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High Sodium Warning Labels…New York’s Latest Public Health Policy

By: Mary Scourboutakos

In just a few weeks, New York will be the first city to introduce high sodium warning labels in restaurants. As a result, come December 1st 2015, any menu item that exceeds 2300 mg of sodium will be required to sport the new graphic illustrating a salt shaker inside of a triangle.

The policy, which is an amendment to the New York City Health Code, will affect any chain restaurant with at least fifteen locations, and will affect over 3000 restaurants, or one-third of all restaurant traffic in New York City.

Megan Lent, the Acting Director of Policy at the Bureau of Chronic Disease Prevention and Tobacco Control, who was involved in the background research and development of the policy, said the idea came from research which showed that people are eating more of their meals away from home. Furthermore, she said the rationale also comes from sodium’s effect on blood pressure, and ultimately heart disease—which is the leading cause of death in New York City. Hence, she explained that this policy will “put information back into consumers hands” and thus hopefully foster healthier choices.

While some might argue that 1500 mg—the daily Adequate Intake level—would be a more conservative limit, Lent says they went with 2300 mg—the daily Upper Tolerable intake level—because “this clearly lets people know when they’ve reached that threshold, without making assumptions.”

As for the choice of a pictorial warning label, Lent explained that listing the number of milligrams of sodium is preempted by the federal calorie labeling law that was passed as part of the Patient Protection and Affordable Care Act, back in 2010. Hence, numerical information regarding sodium simply isn’t allowed. Nevertheless, as Lent highlighted, one advantage of the graphic is that it provides an “actionable symbol.”

The implementation of policies such as this one, rarely come without backlash from critics. However, while this policy did receive some comments from the food industry during the public comment period, Lent explained that with regards to the media coverage “a lot has been fairly supportive.” And while some experts have criticized the whole notion of menu-labeling, citing a lack of evidence of effectiveness, Lent says polling has shown that “many New Yorkers think calorie labeling is useful and that these interventions are helpful.”

In a recent article posted on Nation’s Nutrition News, Anita-Jones Mueller, the founder of Healthy Dining and Healthydiningfinder.com, told industry to “just say no” by stating “save money and time, and prevent the risk of disappointed guests, by saying NO to the icon and making sure that most — if not all — of your menu items contain under 2,300 mg of sodium. It’s possible!”

But is it possible? In my own research, I’ve found that 56% of meals from chain, sit-down restaurants would qualify for the warning label, if it was implemented in Canada. However, when menu items are listed individually on the menu (ex. side dishes separate from entrÉes) only 9% would carry the label.

The New York Department of Health plans to evaluate the policy by monitoring changes in sodium levels over time using “Menu Stat”, their free online longitudinal nutrition database containing information for thousands of restaurant foods. But will the policy encourage decreases in sodium, as was seen in King County, Washington after the implementation of their sodium labelling policy? One can only hope!