Association between salt substitutes/enhancers and changes in sodium levels in fast-food restaurants: a cross-sectional analysis

Scourboutakos, Mary J.; Murphy, Sarah; L’Abbé, Mary R.

doi:10.9778/cmajo.20170137

Cited by 10 publications

(10 citation statements)

References 43 publications

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“…Following the full-text review ( n = 38), we excluded four studies and selected 34 studies that met the inclusion criteria. An additional 16 additional articles were identified from the reference lists of key articles and other sources, and 50 articles were included in the final analysis [78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108,109,110,111,112,113,114,115,116,117,118,119,120,121,122,123,124,125,126,127].…”

Section: Resultsmentioning

confidence: 99%

“…Nine U.S. studies used the MenuStat Database established by the New York City Department of Health and Mental Hygiene to provide nutrition information for products sold by the leading QSR, FCR, and FSR chains from 2012 to 2017 [73,83,84,85,92,100,104,110,126]. Four studies used independent food and nutrient databases to assess the quality of meals [82,96,109,115].…”

Section: Resultsmentioning

confidence: 99%

“…Of the 38 studies that examined the sodium or salt content of chain restaurant meals, two multi-country studies documented substantial differences in the sodium content of menu items that differed by food category at different QSR chains across nine countries [91,101]. Dunford et al (2012) [91] documented that the mean sodium content of foods varied between chains and between the same products across six countries, and Khan et al (2018) [101] found that two-thirds of sodium came from meats, chicken, and buns across four countries including Australia, Egypt, India, and the U.S. Studies across Australia [94,124], Canada [113,114,115,116], Costa Rica [97], Japan [120], New Zealand [93,106,123], and the U.S. [79,87,89,99,109,121,122,126] documented wide variation in the sodium content by restaurant chain and food category that precluded making generalizations about the sodium content of menu items within a single country and across countries. Only a small proportion of children’s meals met the recommended sodium targets in Australia [124], Japan [120], and U.S. [117].…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Progress Evaluation for Transnational Restaurant Chains to Reformulate Products and Standardize Portions to Meet Healthy Dietary Guidelines and Reduce Obesity and Non-Communicable Disease Risks, 2000–2018: A Scoping and Systematic Review to Inform Policy

Kraak

Patiño

Renukuntla

et al. 2019

IJERPH

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Transnational restaurant chains sell food and beverage products in 75 to 139 countries worldwide linked to obesity and non-communicable diseases (NCDs). This study examined whether transnational restaurant chains reformulated products and standardized portions aligned with healthy dietary guidelines and criteria. Firstly, we describe the transnational restaurant industry structure and eating trends. Secondly, we summarize results from a scoping review of healthy dietary guidelines for restaurants. Thirdly, we describe a systematic review of five electronic databases (2000–2018) to identify studies on nutrient profile and portion size changes made by transnational restaurants over 18 years. We used Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, identified 179 records, and included 50 studies conducted in 30 countries across six regions. The scoping review found a few expert-recommended targets for restaurants to improve offerings, but no internationally accepted standard for portions or serving sizes. The systematic review results showed no standardized assessment methods or metrics to evaluate transnational chain restaurants’ practices to improve menu offerings. There was wide variation within and across countries, regions, firms, and chains to reduce energy, saturated and trans fats, sodium, and standardized portions. These results may inform future research and encourage transnational chain restaurants to offer healthy product profiles and standardized portions to reduce obesity and NCD risks worldwide.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Progress Evaluation for Transnational Restaurant Chains to Reformulate Products and Standardize Portions to Meet Healthy Dietary Guidelines and Reduce Obesity and Non-Communicable Disease Risks, 2000–2018: A Scoping and Systematic Review to Inform Policy

Kraak

Patiño

Renukuntla

et al. 2019

IJERPH

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“…Due to the influence of sodium reduction on the palatability of foods, another solution could be the addition of flavor enhancers to low-sodium products such as monosodium glutamate (MSG), yeast extracts, hydrolyzed vegetable proteins nucleotides, and amino acids [ 28 ]. MSG, which is responsible for the umami flavor, contains one-third the amount of sodium when compared with table salt (NaCl), enabling to reduce sodium by as much as 40%, with no loss of palatability [ 29 ]. However, since 1960s, a controversial syndrome, the so-called “Chinese restaurant syndrome” was described as consequence of the use of MSG to flavor most dishes [ 30 ].…”

