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Putting the pinch on salt: As FDA prepares new guidelines to reduce sodium in food, local dietitians, restaurant reps try to balance customer tastes, nutritional concerns

Salt can be hidden in many foods that consumers don’t expect. Dave Wallis / The Forum

FARGO – Elizabeth Meyer’s patients get a pat on the back if they take the salt shaker off their tables – even though it probably won’t do much to reduce the sodium in their diets.

“That’s just not even where we’re getting the majority of it from,” said Meyer, a registered dietitian at Sanford Health in Fargo.

Even if they don’t think the processed foods and restaurant meals they eat taste salty, chances are there’s hidden sodium in many of the items they crave – bread, pizza and soup are major sources, she said. And patients are often shocked when Meyer explains that most breakfast cereals and instant oatmeal packets can be unexpected salt mines.

“It just seems like everything absolutely has sodium in it,” she said.

Now, the U.S. Food and Drug Administration plans to try to address the issue – and the fact that Americans are consuming much more sodium than recommended, putting themselves at risk of high blood pressure that can contribute to other medical woes.

The agency’s officials have said in recent months that the FDA will release voluntary guidelines calling on food manufacturers and restaurants to make its products less salty, potentially saving lives and boosting overall health.

But there’s no clear picture yet of what those guidelines will look like or when they will be issued, or how long the FDA will give the industry to gradually reduce sodium so the public can adjust to the less-salty taste over time.

The issue has prompted discussion among restaurant owners and operators for years, according to Dan McElroy, president and CEO of Hospitality Minnesota, which represents the state’s restaurants, hotels, resorts and campgrounds.

“But the FDA guidelines are one thing, and market preferences are another,” he said.

Some eateries have already taken steps to reduce the amount of salt in their food, McElroy said, as employees are increasingly asked by guests about the salt content of menu items. Still, he said it’s not so easy to cut the sodium out of some foods that traditionally have a salty flavor – French fries and onion rings, for example.

“When I talk to members about this, they say, ‘We want to provide customers what they want,’ ” he said. “What they want isn’t always the healthiest.”

Hard habit to break

Experts recommend a daily consumption of 1,500 to 2,300 milligrams of sodium – the equivalent of about two-thirds of a teaspoon, Meyer said. Instead, the average American is getting more than 3,000 milligrams each day.

Sodium is a necessary part of a proper diet, she said, because a small amount is needed to help maintain normal blood pressure and muscle and nerve function. But too high of an intake can raise blood pressure beyond healthy levels, leading to strokes and other problems.

“I personally think it’s one of the hardest things to change to try to cut it out because we’re so used to it being in everything,” she said.

Lindsay Vettleson, a licensed registered dietitian with IMA Healthcare in Fargo, said sodium isn’t the “top of the line thing” that most concerns the field about our overall nutrition. We do consume too much, she said, but some people are more sensitive to it than others – while reducing sodium intake will dramatically reduce one person’s blood pressure, another might not see any difference, even after changing their diet.

“It’s kind of a trial and error,” she said.

Still, Vettleson said it’s a worthy first step by the FDA to tackle our addiction to salt – even if we don’t always know how much we’re getting in our favorite foods.

One menu item at Applebee’s restaurants, for example, would probably surprise the average diner. The chain’s four cheese macaroni and cheese with honey pepper chicken tenders contains 4,300 milligrams of sodium, she said, and even most of its Weight Watchers menu items have 2,000 or more milligrams.

Salt is so common in restaurant meals and processed foods, Vettleson said, because it’s a cheap flavor enhancer and preservative – which is why many diet foods will add extra sodium to make up for a loss of flavor as they cut out fat and calories. Consumers also tend to like the salty flavor that they’re used to, she said.

“The thing is about these restaurants, they really have to be creative,” she said. “If they’re cutting out the salt, that’s cutting out some flavor, so they might have to be more creative of how are we going to make this more flavorful.”

The answer often is finding a new combination of herbs and spices that will boost the flavor profile of a food without relying on as much salt, she said.

Striking a balance

Dave Scheer, who co-owns several restaurants in the region, including Thai Orchid, Drunken Noodle and the Beefsteak Club, said his employees don’t get many questions from diners about sodium. Still, he said most probably realize it’s a health issue, or have been told by their doctors to watch their salt intake.

“I think it’s in the background of people’s minds, but they never really think to ask, ‘What are you doing to get rid of sodium?’ ” he said. “It’s mostly a, ‘Well, the food doesn’t taste too salty, so I don’t know what I’d want you to do to it to take the sodium out.’ ”

Scheer said it seems like a difficult task for the FDA to regulate this – especially to try to apply the rules to every restaurant, whether it’s a small one-person café or a large chain – and said it makes sense for the agency’s new guidelines to be voluntary.

If a restaurant embraces the effort and can find a way to make less-salty food that tastes good to its customers, it would have a good marketing tool that could help boost business, he said. Still, Scheer said he’s not going to lock up the soy sauce bottles and salt shakers, and moderation is a better approach than an outright ban on the flavors that we tend to enjoy.

“It’s really a question of what is our country about,” he said. “Do we want to give people choices, or do we really want a government big enough (that) they can come down and regulate how much salt’s in your salt shaker?”

The food industry has already made some progress in cutting sodium levels of many of its menu items, according to Rudie Martinson, executive direction of the North Dakota Hospitality Association.

But the limited availability of tasty, healthier replacement products – and strong customer demand for food that often contains high sodium levels – means it’s a careful balance for the restaurants that want to make options available but not be forced into drastic, unpopular changes.

“I think a voluntary guideline is absolutely the appropriate way to approach it,” he said.

Ryan Johnson

Ryan Johnson has been a Forum reporter since 2012 and previously wrote for the Grand Forks Herald.

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