Salty Meals Still on the Menu

Sodium and calorie content of entrees at many popular chain restaurants in the US remains unchanged

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Many popular US chain restaurants are claiming to offer healthier menu options in their marketing and ad campaigns, but do their menu items actually live up to these claims?

A recent study found that there has been little change in the sodium and calorie content for entree items at well-known US chain restaurants.

The authors noted that consumers should be aware of the difficulties of finding healthy meal options when they go to these types of restaurants.

"Choose lower sodium and calorie options at restaurants."

This study was led by Helen Wu, PhD, with the Institute for Population Health Improvement in the University of California, Davis, Health System. The research team examined the changes in calorie and sodium content of menu items at chain restaurants in the US over a one year period.

After the Patient Protection and Affordable Care Act was passed in the spring of 2010, chain restaurants with at least 20 US locations, were required to start listing the nutrition information of their menu items on the menu. The researchers looked at reported changes in calorie and sodium content one year after this law was passed.

Researchers recorded the nutrition information for entrée items at 213 chain restaurants at the beginning of the study (between February and May 2010), and one year later (between April and May 2011). Nutrition information was obtained from restaurant websites or directly from restaurants if information was not available online. The type of restaurants included in the analysis were: fast food, take out, fast casual, buffet, family style, and upscale.

A total of 26,256 entrées were studied. The researchers found that about half of the original menu items remained unchanged in reported nutrition content. The average entrée in 2010 had 670 calories and still had 670 calories one year later. Sodium levels only dropped 15 milligrams at follow-up (from 1,515 milligrams per entrée to 1,500 milligrams).

Family style restaurant entrées decreased in sodium by 70 milligrams in 2011, but the researchers noted that these entrées were much higher in sodium to begin with so there was more opportunity for change. Fast food restaurant entrées were found to decrease by 40 calories on average.

Children's menu items were found to remain relatively unchanged over the study period. Calorie content for children's menu items went from 462 to 468 calories, and sodium content went from 951mg to 932 mg.

As the study authors noted, marketing and advertising efforts for many chain restaurants may make it seem like there are more healthier menu options being offered, but the findings from this study do not support this. They further noted that perhaps as more time passes, greater shifts will be seen in calorie and sodium content.

In a prepared statement, Wu, the study's lead author, noted that, "What consumers need to be aware of is that, currently, the state of restaurant nutrition makes it very difficult to have a healthy meal."

The study authors concluded that more public health efforts are needed to see larger gains in nutritional improvements for menu items at US chain restaurants.

"I find the public debate about sodium to be unfortunately phrased; the problem is the pre-prepared food. Single menu items carrying 1,500 mg provide about half of what one would consume in a full day if one cooked at home and salted food to taste. Excess sodium, and empty calories, along with excess omega 6-fatty acids and starchy carbohydrates, are all drawbacks of restaurant or fast food sourced meals," Deborah Gordon, MD, a nutrition and preventive medicine expert, told dailyRx News.

"The best strategy for eating outside the home is to select salads with olive oil dressings, grilled meats and fish, with simple steamed vegetables, avoiding pasta dishes, all sauces, and deep-fried foods. Oh, and you'll have to ask for an extra helping of real butter (not margarine, please!) to make palatable what restaurants serve hidden in a layer of salt," said Dr. Gordon.

This study was published on October 1 in the Journal of the Academy of Nutrition and Dietetics.

This study was funded by a grant from Healthy Eating Research, a national program of the Robert Wood Johnson Foundation, with extra funding provided through the JL Foundation and Rothenberg Dissertation Awards.

The study authors reported no competing interests.

Review Date: 
October 2, 2013
Last Updated:
October 4, 2013