Hospital patient menus contain “unacceptable” levels of dietary sodium, study finds

hospital foodA study of food served to patients in three Ontario acute-care hospitals found 100 per cent of bedside meals had more than the recommended daily intake of sodium, according a report published online July 16 in the Archives of Internal Medicine.

“We found sodium levels in hospital meals to be unacceptably high,” says Dr. JoAnne Arcand of the University of Toronto’s Department of Nutritional Sciences and lead author of the study. “These are sick, vulnerable patients and many of these individuals require lower levels of sodium to treat underlying health conditions.”

While there has been considerable attention focused in recent years on poor quality fare in hospital food courts and cafeterias, little research has been done on sodium content of food delivered to the bedside. High sodium intake leads to high blood pressure, the leading risk factor for stroke.

University of Toronto researchers analyzed regular, diabetic and sodium-restricted diets between November 2010 and August 2011. Sodium levels were compared with the adequate intake level of 1,500 mg a day and the tolerable upper limit of 2,300 milligrams a day. Most menus came from general medical wards, surgical and cardiology wards.

The study found the mean sodium level in preset daily menus (where the patient does not make any food choices) was 2,896 milligrams of sodium, almost double the adequate daily intake and almost 600 milligrams more than the upper tolerable limit. “Of these pre-set menus, 100% exceeded the adequate intake and 86% exceeded the tolerable upper limit,” the study says.

Diabetic menus had a mean sodium level of 3,406 mg. It is especially important for diabetic patients to keep blood pressure under control as diabetes also increases the risk of stroke.

“Exposing patients to these high levels of sodium undermines their health,” says Dr. Andrew Pipe, chief of prevention and rehabilitation at the University of Ottawa Heart Institute. “Hospitals have a responsibility to address this deficiency in care.”

“The food industry and those planning and ordering foods for hospital patients should be aware of the risks of feeding such high levels of sodium to patients. Governments need to ensure that meals served to patients, who rely totally on the foods provided to them in hospital, meet nutritional standards,” says Dr. Mary L’Abbé of the University of Toronto research team, one-time chair of Health Canada’s Sodium Working Group, an expert panel that made recommendations on reducing sodium in the food supply.

“These findings create an opportunity to develop better procurement and menu planning policies and to work with food manufacturers to lower sodium levels in hospital foods to help benefit patients,” Dr. Arcand says.