Restaurant fare is notorious for being loaded with sodium. Now a new study finds restaurants are also serving up very sodium-dense foods.

The results, published Thursday in the Journal of Food Composition and Analysis, showed that regular menu items had an average of 2,196 milligrams of sodium per 1,000 calories and children’s menu items had 1,865 mg per 1,000 calories. Sodium density is a measurement that accounts for different foods having different numbers of calories.

Eating out plays a big role in the modern American diet, said study author Helen Wu, Ph.D., a research and policy scientist at the University of California Davis Health System’s Institute for Population Health Improvement.

“Compared to decades past, people are eating out more often and they’re getting more of their calories from restaurant foods,” said Wu. About half of Americans eat out at least three times a week, according to 2009-2010 data from the National Health and Nutrition Examination Survey.

Wu analyzed the menus of 237 U.S. restaurant chains in 2010, totaling more than 30,000 separate menu items. She found that pizza and burgers, often perceived as less healthy, were actually less sodium-dense than sandwiches, Asian foods and chicken items.

But what stood out to nutritionist Penny Kris-Etherton, Ph.D., R.D., was that sodium density was too great for all types of foods at all types of restaurants.

“They’re all high, even upscale restaurants,” said Kris-Etherton, chair AHA’s nutrition committee and a professor of nutrition at Pennsylvania State University. “This study shows that it’s really hard to eat out and stay within the recommended sodium limits.”

Many food manufacturers have introduced lower-sodium versions of soups, cereals and other products in recent years. But the average American is still eating too much sodium — about 3,400 mg each day, according to NHANES data. That sodium comes primarily from foods prepared in restaurants and packaged foods.

The American Heart Association recommends that most adults consume no more than 1,500 mg of sodium a day. The federal dietary guidelines currently recommend no more than 2,300 mg of sodium daily — the amount in 1 teaspoon of salt — for otherwise healthy Americans.

According to the Centers for Disease Control and Prevention, some of the biggest offenders are breads and rolls, cold cuts and cured meats, pizza, poultry, soup and sandwiches. Too much sodium can increase blood pressure, a major risk factor for heart attack and stroke.

Wu called on the restaurant industry to reduce the saltiness of its foods — and for consumers to demand it.

“The saltiness of our food comes from an acquired taste, and that taste standard is set by what the food industry gives us,” said Wu. “Now we need the restaurant industry to help us adjust our tastes.

“Consumers need to buy foods that are less salty and ask for lower-sodium options,” she said. “Those sorts of choices and demands will push restaurants to act because they will be responsive to what consumers want.”

Some restaurants, such as Subway, Burger King and McDonald’s, have already reduced sodium in its meals, according to a 2014 report from the nonprofit Center for Science in the Public Interest.

For now, Kris-Etherton suggests people give specific instructions when ordering to cut the salt — and anything high in sodium, like condiments.

“Staying within the recommended sodium limits can probably be done when eating out,” she said. “You just have to be very careful.”

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