A new sodium warning requirement goes into effect in New York City restaurants Tuesday: Diners who eat at chain restaurants will now see warnings on menus next to items that contain high levels of salt.
From now on, the New York City Health Department says chain restaurants with 15 or more locations must display a salt shaker icon next to menu items or combo meals that contain 2,300 milligrams of sodium or more.
That's the recommended daily limit for sodium, but most Americans consume far more. And top contributors are foods we tend to eat when we're dining out, including pizza and deli sandwiches.
In fact, surprisingly, they're among the six most popular foods that add unexpectedly high levels of sodium to our diet, according to the American Heart Association. Store-bought bread – which many of us eat several times a day — is another big offender.
Check out this infographic, which shows that, when you add up the slices of bread, cured turkey meat and cheese, a sandwich could serve up some 1,500 mg of sodium – more than half the recommended daily limit.
The Center for Science in the Public Interest, a consumer watchdog group in Washington, D.C., has identified other meals that can be real sodium bombs, too. For instance, at Red Lobster, diners have the option of creating a combo meal of fried shrimp, french fries, a cheese biscuit, pasta and Caesar salad that has more than 6,000 mg of sodium. That's about three days' worth of sodium.
New York City is the first city in the U.S. to require a sodium warning. The rule applies to restaurants with 15 locations anywhere in the U.S. — not just in the city. Restaurants will have until March 1 to comply. After that, they can be fined.
Deputy health commissioner Sonia Angell — who is also a physician — says many people don't understand the link between excessive sodium intake, high blood pressure and the risk of heart disease.
"The majority of salt in our diet doesn't come from the salt shaker — it's already in the food when we purchase it," Angell says. That includes restaurant food. "And that makes restaurants a really important place to give people guidance about how they might be making decisions — if they choose to do so — that might protect their health and their heart."
Robin Vitale, senior director of government relations at the American Heart Association, cheered the health department's new requirement. "The American Heart Association is thrilled for the pending implementation of the Sodium Warning Label rule," she said in a statement. "Americans are consuming dangerous levels of sodium, most often found in processed or restaurant food. This rule will help to increase transparency. "
Zane Tankel, CEO of Apple-Metro, owner of Applebee's restaurants in New York City, says his company is on board.
"We want our guests to have as much information as needed to make informed decisions when dining in our restaurants," Tankel said in a statement.
KELLY MCEVERS, HOST:
It is hard to walk down the street in a big city like New York, say, and not be tempted by a slice of pizza or a deli sandwich. It turns out, foods like those are among the biggest contributors of sodium to our diets. So today, the New York City health department put in place a new rule aimed at reducing the amount of salt consumed in that city. NPR's Allison Aubrey is here to talk about the new regulation and the health risks for all Americans of consuming too much salt. Hello, Allison.
ALLISON AUBREY, BYLINE: Hi, there, Kelly.
MCEVERS: So tell us about the new rules in New York.
AUBREY: Sure, well, all chain restaurants with 15 or more locations are being told that they need to make a change to their menus and their menu boards to basically highlight items that contain a lot of salt. So if an item or a combo meal exceeds 2,300 milligrams of sodium - which is the most any of us are supposed to be eating in a given day - it will be marked with a little icon of a salt shaker right there on the menu. And restaurants are also being told to post sodium information in the spots where people order. So in a fast food restaurant, that would be the counter.
MCEVERS: So when the restaurants did this with calories - you know, I have some awareness about, like, how many calories are bad - but I don't have much awareness about how much salt is bad.
MCEVERS: How is this going to work?
AUBREY: The daily recommended limit is 2,300 milligrams a day. The typical American consumes about 3,300 milligrams a day. So it's safe to say that most Americans are consuming too much salt.
MCEVERS: OK, so if you see that salt icon, just don't get it basically (laughter). Is that the message?
AUBREY: Well, if you see it, what it means is that, hey, what you're about to eat contains as much sodium as you're supposed to be eating in an entire day.
MCEVERS: New York is the first city to put this kind of rule into place.
AUBREY: That's right.
MCEVERS: I mean, what's their motivation here?
AUBREY: Well, I spoke to the deputy commissioner at the New York City Department of Health. Her name is Sonia Angell. You'll hear from her in just a moment. And she basically says that, you know, too few people understand that too much sodium can lead to high blood pressure, which can then increase the risk of heart attacks and strokes.
SONIA ANGELL: The majority of salt in our diet doesn't come from what we're adding at the table. It's not coming from the salt shaker. It's already in the food when we purchase it. That includes restaurant foods, and that makes restaurants a really important place to give people guidance and understanding about how they might be making decisions, if they choose to do so, that might protect their health and their heart.
AUBREY: Now, I should say it's not clear at all that these sodium warnings will have an immediate effect. I mean, you don't just change people's behavior overnight.
AUBREY: But the health department hopes that people will, you know, kind of stop and think about how much salt they're consuming.
MCEVERS: Do they think people are going to be surprised? I mean, we know that French fries are salty, right...
MCEVERS: ...But like to see other dishes that have the little icon.
AUBREY: Absolutely. Some of the surprising foods that add the most sodium to our diets include pizza, soups, the cold cuts and cured meats on deli sandwiches. In fact, the American Heart Association says these are part of the surprising salty six. I'm looking at an infographic here of a deli sandwich, and once you add up the salt in the bread, the cheese, the slices of turkey, you're easily up to about 1,500 milligrams of sodium, which is more than half of the daily recommended limit. Now, if you were in New York City and you order this sandwich with, say, chips and a pickle as part of a combo, that likely adds up to this 2,300 milligrams. So you're going to see that little salt shaker warning.
MCEVERS: Yet another thing that we have to watch out for, thanks.
AUBREY: (Laughter) Sorry about that, Kelly.
MCEVERS: That's NPR's Allison Aubrey, thank you.
AUBREY: Thank you. Transcript provided by NPR, Copyright NPR.