Evaluation of salt content in Portuguese hospital patient menus

Measures intended to reduce salt consumption are a Public Health priority, in order to address chronic diseases, related to excessive salt utilization. As patients totally rely on meals provided by Hospital caterings, Health institutions should provide nutritional well-balanced menus, in order to help patient’s recovery, to increase their quality of life and reduce the incidence of malnutrition and possible health complications, as cardiovascular diseases and hypertension specially related to excessive salt intake. The aim of this study was to evaluate sodium, and correspondent salt levels, in commonly served Hospital patient’s menus, and to evaluate if the amounts are in agreement with established salt recommendations. Samples of hospital’s meals (n=26) were collected between 2017 and 2019, and included soup, fruit, bread, salad and a composite dish, grinded all together and homogenised. These meals were mostly a general diet, intended to patients who do not require specific food modifications. Analyses were performed in quality management system, according to EN ISO 17025. Sodium levels were determined using an Inductively Coupled Plasma Optical Emission Spectroscopy (ICP-OES). Salt content, in g/100 g of food, was calculated by the formula: salt = sodium × 2.5. Sodium contents ranged from 69.0 to 303 mg/100g of food, and salt amounts from 0.2 to 0.8 g/100g of food. Meal portion size ranged from 500 to 900 g and salt levels from 2.0 to 5.0 g/meal. Taking into account the WHO recommendations of 5 g salt/day, the consumption of 100 g of a composite dish can represent about 30% of the daily salt intake. Also, salt consumption in Portugal almost doubles WHO recommended maximum level of intake, what is in agreement with presented results, where salt levels in one meal, generally covers recommendations for one day. As the prescription of inadequate diets and lack of flexibility of hospitals feeding service can contribute to patient’s malnutrition, early intervention in hospital diets is critical to prevent worsening of patients' nutrition status and can provide an opportunity to adopt healthy eating habits, what should include a salt reduction strategy. N/A