A study released on July 16 in the Archives of Internal Medicine examines sodium consumption for hospital patients — an angle that has not previously been researched extensively. "Guidelines for lowering sodium levels in hospital settings have recently been published but largely focus on consumer food service outlets rather than on foods served to inpatients," the authors point out. Given the vulnerability of most hospitalized patients, understanding in hospital sodium consumption for this population is essential to ensuring smooth recovery and improved health outcomes. Therefore, the authors aimed to study popular inpatient menus to assess if they are meeting widely accepted sodium recommendations.

The study looked at "standard-unselected menus and consecutive patient-selected menus for regular, diabetic, and 3000- and 2000-mg sodium-restricted diet prescriptions at three acute care hospitals in Ontario Canada (N=1935 beds)" between 2010 and 2011. According to the study, "sodium levels in regular and diabetic menus were compared with the adequate intake (AI) level 1500 mg/d and the tolerable upper level (UL) of 2300 mg/d." Twenty-seven percent of menus were in the general medical department, 24 percent of menus were in the surgical department and 20 percent of menus were in the cardiology department. Included in the analysis were "84 standard-unselected menus for the four diet prescriptions and 633 regular, 628 diabetic, 630 3000-mg, and 343 2000-mg sodium patient-selected menus."

Additional Resources CardioSmart for Your Patients: Healthy Eating Fact Sheets CardioSmart for Your Patients: The Truth About Sodium Guidelines

According to the author commentary, "hospital patient menus contain excessive levels of sodium: 86 percent of regular and 100 percent of diabetic standard-unselected menus exceeded the UL of 2300 mg of sodium, and 100 percent of these menus exceeded the AI of 1500 mg." While the sodium intake in the two controlled diet groups tended to fall within the recommended levels, about half of the patients in the 2000-mg group who self-selected their menus exceeded the recommended levels. "This observation could have important clinical implications given the therapeutic necessity of sodium restriction in conditions such as decompensated heart failure," the authors noted.

 

The results of the study indicate that heavily processed foods constitute a significant portion of food listed on hospital menus, a scenario that mirrors a wide-spread trend in the U.S. food system. Based upon these findings, the commentary highlighted "the need for sodium-focused food procurement and menu-planning policies to lower sodium levels in hospital patient menus."

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