Food manufacturers and chain restaurants continue to increase the amount of sodium in their foods to dangerously high levels. Growing concern about the salt in processed and restaurant foods and the lack of industry concern over the health of the American people has led advocates to consider new ways to encourage the food industry to lower the salt in processed food. In this report, CHW describes two distinct efforts: a national initiative started by the New York City Department of Health in April 2009 and a class action lawsuit filed in July 2009 against Denny’s by the Center for Science in the Public Interest (CSPI), an organization with a long history of advocating for stronger policies involving salt content in processed foods. We also describe the recent voluntary action taken by Campbell Soup Co. in July 2009 to lower the sodium content of one of its best-selling products, tomato soup, so that it meets recommended guidelines.
More than 25 years ago, the Food and Drug Administration’s Dietary Sodium Initiative called on the food industry to voluntarily reduce sodium levels in processed foods. However, since that time, food manufacturers and chain restaurants have continued to increase the amount of sodium in their foods to dangerously high levels. Indeed, at some of the nation’s largest chain restaurants, the amount of salt in a single meal is often more than two to three times higher than the recommended daily allowance for sodium. For most Americans, this means an increased risk of high blood pressure, heart attack, and stroke in the long-term, all leading causes of death among U.S. adults. For some, particularly the elderly, consuming several days’ worth of salt in a single meal may be enough to trigger congestive heart failure.1 In a recent news story, pediatric urologists and nephrologists also attribute the sharp rise in kidney stones in children to increased salt intake, particularly from highly processed, high-salt, high-fat foods.
Growing concern about the salt content in processed and restaurant foods and the lack of industry concern over the health of the American people has led advocates to consider new ways to encourage the food industry to lower the salt in processed food. In this report, Corporations and Health Watch describes two distinct efforts: a national initiative started by the New York City Department of Health in April 2009 and a class action lawsuit filed in July 2009 against Denny’s by the Center for Science in the Public Interest (CSPI), an organization with a long history of advocating for stronger policies involving salt content in processed foods. We also describe the recent voluntary action taken by Campbell Soup Co. in July 2009 to lower the sodium content of one of its best-selling products, tomato soup, so that it meets recommended guidelines.
How much sodium is safe to consume? For most adults, no more than 1,500mg daily
According to the Institute of Medicine, children aged 4-8 should consume no more than 1,200 mg of sodium per day. Guidelines issued by the Centers for Disease Control and Prevention, suggest that 69% of the adult population – those over age 40, African Americans, and those with high blood pressure – should consume no more than 1,500 mg daily. And for the third of American adults who do not fit into those high-risk categories, the upper limit of sodium intake is around 2,300 mg. More than three-quarters of the sodium that Americans consume comes from processed and restaurant foods; approximately 12% is naturally occurring in foods such as dairy products; about 5% is added during preparation at home; and only about 6% is added at the table.
Exactly how much sodium is present in chain restaurant foods?
Not only do many restaurant chains add dangerous levels of salt to their products, they often do their best to hide the amount of sodium that is present. This information is hidden on websites to which many customers lack access, and despite the best efforts of consumer advocates, these restaurants have repeatedly refused to disclose this information voluntarily to customers on menus. In other cases, the tables used to determine sodium and caloric content are difficult for the average customer to interpret. A sample of popular items for adults and children, taken from a recent press release by CSPI reveals the high amounts of salt that is typical in today’s chain restaurants:
- Chili’s Honey-Chipotle Ribs with Mashed Potatoes with Gravy, Seasonal Vegetables, and a Dr. Pepper soda has 6,440 mg, or 429% of the advised daily limit for most U.S. adults
- Olive Garden Chicken Parmigiana with a Breadstick, Garden Fresh Salad with House Dressing, and Raspberry Lemonade has 5,735 mg, or 382% of the advised daily limit for most U.S. adults
- Children’s menu at KFC: Popcorn Chicken with Macaroni and Cheese, Teddy Grahams, and 2% milk has 2,005 mg, or 167% the advised daily limit for children
- Children’s menu at Red Lobster: Chicken Fingers, Biscuit, Fries, Raspberry Lemonade has 2,430 mg, or 203% of the advised daily limit for children
What can be done to encourage the food industry to reduce the amount of salt and disclose the amount of salt to their customers?
