Evaluation of Sodium Levels in Hospital Patient Menus

Study Questions:

Is the amount of sodium in hospital patient menus in line with current recommendations?

Methods:

Sodium content of standard-unselected menus and patient-selected menus was assessed in three acute care hospitals in Ontario, Canada (n = 1,935 beds) between November 2010 and August 2011. Menus included regular meals, diabetic, and 3000 and 2000 mg sodium-restricted meals. Assessment of patient-selected menus allowed for evaluation of variations in sodium when patients self-selected items. Other diet types including kosher and textural modifications (such as pureed) were excluded from this analysis. Nutritional analysis was conducted using manufacturer-specific data. Sodium levels were compared with recommendations for 1500 mg/day and upper level of tolerable sodium intake (2300 mg/day).

Results:

A total of 84 standard (not selected by patients) menus for the four diet prescriptions (regular, diabetic, 2000 mg and 3000 mg sodium restrictions) and patient-selected menus (633 regular, 628 diabetic, 630 3000 mg sodium-restricted, and 343 2000 mg sodium-restricted) were assessed. The majority of menus assessed were from general medical (27%), surgical (24%), and cardiology wards (20%). The mean sodium level in standard-unselected regular menus was 2896 mg. Of these menus, 100% exceeded the 1500 mg sodium recommendations and 86% were >2300 mg/day of sodium. For the diabetic menus, the mean sodium was 3406 mg/day, with 100% exceeding both 1500 mg/day and 2300 mg/day of sodium. Patient-selected diabetic menus were similar in amounts of sodium consumed. For the 2000 mg sodium-restriction menus, the mean sodium level was 2041 mg for patient-selected menus and 1504 mg for menus in which patients did not select food items. The proportion of menus exceeding the 2000 mg/day prescription was significantly higher in the patient-selected menus compared to the standard unselected menus (47% vs. 10%, p < 0.001).

Conclusions:

The authors concluded that often hospital menus exceed current recommendations for sodium content, in particular those in which the patient selects.

Perspective:

This is a very interesting study. Health care providers have urged patients to reduce sodium intake and understand the implications of processed foods, which are often high in sodium. Thus, it is interesting that in our health care institutions, we have not met current recommendations for reduced sodium, particularly with standard menus. It also appears that we need to do a better job at assisting patients to make diet selections which are consistent with a low-salt diet while they are in the hospital.

Clinical Topics: Diabetes and Cardiometabolic Disease, Prevention, Diet

Keywords: Food Habits, Canada, Ontario, Meals, Diet, Sodium-Restricted, Fast Foods, Sodium, Dietary, Menu Planning, Cardiovascular Diseases, Ions, Diet, Food Service, Hospital, Diabetes Mellitus


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