How much salt is in your fast food order?

Way too much, according to a recent study by Johnson and colleagues, published in the Archives of Internal Medicine.

Personally, I love salty foods. While I have never been too fond of sweet things (chocolate, candy, etc.), just a few years ago I could have easily gone through a bag of chips or pretzels in one sitting. Just writing about that crunchy/salty goodness makes my mouth water.

However, since hypertension runs in my family, I have recently made a concerted effort to limit my sodium intake - largely by cutting out my intake or salty snacks. This process was made that much easier by living with a partner who is doing PhD research on the effects of salt intake on blood pressure, among other things. She got on my butt to limit my salt intake, while I got on hers to limit her intake of sugar - as diabetes runs in her family.

Regarding dietary sodium limits, it is suggested that adults stay under 1500 mg per day, and should never exceed the upper limit of 2300 mg/day.

Unfortunately, as a population, the large majority of North Americans consume considerably more than the upper limit of sodium every single day (~80% of men and women). Given the well established effect of sodium intake on health (check this great resource for more info on salt and health) this collective hyper-salinity of our diet is contributing to high rates of cardiovascular problems.

So where's the excessive salt coming from?

That's where the recent study comes in.

In this trial, meals bought from 300 randomly selected chain restaurant locations in New York City during the weekday lunch hour between March 27 to June 8, 2007 were assessed for salt content. A meal was defined as any purchase with at least 1 entrée.

The main findings?

  • 56% of meals purchased at fast food outlets contained more sodium than should be consumed during the entire day (>1500mg), with 20% of meals exceeding the uppermost limit for daily sodium intake (>2300mg)
  • Chicken fast food places tended to have the worst sodium levels per meal with 83.8% of meals exceeding the daily recommended level (1500mg)
  • Only 1 in 36 purchased meals met the Food and Drug Administration "healthy" sodium level for meals (600 mg)
  • The high sodium intake wasn't necessarily driven by a high calorie intake, but rather by a high sodium per calorie ratio, with an average of 2136 mg sodium per 1000 calories purchased. Thus, even those eating lower calorie meals were likely to exceed their daily sodium limit within a single meal.

Take home message:

Stay the hell away from fast-food outlets!

And if you have absolutely no choice but to eat fast food (never the case), at the very least avoid fried chicken places such as KFC and Popeye's.

Peter

Johnson CM, Angell SY, Lederer A, Dumanovsky T, Huang C, Bassett MT, & Silver LD (2010). Sodium content of lunchtime fast food purchases at major US chains. Archives of internal medicine, 170 (8), 732-4 PMID: 20421561

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I attempted a relatively low sodium diet for a week and found it quite difficult, even without eating at fast food places. Nearly any processed food is loaded with sodium. Couple that with my love of cheese and it was a deadly combination. I made it, but just barely!

You are rigth, but some days I need to recover the crapalogical equilibrium of my body and need a good cheesburger with everything, including a sugar loaded soda, expresso coffee with sugar and dessert with more real sugar. Just once in a month.
Thinking about this, I realized I haven't eaten bacon in months!!
It is one of the pleasures of life to be able to eat delicious junk food without clogging your arteries. How: exercise and few, but special junk food sessions.

Is there any data at all suggesting sodium intake is bad for those with obnoxiously low blood pressure (e.g. 80/40 and dizzy when standing up)?
I always ignore advice to avoid sodium since my bp is generally low, but I don't know if there are any other health outcomes I could be tempting fate with.

I'm not sure why just fast food is being singled out. All restaurant chains serve food that is high in fat (lots of butter) and salt. Yes, even the veggies.

I have to ask them not to put salt and butter on my "healthy" veggies...sad, but true.

Ken, my guess is because it would be too hard to segment the restaurants into any grouping that would make logical sense. Fast food is a pretty defined concept and you also have fewer choices and combinations of foods as compared to most other sit-down type restaurants.

This was an important topic to highlight as many people completely gloss over the sodium contents and look strictly at the calories and fat content. In fact, I was at a Panera that had the calories and fat listed on their menu behind the registers, but no sodium data.

There's more to sodium than the taste. Consider the salt in a small bag of salted peanuts, a small bag of french fries, a regular hamburger, and a bran muffin from starbucks. In milligrams: 110, 160, 350 (of which 250 is the bun), 650. At least last time I checked, and it does vary somewhat. Oh,here's a good comparison: a flour tortilla: 275. A corn tortilla: zero. I have to do this kind of comparison all the time as a caregiver for someone with impaired kidney function and hypertension.

Yeah, doug, that makes sense - leavened baked goods have sodium in them not only from sodium chloride (table salt) but from baking soda (sodium bicarbonate) or baking powder (which usually contains baking soda and often contains additional sodium compounds.) Flour tortillas are leavened but corn tortillas aren't.

I was always told in my exercise phys classes that only about 20% of us are sensitive to sodium intake with regards to hypertension. Not so?

A whole lot of the salt in fast food is there because it is frozen prepackaged processed stuff. When you've processed the food to the point that it's freezer stable to ship all over the country and ready to cook on order each day you hafta pump it full of salt so that it will taste like anything at all.
I would expect most of the big chain sit down places like TGI Fridays and Chili's and such suffer from similar problems.

If you must get fried chicken (and imho one must get fried chicken at some point) seek out a soul food joint where they make the chicken fresh each day. Or make it yourself, fried chicken keeps great as cold leftovers.