Three recent examples illustrate the range of strategies for that are being used to reduce salt in processed food.
NYC Department of Health launches nationwide public health campaign to cut the salt in restaurants and processed foods
Some public health departments have begun campaigns to encourage chain restaurants to reduce the amount of sodium in their foods and to disclose the amount of sodium in their products to consumers. The New York City Department of Health’s Cardiovascular Disease Prevention division launched a national campaign in April of this year with the support of numerous public health departments across the country and organizations such as the American Medical Association, the American Public Health Association, the American College of Epidemiology, and the American College of Cardiology. According to a campaign press release, “The initiative calls on food industry leaders to help develop, and then adhere to, sodium targets for all products, using categories such as breads, breakfast cereals and prepared entrees. The goal is to achieve substantial, gradual reductions in salt levels across a wide range of foods.” In New York City alone, more than 750,000 people are at increased risk of heart attack and stroke because of uncontrolled high blood pressure. Nationwide, it is estimated that a 50% reduction in salt in processed and restaurant foods could prevent 150,000 premature deaths each year. In a fact sheet, the campaign describes in greater detail the strategy of “Working with the food industry to set salt reduction targets that are substantial, achievable, gradual, and measurable.” In addition, the campaign seeks to educate consumers about the dangers of salt and hypertension in publications such as “Cut the Salt! And lower your blood pressure and risk of heart attack and stroke” [pdf].
Campbell Soup Co. adopts a new strategic priority: the reduction in sodium in hundreds of its products
In late July 2009, approximately three months after the start of the national health campaign described above, Campbell Soup Co. announced that it would voluntarily reduce the amount of sodium in one of its best-selling products, tomato soup, which it has been producing for 62 years. The new formulation meets federal nutritional guidelines for sodium because it contains 480 mg or less of sodium per serving. Instead of relying on excessive amounts of sodium to enhance the flavor of its tomato soup, the company says that it is experimenting with different varieties of tomatoes and other flavorings.2
According to executives in the company, cutting sodium across hundreds of its products is now a top strategic priority.2 Denise Morrison, president of Campbell Soup North America, has said “We hope it’s the biggest change you never notice.” 2 The company says that it has test-marketed the newer formulation of its soup in all 50 states, and most people say they do not miss the salt or that they like the new formulation better.2 This is precisely the type of positive action by the private sector that the national campaign started by the New York City Health Department seeks to achieve.
A class action lawsuit is filed against Denny’s by CSPI
In July 2009, the Center for Science in the Public Interest filed a class action complaint in New Jersey against Denny’s Corporation. Denny’s is a corporation that in 2008 had more than $648 million in company restaurant sales in its more than 1,500 restaurants across the country. The goal of the suit is to compel the restaurant corporation to disclose the amount of sodium in its meals, and to provide customers with a warning concerning the safety of high-sodium food. CSPI met with Denny’s Corporation lawyers initially in an effort to convince Denny’s to lower sodium content in their meals. It became clear, however, that the corporation was not willing to cooperate with this request.3 According to a Public Citizen blog entry, “We chose to contact Denny’s as the first (but not, we suspect, the last) restaurant chain to face a lawsuit for it’s wrongdoing because, as best we could tell, Denny’s is Public Health Enemy Number One when it comes to sodium. Denny’s admitted, when we first met with its lawyers, that it knew that excess sodium was a problem for Americans, and that its meals contained astronomically high levels of sodium. This is a classic consumer protection lawsuit, no different from a suit against a used car dealer who sells a car with 200,000 miles, but with the odometer disconnected. What we seek is simple – a court order forcing Denny’s to do what it should already be doing: Warning of the risks of high-sodium meals and telling its customer’s just how much sodium they get when they eat at Denny’s. That way, folks can decide whether or not to risk their lives by eating Denny’s meals.”
