A new study shows that 100% of standard hospital menus, in which patients did not pick their own meal choices, exceed the adequate daily intake of 1,500 mg of sodium, while 86% surpass the maximum recommended levels of 2,300 mg.

Researchers at the University of Toronto (Canada) examined the contents of several types of menus from three acute care hospitals in Ontario (Canada). Of these, 84 menus were those in which the patients do not select their own items; 633 regular menus in which patients can pick their own food; 628 menus for diabetics picking their own food; 630 patient-selection menus for those on 3,000-mg sodium daily diets; and 343 patient-selection menus for those on 2,000-mg sodium a day.

The researchers found that the mean sodium level in the standard menus in which patients do not choose their own meals was 2,896 mg. When patients could choose their own items, 97% of the menus exceeded acceptable intake and 79% exceeded the upper-level limits. For diabetics who did not choose their own items, the mean sodium level for their menu was 3,406 mg, and all of these menus exceeded both the acceptable and upper limits of sodium intake. Sodium levels were similar when diabetics chose their own food, and 99% exceeded the 1,500 mg limit, while 95% exceeded the 2,300 mg level.

For patients on salt-restricted diets, both the standard menus and the patient-selected menus contained similar levels of sodium, with the majority falling within prescribed levels. However, for patients on a 2,000-mg diet, mean sodium levels were significantly higher when patients chose their own items, compared with the standard preselected menus; almost half of the patient-selected menus for the 2,000-mg diet exceeded the prescribed levels, and were significantly more likely to do so than the preselected menus. The study was published on July 16, 2012, in the Archives of Internal Medicine.

“Hospitals are increasingly serving prepared foods rather than preparing foods from unprocessed ingredients. This is cause for concern because most of these patients are nutritionally vulnerable or have cardiovascular diagnoses for which sodium intake regulation is essential,” concluded lead author JoAnne Arcand, PhD, RD, and colleagues of the department of nutritional sciences.

A low sodium diet is one that is 2,000 milligrams per day or less; this is the amount found in one teaspoon of table salt. Too much sodium causes the body to retain water. As the level of fluid increases in the body, various systems will have to work harder to process the extra fluid, which can lead to high blood pressure, heart disease, and heart failure. The kidneys and liver also play a role in regulating fluid and can become overworked, leading to chronic disease or failure of these organs. Restricting sodium helps to reduce the workload of these structures and prevents serious disease.

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