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The common salt problem
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In the coming year, the federal Liberal government will introduce a policy that would set sodium-reduction targets for Canadian food, as it has for sugar, saturated fats and other problematic nutrients. However, Ann Hui writes, it is unclear how those targets will be applied and how effectively they might curb unhealthy habits. The food industry, for one, is taking the transition with a grain of salt
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By ANN HUI
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Monday, November 20, 2017 – Print Edition, Page A8


Like most professional chefs, Michael Olson relies on muscle memory when it comes to salt. He's spent decades in kitchens, honing this ability to understand through taste, touch and feel when to layer salt into a dish - and how much to add at a time.

And whether they're cooking blanched haricots verts, or a terrine of foie gras, pretty much every cook he's ever worked with relies on that same instinct. "It's kind of a sweet spot," he said.

"Rarely, rarely, rarely," do professional chefs measure the stuff.

But they might have to start.

Over the past year, the federal Liberal government has been putting in place healthy-eating policies in a bid to curb the use of sugar, saturated fat and other problematic nutrients in food. It's now turning its attention to salt, including salt on restaurant menus.

In the year ahead, Health Canada plans to draft a policy that would set targets for sodium reduction in the restaurant industry. The department wraps up consultations with the industry this week and hopes to have targets in place by the end of 2019. What those targets would look like, and who might be affected - whether just the major restaurant chains, or all restaurants - is still up in the air. Also up in the air is whether the targets would be voluntary or mandatory.

What is clear is this: The average Canadian adult consumes "harmful" levels of sodium each day - about 3,400 mg, far exceeding the recommended limit of 2,300 mg. A highsodium diet increases the risk of high blood pressure, a major cause of stroke and cardiovascular disease.

Bringing Canadians' intake within the recommended range of 1,500 and 2,300 mg could reduce cardiovascular disease by 13 per cent each year, according to Health Canada - an annual health-care savings of about $1.3-billion.

With Ottawa's plan still in its early stages, "everything is on the table," said Alfred Aziz, chief of nutrition regulations and standards at Health Canada. "Our objective is to reduce risk to health caused by excessive sodium intake. Whichever measure will help us get there, we'll be looking at those measures."

But as Mr. Olson can attest, they'll have a fight ahead of them. Restaurants have long cited a list of challenges - everything from their complicated supply chains (especially for some multinational restaurant companies) to consumer tastes to the centuries-old traditions that govern chefs and their use of salt.

"Chefs are the most stubborn [people] on the planet," said Mr.

Olson, who teaches at the Canadian Food and Wine Institute in Niagara, Ont. "If somebody comes in and tells them not to use [an ingredient], they will make it a mission of theirs to use as much as they can."

'Long overdue' Several years ago, University of Toronto professor Mary L'Abbé began compiling data on the sodium content of food in Canadian restaurants. She was stunned by what she found.

In her 2013 study, she found that at 19 popular sit-down chain restaurants, the average meal contained 151 per cent the amount of sodium recommended - for an entire day.

Even some side dishes exceeded the daily limit. The same was true with some children's menu items.

A quick scan of many chain restaurants' websites echoes this. Most major chains post nutritional information about their menu items on their websites - and in Ontario, some of that information (calorie counts, but not sodium) is required to be printed on the menu.

At the Joey chain restaurants, the rotisserie chicken has 3,840 mg of sodium - more than 1,500 mg above the recommended limit. The Montreal smoked-meat sandwich at Boston Pizza has 3,030 mg.

Fast-food restaurants fared only a bit better. At Thai Express, the tom yum soup meal contains 2,900 mg of sodium. At Pizza Hut, a single slice of thin-crust Pepperoni Lover's pizza has more than 500 mg.

Even seemingly healthy options make up a high proportion of the daily sodium limit. The Mediterranean bowl of quinoa, olives and vegetables at Freshii accounts for almost 65 per cent of the daily recommended sodium limit.

Part of the problem is the ingredients themselves. Many restaurants rely on prepackaged or processed ingredients, which are already high in sodium.

In other cases, restaurants (and consumers) may not be aware of the sodium contained in certain ingredients. A cup of milk, for example, contains more than 100 mg of naturally occurring sodium. Bread and other baked goods are high in sodium, too. This helps to explain why a hot chocolate or a blueberry danish at McDonald's has more sodium than an order of french fries.

To address this, Health Canada set voluntary targets back in 2012 for packaged and processed foods - the results of which have yet to be released.

But the restaurants themselves have just as large of a part to play, says Dr. L'Abbé, who chairs the department of nutritional sciences at the University of Toronto.

"Establishing sodium-reduction targets for the restaurant and foodservice industry is long overdue," she said. Almost one-third of Canadian household budgets are now spent on eating out. And at restaurants, unlike with packaged foods, nutritional information isn't always publicly available, making it even more difficult for customers to make healthy decisions.

Still, she added, "better late than never."

Canada is not alone. In the United States, the average sodium intake is 3,435 mg a day. In 2008, the sodium intake in Turkey was an astounding 7,200 mg a day.