Section: How To Reduce the Dietary Intake Of Saltmentioning

confidence: 99%

Strategies for Reducing Salt and Sugar Intakes in Individuals at Increased Cardiometabolic Risk

et al. 2021

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Non-communicable diseases (NCDs) are the first causes of death worldwide. Reduction in the dietary intake of salt and sugars is important lifestyle advice that is useful for NCD prevention. However, the simple recommendations of reducing salt and sugars by healthcare professionals are often ineffective; innovative strategies are therefore necessary. This review aimed at describing the current knowledge about the strategies to reduce dietary salt and sugar intake, including both strategies for the food industry to reduce the salt or sugar of its products and recommendations for health professionals in a clinical context, such as the replacement with substitutes in foods, the gradual reduction to allow a progressive consumer adaptation towards less intense taste, and the different spatial distribution of tastants within the food matrix with taste intensity enhancement. In addition, the cross-modal interaction between two or more different sensory modalities as an innovative strategy for enhancing sweetness and saltiness perception was described. Finally, the dietary tips for salt and sugar reduction were summarized in order to create a comprehensive guide of dietary advices for healthcare professionals for optimizing the management of patients at increased cardiometabolic risk.

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“…Restaurant dishes have a higher sodium level than home-made foods [ 16 ], thus eating out is reported to be associated with higher intake of sodium [ 17 , 18 ]. Besides their high sodium content, restaurant foods also are characterized by the use of salt substitutes and flavor enhancers [ 19 ], indicating different sources of sodium compared with home-made dishes. With rapid urbanization and economic development, the contribution of restaurant foods to the population’s sodium intake is increasing [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Sodium content of restaurant dishes in China: a cross-sectional survey

Wang

Zhang

et al. 2022

Nutr J

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Background Sodium intake in China is extremely high and eating in restaurants is increasingly popular. Little research has explored the sodium level of restaurant dishes. The present study aims to assess the content and sources of sodium in Chinese restaurants. Methods Cross-sectional data were obtained from the baseline survey of the Restaurant-based Intervention Study (RIS) in 2019. A total of 8131 best-selling restaurant dishes with detailed recipes from 192 restaurants in China were included. Sodium content per 100 g and per serving were calculated according to the Chinese Food Composition Table. The proportion of restaurant dishes exceeding the daily sodium reference intake level in a single serving and the major sources of sodium were determined. Results Median sodium content in restaurant dishes were 487.3 mg per 100 g, 3.4 mg per kcal, and 2543.7 mg per serving. For a single serving, 74.9% of the dishes exceeded the Chinese adults’ daily adequate intake for sodium (AI, 1500 mg per day), and 62.6% of dishes exceeded the proposed intake for preventing non-communicable chronic diseases (PI, 2000 mg per day). Cooking salt was the leading source of sodium in Chinese restaurant dishes (45.8%), followed by monosodium glutamate (17.5%), food ingredients (17.1%), soy sauce (9.4%), and other condiments/seasonings (10.2%). More types of salted condiments/seasonings use were related to higher sodium level. Conclusions The sodium levels in Chinese restaurant dishes are extremely high and variable. In addition to cooking salt, other salted condiments/seasonings also contribute a large proportion of sodium. Coordinated sodium reduction initiatives targeting the main sources of sodium in restaurant dishes are urgently needed.

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Association between salt substitutes/enhancers and changes in sodium levels in fast-food restaurants: a cross-sectional analysis

Cited by 10 publications

References 43 publications

Progress Evaluation for Transnational Restaurant Chains to Reformulate Products and Standardize Portions to Meet Healthy Dietary Guidelines and Reduce Obesity and Non-Communicable Disease Risks, 2000–2018: A Scoping and Systematic Review to Inform Policy

Progress Evaluation for Transnational Restaurant Chains to Reformulate Products and Standardize Portions to Meet Healthy Dietary Guidelines and Reduce Obesity and Non-Communicable Disease Risks, 2000–2018: A Scoping and Systematic Review to Inform Policy

Strategies for Reducing Salt and Sugar Intakes in Individuals at Increased Cardiometabolic Risk

Sodium content of restaurant dishes in China: a cross-sectional survey

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