Hold the salt: Hospitals seek sodium reduction
Cafeteria strategies are healthy, not costly
In patient rooms, doctors are prescribing a low-sodium diet to improve health. But in hospital cafeterias, employees and visitors may be loading up on salty and processed food.
The average American consumes 3,400 mg of sodium every day, although current dietary guidelines recommend no more than 2,300 mg — and even less for older people, African-Americans, and those with chronic diseases such as high blood pressure and diabetes.
Small and rural hospitals in Illinois successfully targeted sodium reduction with a range of inexpensive strategies. They gathered a multi-disciplinary work group and designed ways to promote healthier eating.
Changing the food environment has a broad impact, says Nancy Amerson, MPH, chronic disease epidemiologist with the Illinois Department of Public Health, which sponsored the project with the Illinois Hospital Association. "It affects the whole community that utilizes the hospital," she says.
Nine participating hospitals received $5,000 grants to implement new strategies to reduce sodium consumption during a four-month study period. "The hospitals educated employees, patients, and the community overall about the effects of sodium," says Abby Radcliffe, MA, manager of member program development at the Illinois Hospital Association in Naperville.
Sodium-reduction strategies included:
• Providing alternatives to salt for flavoring food. Most of the hospitals removed salt shakers from cafeteria tables, although cafeteria customers could request it, says Radcliffe. Many replaced the salt with a seasoning such as Mrs. Dash. One hospital offered a seasoning blend day in which employees could use herbs and spices to make their own seasoning — and learn about sodium reduction.
• Promoting more information about nutritional content and sodium. Some hospitals used table tents to provide information about sodium reduction. One hospital had a vending machine with a touch screen that offered nutritional information. Another hospital used new employee orientation as an opportunity to point out healthier options in the cafeteria. One hospital even held cooking demonstrations for patients on a low-sodium diet.
• Offering healthier menu items. One hospital switched to lower-sodium items, such as from regular bacon to turkey bacon. Others created new recipes with lower sodium levels for the cafeteria menu.
• Making healthier choices more convenient. Some hospitals placed fruit or other healthy items in a convenient place, such as near the cash register.
"Just those little things can make a big difference," says Radcliffe.
The grants helped the hospitals implement changes, but cost is not a barrier to implementing strategies, says Amerson. "You don’t need money to do a lot of the different interventions that the CDC recommends," she says.
[Editor’s note: More information on sodium reduction is available in "Under Pressure: Strategies for Sodium Reduction in the Hospital Environment," published by the Centers for Disease Control and Prevention and available at www.cdc.gov/salt/pdfs/sodium_reduction_in_hospitals.pdf.]