Around the world, countries have taken varied approaches to tackling the problem. In Argentina, the government turned to regulation, including a law requiring restaurants to include no-salt-added items on their menus. Britain has set voluntary targets for industry - but with close government monitoring.

And the United States last year proposed voluntary "guidelines" for the major restaurant chains.

In Canada, attempts at regulation have seen fits and starts. More than a decade ago, the Harper government assembled a "sodium working group," which eventually recommended voluntary targets for restaurants. But the recommendation was never adopted.

Norm Campbell, a professor of medicine at the University of Calgary, was a member of that working group. The restaurant industry at the time, he said, was "pretty adamantly against the targets and timelines." Out of all the groups around the table, "the restaurants were least co-operative."

With the salt issue back on the agenda, Dr. Campbell said he still thinks a mixed approach would be best.

He'd like to see voluntary targets in Canada phased in over time, with close monitoring by the government.

Those targets would eventually become mandatory, to ensure a level playing field across the industry.

But, "it all depends," he said, "on whether the restaurants co-operate."

'That'll be a battle' Two years ago, restaurants across the country received a guide, titled "How to reduce sodium in menu items." The 19-page booklet was produced by Restaurants Canada, the lobbying group that represents some 30,000 restaurants across the country, including some of the largest chains. With its publication, the group hoped to show that the restaurant industry was already working to reduce sodium - that it was doing this voluntarily, without mandatory targets. According to the group, the top-10 menu items at its members' restaurants saw a decrease in sodium of about 17 per cent over the past seven years - changes that were made voluntarily.

The booklet discussed restaurants' role in reducing salt and included a range of tips. "Ingredients such as cheese, bacon or croutons can add a substantial amount of sodium," it said. "Consider reducing the amount used or removing them altogether."

Another suggestion was to "dilute soy sauce used in recipes and food preparation methods with water."

And another: "Do not add salt to cooking water for boiling potatoes, pasta or rice."

For Mr. Olson, all of the suggestions gave him pause. But it was the last one that really worried him.

"To get everyone to stop putting salt in their pasta water," he said, before letting out a sigh. "That'll be a battle."

The practice of salting pasta water - and many other principles surrounding salt, he said, are "foundational" in professional kitchens.

"Every time we blanch vegetables, every time we cook pasta, we season the water."

For chefs, salt serves a number of functions. It reduces bitterness in food. It enhances the other tastes - sweet, sour, umami. To many chefs, salt is what makes food taste good.

Described by elBulli chef Ferran Adria, salt is "the only product that changes cuisine."

For the restaurant industry, this has long been its main argument against mandatory targets. People like salt, it says - or at the very least, they have grown accustomed to it.

Add to that the perception that eating out is a "treat," and this explains why restaurants and chefs have long felt entitled to be so liberal with salt.

This is why, according to Restaurants Canada, that despite the industry's efforts, much of it is still dependent on consumer tastes. It's also why the industry has traditionally been opposed to mandatory targets.

"We're prepared to work with [Health Canada], provided that we can get customers on-board," said Joyce Reynolds, Restaurants Canada's executive vice-president of government affairs. "Customers will indicate they are interested in reducing sodium, but what our members find is what customers say they want and what they actually want is not the same."

Some restaurants have experimented with low-sodium items in the past, Ms. Reynolds said - only to have to remove those items because of lack of demand.

Still, studies show that what customers want can change.

According to the Harvard School of Public Health, the average person often cannot taste a difference when salt is reduced in a dish - by as much as 25 per cent. Studies have shown that when salt is reduced gradually over time, customers' sense of taste adjusts, as does their preference for salt.

But other challenges exist, too, Ms. Reynolds said. For the larger, multinational restaurant chains, the reformulation of menu items represents a hornet's nest of logistical challenges. For some restaurant companies, she said "they're looking at these issues globally. They're not just looking at them here in Canada."

And for the major chains, sodium represents a labour issue - using preseasoned, prepared or processed ingredients means the restaurants can get by with lower-skilled workers in their kitchens.

For the smaller, independent and chef-run restaurants, meanwhile, even measuring sodium is a challenge. Short of lab-testing, it can be difficult to calculate sodium levels, including the amounts inherent to raw ingredients. Plus, as Mr. Olson highlighted, many cooks in these smaller, independent restaurants do not rely on recipes, but go by taste, touch and feel.

Despite all this, Mr. Olson said he agrees with the goal of making restaurant food healthier. He hopes that other chefs will come around, too.

"I think there's an opportunity to change our attitudes," he said. In his own kitchen, instead of reaching for the salt, he's increasingly using lemon or hot sauce to finish a dish.

Sometimes, he'll throw in a "textural" element instead, such as crunchy breadcrumbs.

Canadians are eating out routinely now and not just on special occasions, he said. And restaurants need to be mindful of this.

"As professional cooks," he said, "we can't continue in the same effort of making every meal someone's death-row dinner."

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