In an effort to help prevent heart attacks and strokes, New York City health officials are coordinating a program called the National Salt Reduction Initiative (NSRI): the goal is to reduce the amount of salt used in packaged and restaurant foods by 20 percent over five years nationwide.  Based upon a program established in the United Kingdom, the NSRI website notes that Canada , Australia, Finland, France, Ireland, and New Zealand have also launched public policy initiatives to reduce the amount of sodium that people consume.

“Public Policy versus Freedom of Choice” or Does it Boil Down to the Economics?

As I read through the list of participatory countries, it occurs to me that all of the other countries [listed in the sodium reduction collective above] provide universal healthcare to their citizens. Are all of these developed nations investing in salt reduction public service announcements and programs because they foresee a tipping point and healthcare crisis? Clearly, the healthcare impact/cost projection numbers have been run because the spend and programs are concrete (this includes the World Health Organization).

On the flip side, here in the US, capitalism drives our economy; most people (and/or employers) pay for their own healthcare and medications (or insurance, co-pays, and out of pocket deductibles).  Interestingly enough, many people who are upset with the NSRI cite their concerns of government intervention and limiting their freedom of choice — but is there more to the equation?  After all, we live in a free society: in theory, people could order their meals “with extra salt” (similar to how we can order food “extra hot/spicy”), or simply pull out the salt shaker and go to town.  For the universal healthcare countries, are these healthy eating initiatives more about limiting social (impact from disease) and economic damage, and less about limiting people’s choices?

While the NSRI initiative is great news for people who regularly eat low sodium foods, I suspect that reducing $alt in American restaurant kitchens is causing a ripple of discontent for another rea$on – the economic reality of implementing the changes.  Taking “limiting consumer choice” and government intervention off the table (remember, I’m a low sodium convert by choice and not by requirement – so this is a “tough love” approach), the fight to limit sodium dietary intake boils down to dollars and cents.

A salt reduction program throws a short (and potentially mid) -term wrench into manufacturer and restaurant profit margins:

• Sodium is a very low cost alternative to “flavor” (or preserve) food: it costs more to make foods by flavoring with low sodium spices and seasonings.
• Recipe reformulation, consumer testing, re-packaging, and rebranding costs a lot of (non budgeted) money.
• Internal training costs are increased because staff need to learn new skills
• Consumer adoption can be slow; if customers don’t like the new formulations/higher costs, customer (volume) purchases or line profitability can be impacted or newly reformulated product lines abandoned entirely.
• For restaurants, it may mean having to use higher quality cuts of meat (because lower cuts of meat can’t be quickly tenderized using salt), better ingredients, and/or the staff may require more time to prepare the dish; all of these components increase the total cost per serving — the cost increase is either offset by lowering profit margins or increasing prices.

Whether or not you agree with (or want to wait for) the NSRI initiatives to be implemented, if you follow a low sodium lifestyle, you probably already know that eating low sodium at a restaurant can be tricky at best.

Notwithstanding public policy, I like to think that my wallet speaks volumes.

Below, we’ve included some low sodium dining tips [that we use] and a list of ways that restaurants commonly use salt in food preparation or cooking.

Eating Out: Low Sodium Restaurant Dining Tips

• When eating out and high sodium intake is of concern, consider calling the restaurant (or hotel concierge) well in advance to discuss your specific low-sodium dietary needs.
• Busy restaurants typically have a day crew that preps most of the food for each station/line that evening.  Consider reviewing the list below (Ways Restaurants Use Salt), or look at our list of high sodium foods if you are unsure of ways that salt sneaks onto the menu.
• We’ve had better luck negotiating lower sodium meals at smaller, boutique, or independent (no chain) restaurants that bill themselves out as
• “make to order”,
• “locally sourced food”,
• “sustainable foods”, and
• “slow food” establishments.
• We follow up with the restaurant right before our visit and confirm our requests with restaurant staff at different times throughout the course of our dinner (ordering, when food is served, etc.).
• Here are some (typically) low sodium dessert options: consider fruit, sorbet/sherbert, ice cream, and frozen yogurt as potential low sodium dessert alternatives.

