Who is the saltiest one of all?

Think all fast foods are created equal? If you’re enjoying them in North America, you could be consuming two to three times more salt than if you ate the same foods from the same restaurant chain in another country, reveals a new study published in the Canadian Medical Association Journal (CMAJ). The findings call into question industry claims about obstacles in reducing the sodium content of some of our favourite foods.

Why is this issue important? We know too much sodium in our diets is bad for us: it’s a known contributor to high blood pressure, which is a risk factor for a whole host of chronic issues. Over time, high blood pressure can damage the arteries, the heart, kidneys and even the brain — including complications like stroke and dementia, according to the Mayo Clinic. That’s why experts advise healthy adults to limit their consumption to 2300 mg of sodium each day — that’s about 6 g of salt — or as low as 1500 mg for people at risk for certain conditions.

We also know the biggest threat isn’t the salt shaker: it’s the sodium added to the processed foods we grab at the grocery stores or the meals our favourite restaurants and fast food chains serve up. Worse yet, people are consuming more and more of these prepared foods.

Many restaurant chains have voluntarily committed to reducing sodium content in their foods, but often point the finger at food production issues — that is, how the food is formulated and produced — as standing in their way. If that’s the case, you would think the food served at a McDonald’s in France would have the same nutritional content as the food served at a McDonald’s in the U.S.

To test these claims, an international team of researchers from Australia, Canada, France, New Zealand, the United Kingdom and the United States analyzed the salt content of over 2100 foods offered by six major companies all operating in their home countries. The chains under the microscope? Burger King (known as Hungry Jack’s in Australia), Domino’s Pizza, Kentucky Fried Chicken, McDonald’s, Pizza Hut and Subway. Products were divided into seven categories: savoury breakfast items, burgers, chicken products, pizza, salads, sandwiches and French fries.

How did they find this information? The same place you or I can read it: on the nutritional information section of the companies’ websites. Researchers compared items among companies as well as among a given company across the various countries.

What researchers discovered

As you’d expect, the sodium levels in different categories varied among different companies. For example, the mean salt level in sandwiches was 70 per cent higher at Pizza Hut than at Subway, reports the study.

However, more important are the differences found between countries. Any guesses which ones had the highest levels of sodium in foods? Experts say foods in North America have significantly higher levels of sodium than the comparable products in the U.K. and France, among others.

For example, restaurants in Australia and New Zealand had the lowest rates of sodium in savoury breakfast items while the U.S. had the highest — a difference of 1.1 g of salt versus 1.8 g of salt per 100 g serving. (If that number doesn’t sound significant, remember that the daily limit for healthy adults is 6 g of salt.)

Even more troublesome is the difference among products marketed with the same name. For instance: In Canada, McDonald’s Chicken McNuggets contained two and a half times the amount of sodium as in the U.K — about 600 mg sodium (1.5 g salt) per 100 g serving compared to 240 mg sodium (0.6 g salt) per 100 g in UK.

“We saw marked variability in the reported salt content of products provided by major transnational fast food companies,” writes Dr. Norman Campbell, University of Calgary, with coauthors in the CMAJ article. “… Although some differences are to be expected on the basis of the different types of foods served, there is a clear opportunity for widespread reformulation of products toward the lower end of the range of salt content for most categories. Technical feasibility is unlikely to be an issue for product renovation.”

In other words: if some companies in some countries have found ways to reduce sodium in their foods, why can’t others follow suit?  One answer could lie in a lack of government regulation.

“Canadian companies indicate they have been working to reduce sodium but the high sodium in these foods indicates voluntary efforts aren’t working,” states Dr. Campbell. “These high levels indicate failure of the current government approach that leaves salt reduction solely in the hands of industry. Salt reduction programs need to guide industry and oversee it with targets and timelines for foods, monitoring and evaluation, and stronger regulatory measures if the structured voluntary efforts are not effective.”

In other words: it is possible to reduce sodium in prepared foods — and the government should be doing something about it since industry isn’t doing enough, say experts. Reducing the sodium in these commonly enjoyed foods could lead to significant benefits down the road.

Canada versus the U.S.

We know you’re curious — how does Canada measure up to the U.S.? Does our fast food have less salt?

The answer: Yes… and no. It all depends on the category. The study found the U.S. had higher levels of salt in savoury breakfast items (1.8 g/100 g versus 1.5 g/100 g), chicken products (1.8 g.100 g versus 1.6 g/100 g) and pizza (1.7 g/100 g versus 1.6 g/100 g) than in Canada. When it comes to burgers, the two countries were equal.

However, before we crow too loudly over our neighbours to the south, the balance shifted in the remaining three categories. When it comes to foods that appear to be on the healthier side, Canadian companies are loading up the salt. Both sandwiches and salads have higher salt content — (1.4 g/100 g versus 1.2 g/100 g and .8 g/100 g versus .5 g/100 g respectively). Again, while these numbers may sound small, remember they’re significant when you look at them as percentages — and when you factor these small servings into the daily limit of 6 g.

However, the worst offender is French fries — in Canada, they have more than double the salt than in the U.S. (1.4 g/100 g versus 0.6 g/100 g).

Think the differences are just a matter of different foods being sold in different countries? Not so, says the report. When researchers compared foods sold by the same name — like Burger King’s Double Whopper or Subway’s Club sandwich — there were significant differences among countries, including differences between Canada and the U.S.

While it’s interesting to compare Canada and the U.S., it’s important to keep in mind that we’re competing for the dubious honour of second to last place. If salads in the U.K. and France have as little as .3 g/100 g, what can the rest of the world do to approach that number?

More to the story?

If you’re thinking of doing some comparisons of your own, bear in mind that the study was conducted in 2010 so some of the information may have changed. The researchers also note that one of the limitations of the study is that they’re relying on this public information to be accurate. (Their analysis was based on publicly available information, not independent laboratory tests.) Actual amounts of salt and sodium could be higher.

As you know, salt isn’t the only ingredient containing sodium. It’s unclear whether or not researchers considered other ingredients like monosodium glutamate.

Another issue: you’ve likely noticed that researchers used a 100 g baseline for their comparisons. However, actual serving sizes vary among companies and countries. For example, some countries — and we think you can guess which ones — sometimes have larger serving sized for a given product, like French fries.

You might also be wondering if this study goes far enough — what would happen if added sugars and fat were also considered? We know from past research that manufacturers have upped the salt and sugar content to compensate for a lower fat content in foods. (After all, fat makes things taste good.) Is that principle at work here?

Lastly, it’s important to note that while the researchers recommend governments step in and enforce changes, these changes should be made gradually so that consumers won’t get upset. In other words, don’t expect to see big reductions any time soon.

The bottom line:  We could be waiting a long time for the government and companies to make changes, one thing will always remain the same: no one is forcing us to consume these foods. Ultimately, it’s up to us as consumers to make informed decisions about our diets. New regulations don’t change our responsibility to read labels and find some balance in the foods we choose to put in our bodies.

ON THE WEB

Read the full article in the Canadian Medical Association Journal.

Note to our readers: the researchers did report some competing interests, including membership on the boards of pharmaceutical companies, participation in salt reduction initiatives and funding from organizations the World Health Organization. (A full list can be found on the final page of the article at the link above.)

For more information on salt, sodium and heart health, visit:

Health Canada
The Heart and Stroke Foundation
The Heart Foundation (U.S.)
The British Heart Foundation

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