The complaint highlights the fact that “at least 75 percent of Denny’s meals contain more than the maximum amount of sodium most Americans should consume in an entire day.” Below are some menu items CSPI listed in its complaint against Denny’s.
A: Moons Over My Hammy: A ham and scrambled egg sandwich with Swiss and American cheese on grilled sourdough served with hash browns has 3,230 mg sodium, or 215 percent of the advised daily limit.
B: The Super Bird: A turkey breast sandwich with melted Swiss cheese, bacon strips and tomato on grilled sourdough served with French fries has 2,610 mg sodium, or 174 percent of the advised daily limit.
C: Double Cheeseburger: Two beef patties and four slices of American cheese with lettuce, tomato, pickles, and red onion served with French fries has 4,130 mg sodium, or 275 percent the daily limit.
D. Spicy Buffalo Chicken Melt: A fried chicken breast covered in a buffalo sauce with lettuce, tomato, and Swiss cheese on ciabatta bread with a garlic spread served with French fries has 4,120 mg sodium, or 275 percent of the advised daily limit.
E. Super Grand Slam Slamwich: Two scrambled eggs, sausage, crispy bacon, shaved ham, mayonnaise, and American cheese on potato bread grilled with a maple spice spread served with hash browns, and two pancakes has 5,690 mg sodium, or 379 percent of the advised daily limit.
On July 23, 2009 Denny’s responded to investors regarding the class action complaint in a. in which the company reassures investors that it will fight CSPI’s lawsuit aggressively in court, claiming the suit is “without merit.” The company points to a new menu for health-conscious consumers Better for You introduced in June 2009.
However, CSPI defends its legal action. Said Michael F. Jacobsen, CSPI’s Executive Director, “Who knows how many Americans have been pushed prematurely into their graves thanks to sodium levels found in Olive Garden, Chili’s, and Red Lobster? These chains are sabotaging the food supply.” 4
The new national campaign begun by the New York City Department of Health shows that reducing the amount of salt that people consume requires action by individuals, governments, and the private sector. Individuals can learn about how to monitor and reduce their salt intake, but chain restaurants such as Denny’s that serve customers dangerously high levels of sodium and fail to properly disclose salt content to customers make this task much more difficult.
By their recent action, the New York City Department of Health and the Center for Science in the Public Interest demonstrate two complementary and reinforcing strategies to encourage the food industry to make it easier for their customers to avoid dangerously high levels of salt. Campbell Soup Company’s decision to hold the salt in its tomato soup shows that the processed food manufacturers can find innovative ways to reduce the salt content of its products so that they meet federal guidelines, without necessarily sacrificing taste. By pursuing multiple strategies to lower salt in processed food, health advocates can help lower the burden of salt-related chronic diseases.
By Lauren Evans, doctoral student in public health at City University of New York.
1 CSPI press release dated 7/23/09. Unsafe sodium levels at Denny’s prompt class action lawsuit. http://www.cspinet.org/new/200907231.html. Accessed September 3, 2009.
2 Downing J. Campbell takes a gamble, cuts salt in tomato soup. The Sacramento Bee. August 20, 2009. http://www.sacbee.com/161/story/2124138.html?storylink=lingospot_related_articles. Accessed September 3, 2009.
3 Activist group sues Denny’s over sodium levels. July 23, 2009. http://www.reuters.com/article/healthNews/idUSTRE56M4J320090723. Accessed September 3, 2009.
4 CSPI press release dated May 11, 2009. “Heart Attack Entrees with Side Orders of Stroke”
src=”uploads/images/old_archives/img/clip_image005_0000.gif” border=”0″ alt=”blank2″ width=”1″ height=”5″ />Overly Salty Restaurant Meals Present Long-Term Health Risks for All, and Immediate Danger for Some. http://www.cspinet.org/new/200905111.html. Accessed September 3, 2009.