassium to do its work.

                                        A lot of "salt sensitive" folks (another name for hyperaldosteronism) wouldn't be if those other minerals were also present. But they usually aren't in the foods that carry so much salt, like the prepared stuff you mentioned.

                                  2. re: Bob Martinez

                                    My blood pressure is medicated and when I check it in the morning it varies by up to 30 points - mostly depending on whether/how much I've eaten fast food in the last few days! Sometimes in weeks when I'm doing my own cooking from scratch, it's too low to even take my meds or I'll be on the floor... does that mean I should have more salt? No, because when I do, it's too high even with the meds... I hate salty foods anyway. I haven't added more than a sprinkle of salt to my cooking in decades. I'm always surprised and grateful when I order a dish at a restaurant and it comes out lightly salted instead of tasting like a salt lick. I can always grab a salt shaker and add a sprinkle at the table, but it's impossible to take it away and all the water in the world won't dilute it enough to make it go away...

                                    1. re: Kajikit

                                      <I can always grab a salt shaker and add a sprinkle at the table, but it's imposs....>

                                      I think this is the point. If the chefs cook the food slightly on the less salty (bland) side, then you can always just sprinkle a little bit. However, if the chefs add too much salt to the dish, then you are in trouble.

                                      1. re: Chemicalkinetics

                                        I agree.

                                        I think that the taste of many dishes benefits from a bit of salt during cooking and another bit to finish.

                                        Premade, frozen, processed...whatever...foods that are soaked for weeks or months in five kinds of super-pumped sodium don't taste good.

                                  3. re: GH1618

                                    Very few people need to worry about their salt as much as they and their doctors should be worrying about adequate magnesium, potassium and calcium.

                                    This is another one of those stupid associations mistaken for causation.

                                  4. re: Bob Martinez

                                    <Is it worth changing the eating habits of the entire population for the small percentage that might be affected?>

                                    Maybe. :)

                                    It really depends, doesn't it?

                                    1) Saltiness is something we adapt overtime. What I am driving at is that a lot of restaurant foods are overly salty because they compete with each others and we have gotten used to this. It does not mean we have to eat this level of saltiness. This is why most restaurant foods taste saltier than home foods.

                                    2) The percentage thing here is actually underplayed not overestimated. This is because the hypertension prevalence increases with our age.

                                    http://img.medscape.com/fullsize/migr...

                                    So while the total hypertension prevalence may seem only like <20% for the total population. It is 50% for the seniors. In other words, half of the people eventually will have hypertension in their life (sooner or later).

                                    Recently, we have also seen the growth in hypertension too.

                                    "The number of confirmed hypertensives (defined as already on treatment or BP > 140/90 mmHg on three or more occasions) has risen steadily from 564 in January 2002 to 738 in April 2005; an increase of 31% giving a current prevalence of 11.7% for all age groups. "

                                    In other words, this problem is predicted to get worse.

                                    3) Just because a small percentage of population suffers, it does not mean we don't do anything about it.

                                    <the mayor is prepared to distort an entire food culture for the benefit of less than 5 percent of the population>

                                    We are talking about "benefit" of saving lives, not "benefit" of getting a coupon here. US has 313 million population. 5% is 15 millions of people. 15 millions of people.

                                    1. re: Chemicalkinetics

                                      It's metabolic syndrome and it's NOT caused by salt. Salt is a passenger on and in many of the foods that are, though.