 

A List of Ways Restaurants Can Use Salt

In case you need some negotiating information, here are some of the more popular ways that many restaurants can use salt to prepare and cook foods:

- aging meat

- breadcrumbs

- brining solutions (i.e., soak the meat in a salt water solution prior to cooking)

- crushing garlic (from minced, they will add salt during the final step)

- desserts/baking: baking soda, baking powder, cream of tartar, salt

- salting boiling water; pre-cooking vegetables (blanching); cooking grains/pastas

- seasoning fish/meats/vegetables (or tenderizing lower priced cuts of meat to make them more food friendly)

- stocks: salt or high sodium products (such as pancetta, ham hocks, etc) used in stocks

- toasting nuts

- pancetta wrapped around fish (sometimes done as part of the prep)

Check our favorite low sodium recipes that parallel DASH (Dietary Approaches to Stop Hypertension) food groups — a fun inspiration!

Shockingly on average, people in the US consume somewhere in the neighborhood of 3,500 milligrams of sodium/day. The DASH diet information on the National Heart Lung and Blood Institute website is presented in a simplified format so that the goals of healthy eating and reduced sodium consumption (from 3,500 to the neighborhood of 2,400 mg sodium/day) can be quickly understood. Dash’s guidelines advise “people who have high blood pressure, African Americans, and middle-aged and older adults to aim for no more than 1,500 mg of sodium per day”.

Armed with our list of individualized list of low sodium foods (we consulted with our integrated healthcare provider team to derive our own individual list), it’s important to keep in mind that our own low sodium foods and goals may differ from yours.   We’ve included a short list of our favorite recipes and posts, which parallel some of the Dash Diet Food food groups.

Grains.
Quiona is one of our favorite grains: we blogged about it earlier this year, having stumbled across it on our trip to Peru.

Some quinoa recipes we’ve prepared were: Quinoa Stuffing

Peruvian Lemon Chicken Soup, Quinoa & Potatoes

If you’re looking for something more North American, try our Homemade Orange-Vanilla, Cranberry and Pecan Granola (or Granola Bars)

 Vegetables and Fruits – our new passion.

Low Sodium Basil Pesto Basil pesto is one of our “staple” recipes, it’s regularly kept under a layer of olive oil in our fridge – and is a great way to cook up an easy pesto dinner, chicken, salmon, or perk up a panini, pizza, or tomato sauce.  Versatile and easy — it’s key!

Roasted Tomato Sauce Oven roasting the tomatoes helps to bring out the sugar and brings the flavors to a whole new level.  If you’re looking to re-purpose recipes, you may want to consider that your cooking techniques may require a little “upgrade” as you’ll want to squeeze that extra bit of flavor out of each key ingredient.

Roasted chiles are also sublime and add a lot of flavor.  They can be stuffed or diced up and used in a stew.

Fresh Figs, Mascarpone Cheese, Honey & Walnuts Recipe – Quick and Yummy! A healthy way to keep your taste buds entertained is to eat strongly flavored fruits.  Figs have deliciously strong flavors, and a small dab of mascarpone cheese helps to balance the flavor.

Fat Free or low-fat milk and milk products – we don’t really eat much “dairy”; it’s an individual lifestyle choice for us.

Garlic Aoili is always a fun way to add a “zing” to a dish, or used as a dip for artichokes:

For warmer weather, we love our  lavendar r-ice cream recipe

Lean meats, poultry and fish

From time to time, we’ll eat “lean meat” (mostly, red meat has been taken out of the equation for us).  More often than not, we’ll eat fish or poultry.

Simply Tasty: Chicken with Grilled Pineapple Salsa and a Balsamic Vinegar Reduction Sauce

Tasty Fish (and Shrimp) Ceviche Recipe Inspired by our trip to Peru, we came home and created this ceviche recipe.  We tested this out on  an unsuspecting set of dinner guests (3 kids, 3 adults), all of which quite happily chowed it down! Given the glimmer of clean plates, we don’t think they missed the fact that the sodium went missing — otherwise, there would have been “left overs”!

Easy Salmon Recipe

Fats and Oils – we try to stay away from the “bad” fats: saturated fats, cholesterol, and trans.  We’ll often use olive oil or grape seed oil

We tend to snack on unsalted (roasted or raw) nuts and seeds, and we’ve reduced our sweets and added sugars consumption.

Happy DASHing!