What’s in Your Whopper? Salt in Fast Food Varies Greatly Between Countries

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All French fries are not created equal. It turns out that sodium levels in the same fast food items can vary significantly between countries, according to a recent study — and can you guess which country’s Big Mac is especially salty?

An international group of collaborating researchers looked at the reported sodium content of menu items from six fast food chains in Australia, Canada, France, New Zealand, the United Kingdom and the United States. The chains included Burger King, Domino’s Pizza, Kentucky Fried Chicken, McDonald’s, Pizza Hut and Subway. For each restaurant, the team analyzed savory breakfast items, burgers, chicken products, pizza, salads, sandwiches and French fries.

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Overall, sodium levels in similar foods were inconsistent between countries, with fast food from Canada and the United States containing the most salt, and items from the U.K. and France remaining relatively low on the list. In the U.K., McDonald’s Chicken McNuggets contained 0.6 g of salt per 100 g, for example, but in the U.S., they contained more than twice that amount at 1.6 g per 100g.

Here’s how the salt in McDonald’s Chicken McNuggets broke down by country:

Australia: 1.1 g
Canada: 1.5 g
France: 1.2 g
New Zealand: 1.1 g
United Kingdom: 0.6 g
United States: 1.6 g

“Many business decisions are made by the chains saying they are making the products based on the preference of the people, but those preferences could come from a test group of 20 people,” says study author Dr. Norm Campbell, from the University of Calgary. “In Canada, our fries have about twice as much salt as anywhere else. It should be a travel advisory. But overall, our consumption is two times less than that of the United States. People want to eat healthier. Nobody can tell me the people in Canada want more salt.”

And it’s not just your fries or McNuggets that are packing the excess sodium. Restaurant food in general — and any processed or packaged food — is high in salt. “If you go to an expensive restaurant, it is just as unhealthy, you just paid more money for it,” says Campbell. “You’re no better off. If you go to the grocery store and you buy packaged food it is just as bad. It’s a much larger issue.”

Food makers often cite technical difficulties as barriers to salt reduction, but given the range of sodium levels that already exist between countries, the researchers are skeptical. According to the team, the real problem lies in a lack of government moderation. “These are federal government responsibilities. The fast food industries are responsible for their shareholders. They are not responsible for the health of the population,” says Campbell. “We elect politicians who have responsibility to oversee the changes in added salt and sugars in our foods that are killing us.”

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Indeed, U.S. health officials are by no means unacquainted with the issue. In February, the Centers for Disease Control in Prevention (CDC) released a report warning that 9 out of 10 Americans are consuming too much sodium.

CDC Director Dr. Thomas Frieden said in the statement, “too much sodium raises blood pressure, which is a major risk factor for heart disease. These diseases kill more than 800,000 Americans each year and contribute an estimated $273 billion in health care costs.” The report further stated that the CDC supports recommendations for food manufacturers and restaurants to reduce their sodium contents.

“It is imperative that we reduce sodium in the content of food sold and eaten in the U.S.,” says Douglas Karas, a press officer for the U.S. Food and Drug Administration. “While we recognize that sodium reduction is easier for some products than for others, we know that many food companies and retailers have lowered sodium in the foods they produce and serve, indicating that reductions are in fact feasible.”

The CDC’s sodium study also cited local efforts like the New York City Health Department’s National Salt Reduction Initiative, which has proposed targets for voluntary reduction of salt in packaged foods and in 25 categories of restaurant foods.

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But is it enough? Other countries are getting even more serious about salt, and the researchers are wary of the effectiveness of voluntary reductions. “Companies have voluntarily agreed to reduce salt over and over but they are never able to do that. I assume their business models may not support it,” says Dr. Campbell.

Countries like the U.K. are doing better than we are, according to the authors. “There is good evidence from the U.K. that an agreement between government and industry on salt targets has driven down the salt levels of processed foods,” the authors concluded in the study.

“Lower income countries are seeing [the health-care costs] as an economic disaster and their heads of government are leading their efforts,” says Campbell. “You are not going to see that in the U.S. are Canada.”

(MORE: Does Cutting Salt Really Improve Heart Health?)

To successfully lower sodium levels, the authors recommend a slow and steady reduction that works with both the government and food industry companies:

Because large fast food companies already have dynamic ongoing programs of product reformulation, the marginal cost of incorporating salt-reduction targets should be minimal…There is clear evidence that the serving sizes of fast foods have increased substantially in recent decades, so such a change would simply represent a return to the norm…Governments setting and enforcing salt targets for industry would provide a level playing field, and no company could gain a commercial advantage by using high levels of salt.

Current guidelines recommend that most healthy adults consume less than 2,300 mg of sodium each day, with a lower target of 1,500 mg for those at higher risk because of age, ethnicity or health conditions — that accounts for about half the U.S. population. Despite the guidelines and doctors’ warnings, however, the average American over age 2 consumes near 3,500 mg of sodium a day.

The study was published in Canadian Medical Association Journal.

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