Certainly most dietitians are well aware of the fact that obesity and hypertension are on the rise in America. And most also know that Americans who dine out frequently often get far more salt and calories in those meals away from home than they imagine. This is due to the fact that nutrition labeling information at most restaurants is difficult, if not impossible, to attain. Under current law there is no requirement for restaurants to provide any nutrition information unless they make a specific health claim such as ?low sodium? or ?heart healthy?. If such a health claim is made restaurants are only required to provide information that the specific menu item meets the Food & Drug Administration?s guidelines for using it.To help consumers make more informed choices when consuming restaurant meals Congress is considering several new laws that would increase consumer access to nutrition information about what they are ordering.The two main bills are the Meal Education and Labeling (MEAL) Act promoted by the Center for Science in Public Interest and the second is the Labeling Education and Nutrition (LEAN) Act being promoted by the restaurant industry. The third Act is largely the LEAN Act incorporated into the huge healthcare reform bill known as the Affordable Health Choices Act.All three new potential laws would require restaurants with 20 or more outlets to display the calorie content of all the standard items on their menus.However, the MEAL Act would also require restaurant chains to list the amount of sodium, saturated and trans fat and carbohydrate in all standard food items on menus and menu boards.The LEAN Act, by contrast, only requires restaurants to provide this additional information when the customer requested it. Would the warning labels on tobacco products be just as effective if they were not on the packages but only available to customers who requested it? Probably not.Another potential problem with the LEAN Act is that it would prevent states and local communities from requiring more extensive dietary information on the menus. This would be like if Congress had passed a law requiring all restaurants to have both smoking and non-smoking sections but prohibiting states and local communities from banning smoking in restaurants, which is what the restaurant industry wanted many years ago. It seems likely that while the LEAN Act may be a small step in the right direction now it may actually impede the development of more effective nutrition labeling of restaurant foods in the future.Currently about 14% of Americans on Medicare have some degree of heart failure. When they eat too much salt many retain salt and fluid to the point where the fluid build up in their lungs becomes life threatening. Congestive heart failure (CHF) is the #1 reason Americans in the 60s and older get admitted to a hospital. Many come back repeatedly over several years with an average hospital stay of about 4 days. As a result patients with CHF account for 43% of all Medicare expenditures.

Bottom Line:If menus listed the amount of sodium and if Medicare paid more for dietary counseling to assist people in avoiding excess salt at home and in restaurants, it is likely that many would live longer. If they cut their salt intake appreciably there is no doubt they would have a better quality of life and require far fewer hospitalizations to get rid of the excess salt and fluid in their bodies. Isn't cutting healthcare costs and improving healthcare outcomes what everyone wants? If so the MEAL Act appears to be the better bill for RDs to support.By James J. Kenney, PhD, RD, FACN