CSPI Report: Chain Restaurants Decrease Sodium Slightly but Progress is Slow & Uneven

03 Jul 2014 --- A review of 136 meals from 17 top restaurant chains finds that the companies have reduced sodium on average by six percent between 2009 and 2013, or just 1.5 percent per year. The nonprofit Center for Science in the Public Interest says that the progress has been slow and inconsistent.

The biggest reductions in sodium were posted by Subway, Burger King, and McDonald's, but KFC and Jack in the Box actually increased sodium by 12.4 percent and 7.2 percent, respectively, in the sample of meals reviewed.

Despite the progress, 79 percent of the 81 adult meals in the study still contained more than 1,500 milligrams (mg) of sodium. A majority of Americans, including people 51 and older, people with high blood pressure, and African-Americans, should try to limit themselves to 1,500 mg of sodium per day, according to the Centers for Disease Control and Prevention. At higher levels, sodium promotes high blood pressure, stroke, heart attacks, kidney disease, and other health problems, making it the single most harmful ingredient in the food supply, according to CSPI. The average sodium in 55 kids' meals dropped by just 2.6 percent.

At table-service chains such as Red Lobster, Chili's, and Olive Garden, it's easy to find meals in the ballpark of 5,000 mg of sodium—more than most people should consume over the course of three days. CSPI says that these alarming levels are one reason why the Food and Drug Administration should set reasonable limits on the amounts of sodium that can be used in various categories of food.

"For far too long, the FDA has relied on a voluntary, wait-and-see approach when it comes to reducing sodium in packaged and restaurant food," said CSPI executive director Michael F. Jacobson. "If chains like KFC, Jack in the Box, and Red Lobster are actually raising sodium levels in some meals, FDA's current approach clearly isn't working."

At KFC, CSPI evaluated nutrition data provided by the company for three adult meals and four kids' meals. Of the seven meals, one of those meals posted a 22 percent decrease in sodium and one remained the same. But five meals posted increases. In 2009, a meal of an Extra Crispy Chicken Breast, an Extra Crispy Whole Wing, a biscuit, BBQ Baked Beans, Macaroni Salad, and a medium Pepsi had 3,110 mg of sodium. In 2013, that same meal had 3,445 mg of sodium, an increase of 11 percent.

In 2009, a Jack in the Box meal composed of a Bacon Ultimate Cheeseburger, a large order of Seasoned Curly Fries, and a 1% Chocolate Milk had 3,370 mg of sodium. In 2013, the chain's nutrition information showed that that meal contained 3,670 mg, a 9-percent increase.

Subway showed dramatic progress between 2009 and 2013, reducing sodium in every one of the 10 meals reviewed in the study. In 2009, a meal of a Footlong Ham Sandwich, a bag of Lay's Classic Potato Chips, and a Diet Coke had 2,730 mg of sodium. In 2013, that meal had just 1,895 mg of sodium. In 2009, a Subway meal of a six-inch Veggie Delite Sandwich, Apple Slices, and a Coke had a very reasonable 500 mg of sodium. In 2013, it had just 295 mg of sodium. The chain showed similar progress in the four children's meals reviewed in the study, which were reduced in sodium by an average of 29 percent.

"Reducing sodium is just one of many parts of our commitment to continuously improve our menu," said Lanette Kovachi, senior dietitian for the Subway restaurant chain. "So far we have reduced sodium 30 percent in our sandwiches, including the sandwiches in the 10 meals cited by CSPI, and 35 percent in our Fresh Fit offerings, meeting the National Salt Reduction Initiative targets for sandwiches. We are always working to find new ways to serve our customers a wide variety of menu offerings that taste great and are better-for-you."

The three Burger King kids' meals in the study were 40 percent lower in sodium on average in 2013 than in 2009, largely because the chain switched its default side dish from French Fries to Apple Slices, though it also reduced sodium in its Double Cheeseburger, Cheeseburger, and Chicken Nuggets.

A McDonald's meal of five Chicken Premium Selects Breast Strips, Spicy Buffalo Dipping Sauce, a Side Salad with Low Fat Balsamic Dressing, and a large Powerade Mountain Blast had 3,570 mg of sodium in 2009. In 2013, it had 34 percent less (2,360 mg). It showed reductions in each of those meal components. For instance the portion of dipping sauce was cut nearly in half, saving 420 mg of sodium; sodium in the salad dressing declined from 740 mg to 430 mg.

One meal at Dairy Queen (Bowl of Chili, Side Salad with Fat Free Ranch Dressing, and a Mountain Dew) dropped by 57 percent, from 4,500 to 1,925 mg, the biggest drop in the study. But that chain also posted one of the biggest increases in the study, with a meal of Grilled Chicken Wrap, Side Salad with Fat Free Ranch Dressing, and Orange Juice having 38 percent more sodium in 2013 (1,135 mg) than it did in 2009 (820 mg). The biggest increase in terms of milligrams was seen at Sonic in a meal of a large order of Jumbo Popcorn Chicken, Tater Tots, and Powerade Mountain Blast, which had 2,830 mg of sodium in 2009 but had 950 mg more sodium (3,780) in 2013.

"Some companies are clearly making an effort, but we won’t see sustained progress by all companies unless they know that their competitors will be lowering sodium also, which is why the FDA needs to level the playing field," said Jacobson.

In 2005, CSPI filed a regulatory petition with the FDA asking it to revoke the "generally recognized as safe" status of salt and to set upper limits on the amounts allowed in food. The Institute of Medicine endorsed that approach in 2010. The American Public Health Association passed a similar resolution in 2011, citing the "strong, continuous, graded, consistent, independent, and etiologically significant" relationship between blood pressure levels and the risk of developing cardiovascular disease.

Some chain restaurants not in the CSPI study disclose that they have items with more sodium than any of the meals in the study. At P.F. Chang's, an order of Dan Dan Noodles has 6,190 mg of sodium and a bowl of Hot & Sour Soup has 7,980 mg, according to the chain’s website. A meal called "The Big Hook Up" from Joe's Crab Shack has more than five days' worth of sodium, 7,610 mg, according to the company's website. That latter meal has more than five days' worth of sodium for most people.

"If FDA fails to act on the IOM recommendations, the agency will have missed one of the great public health opportunities of our day," Jacobson wrote to FDA Commissioner Margaret Hamburg.

Source: CSPI