0731-Feature-High salt in NYC_Blog

The public has had its say, and now New York City health officials have the next month to determine whether Olive Garden, Applebee’s and other chain restaurants in the city must place warning labels on high-sodium menu items.

The proposed rule, introduced by the city’s Board of Health in June, would place a salt-shaker symbol next to menu items with more than 2,300 milligrams of sodium, the daily limit recommended by federal guidelines. That’s roughly equivalent to a teaspoon of salt.

A public comment period on the proposal concluded Wednesday following an open hearing before the city’s health department.

The board has more than a month to make any adjustments to its proposal to accommodate suggestions made by the public. Board members will vote on the measure at their next meeting on Sept. 9 and, if approved, the measure could take effect Dec. 1. Penalties, however, wouldn’t be imposed for the first six months.

Although the proposal has received overwhelming general support, its major critics include the Salt Institute, an industry group that believes the measure is based on “outdated, incorrect sodium guidelines.”

The National Restaurant Association also opposes the proposed rule, saying in a statement it would “only cause confusion and increase the burden placed on business owners” in the city.

But Mitchell Elkind, M.D., a neurologist and stroke expert, said he’s seen a “lot of excitement in the public health community” over the potential to improve community awareness about dangerous sodium levels.

“People really have no idea how much salt they’re eating, and many would be shocked to discover they can get their full recommended salt intake at a single meal, or even a single dish,” said Elkind, a neurology and epidemiology professor at Columbia University in New York. “We have to educate them every step of the way, instead of just putting out a pamphlet that nobody reads. Educating people at the place where they’re actually eating could make a big difference.”

Americans currently consume more than 3,400 milligrams of sodium daily, more than double the amount recommended by the American Heart Association for ideal cardiovascular health.

Health studies show that about 77 percent of the sodium Americans consume comes from packaged and restaurant foods. Increased sodium intake leads to elevated blood pressure, which is a leading risk factor for stroke and heart disease.

Sonia Angell, M.D., a deputy commissioner for the city’s Department of Health and Mental Hygiene, said she felt optimistic about the proposal’s passage. She also expressed excitement about the potential for New York to be the first major city with such warnings.

“Heart disease is a leading cause of death here in the city, but it’s also a huge contributor to health inequities that exist, so any time we can introduce a policy that everybody has access to and we think anybody can use, it’s an important opportunity for us,” she said.

If approved, the rule would apply to any restaurant chain with at least 15 locations nationwide.

“People try to make good decisions in the restaurant environment, but it’s shocking sometimes how much sodium can be in something that you think is healthy, like salads and turkey sandwiches, which can easily exceed the total daily amount,” Angell said.

New York’s health board was the first entity to propose that chain restaurants require both calorie counts and eliminate artificial trans fat from their food. It also tried to limit the sales of jumbo-sized sugary drinks until a state court last year overturned the effort.

But Angell said the city’s sodium warnings have been thoroughly vetted by the department’s legal team and should have no problem holding up to a court challenge.

“Certainly, it’s up to different institutions whether they’d like to introduce legal proceedings and if that happens, we’re ready to respond,” she said.

New York’s health policies often have an impact that can reach beyond the Big Apple’s borders, said Jim O’Hara, health promotion policy director for the Center for Science in the Public Interest.

“Overall, this proposal has spurred debate and conversation and awareness – and that’s all to the good. But it’s going to take more than just raising awareness to save lives,” he said. “It’s going to take some real policy change and if the policy change needs to happen at the local level, that’s great. If the policy change can happen at the federal level, so that all Americans are healthier, that would be even better.”