摘要：We reviewed methods of studies assessing restaurant foods’ sodium content and nutrition databases. We systematically searched the 1964–2012 literature and manually examined references in selected articles and studies. Twenty-six (5.2%) of the 499 articles we found met the inclusion criteria and were abstracted. Five were conducted nationally. Sodium content determination methods included laboratory analysis (n = 15), point-of-purchase nutrition information or restaurants’ Web sites (n = 8), and menu analysis with a nutrient database (n = 3). There is no comprehensive data system that provides all information needed to monitor changes in sodium or other nutrients among restaurant foods. Combining information from different sources and methods may help inform a comprehensive system to monitor sodium content reduction efforts in the US food supply and to develop future strategies. IN THE UNITED STATES, MORE than 90% of the population consumes excess sodium relative to guidelines (< 2300 mg overall and 1500 mg for specific populations). 1–3 In 2007–2008, an estimated 25% of sodium intake among the US population was from foods obtained at restaurants. 3 On any given day, an estimated 53% of the US population consumed at least 1 food or beverage item from a restaurant. 4 Average total daily intake of sodium from all foods was higher for individuals who consumed at least 1 food from a restaurant (3623 ±71 mg) than among those who did not (2999 ±58 mg). 4 The greater contribution of restaurant foods to sodium intake may be attributable to the food types consumed, a greater amount of sodium in restaurant foods than in versions of these foods made at home, or the consumption of larger portions. Monitoring the nutrient content and other characteristics (e.g., serving size) of restaurant foods may aid the development of strategies to reduce sodium intake. 3 Because the vast majority of sodium intake is estimated to come from packaged and restaurant foods, efforts to reduce the sodium content of these foods are ongoing. 5–9 Monitoring the sodium content of packaged foods is feasible because of the Nutrition Facts label that can be found on packaged foods and the availability of public and private databases containing this information. 10 At present, data on the sodium content of restaurant foods are more limited. The Institute of Medicine (IOM) recommends the monitoring of sodium in the US food supply 5 because excess sodium intake is a major preventable risk factor for high blood pressure, a leading cause of heart disease and stroke. 11 The IOM indicated that the substantial contribution to the nation’s sodium intake made by restaurants and items provided by food services warrants the monitoring of the sodium content of restaurant foods. 2,5,12 To date, several groups have assessed the nutrient content of foods from fast-food and other restaurants in the United States and other countries. 7,13–16 However, the wide range of restaurant types and foods consumed from these establishments, combined with the lack of public and private databases incorporating nutrient values for these foods, presents a challenge to the development of national monitoring systems and has prompted calls for better methods to monitor and track restaurant foods. 10,17 We reviewed studies assessing the sodium content of restaurant foods in the United States and other countries to help inform the development of a US national monitoring system. Our objectives were (1) to identify the strengths and limitations of the methods that have been used to select restaurants and foods as well as the measures and methods used to assess sodium content, and (2) with the information from this review, to evaluate the utility of current US nutrient and restaurant databases for building a national system to monitor the sodium content of restaurant foods.
