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Research

The variability of reported salt levels in fast foods across six countries: opportunities for salt reduction

Elizabeth Dunford, Jacqueline Webster, Mark Woodward, Sebastien Czernichow, Wen Lun Yuan, Katharine Jenner, Cliona Ni Mhurchu, Michael Jacobson, Norm Campbell and Bruce Neal
CMAJ June 12, 2012 184 (9) 1023-1028; DOI: https://doi.org/10.1503/cmaj.111895
Elizabeth Dunford
From The George Institute for Global Health (Dunford, Webster, Woodward, Neal), The University of Sydney (Dunford, Neal), Sydney, Australia; the Department of Nutrition, University Versailles St-Quentin and A. Paré Hospital, Boulogne-Billancourt, France (Czernichow); the Department of Epidemiology (Yuan), McGill University, Montréal, Que.; Wolfson Institute of Preventive Medicine (Jenner), Queen Mary, University of London, London, UK; Clinical Trials Research Unit (Ni Mhurchu), The University of Auckland, Auckland, New Zealand; Center for Science in the Public Interest (Jacobson), Washington, DC; and Libin Cardiovascular Institute of Alberta (Campbell), the University of Calgary, Calgary, Alta.
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  • For correspondence: edunford@georgeinstitute.org.au
Jacqueline Webster
From The George Institute for Global Health (Dunford, Webster, Woodward, Neal), The University of Sydney (Dunford, Neal), Sydney, Australia; the Department of Nutrition, University Versailles St-Quentin and A. Paré Hospital, Boulogne-Billancourt, France (Czernichow); the Department of Epidemiology (Yuan), McGill University, Montréal, Que.; Wolfson Institute of Preventive Medicine (Jenner), Queen Mary, University of London, London, UK; Clinical Trials Research Unit (Ni Mhurchu), The University of Auckland, Auckland, New Zealand; Center for Science in the Public Interest (Jacobson), Washington, DC; and Libin Cardiovascular Institute of Alberta (Campbell), the University of Calgary, Calgary, Alta.
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Mark Woodward
From The George Institute for Global Health (Dunford, Webster, Woodward, Neal), The University of Sydney (Dunford, Neal), Sydney, Australia; the Department of Nutrition, University Versailles St-Quentin and A. Paré Hospital, Boulogne-Billancourt, France (Czernichow); the Department of Epidemiology (Yuan), McGill University, Montréal, Que.; Wolfson Institute of Preventive Medicine (Jenner), Queen Mary, University of London, London, UK; Clinical Trials Research Unit (Ni Mhurchu), The University of Auckland, Auckland, New Zealand; Center for Science in the Public Interest (Jacobson), Washington, DC; and Libin Cardiovascular Institute of Alberta (Campbell), the University of Calgary, Calgary, Alta.
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Sebastien Czernichow
From The George Institute for Global Health (Dunford, Webster, Woodward, Neal), The University of Sydney (Dunford, Neal), Sydney, Australia; the Department of Nutrition, University Versailles St-Quentin and A. Paré Hospital, Boulogne-Billancourt, France (Czernichow); the Department of Epidemiology (Yuan), McGill University, Montréal, Que.; Wolfson Institute of Preventive Medicine (Jenner), Queen Mary, University of London, London, UK; Clinical Trials Research Unit (Ni Mhurchu), The University of Auckland, Auckland, New Zealand; Center for Science in the Public Interest (Jacobson), Washington, DC; and Libin Cardiovascular Institute of Alberta (Campbell), the University of Calgary, Calgary, Alta.
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Wen Lun Yuan
From The George Institute for Global Health (Dunford, Webster, Woodward, Neal), The University of Sydney (Dunford, Neal), Sydney, Australia; the Department of Nutrition, University Versailles St-Quentin and A. Paré Hospital, Boulogne-Billancourt, France (Czernichow); the Department of Epidemiology (Yuan), McGill University, Montréal, Que.; Wolfson Institute of Preventive Medicine (Jenner), Queen Mary, University of London, London, UK; Clinical Trials Research Unit (Ni Mhurchu), The University of Auckland, Auckland, New Zealand; Center for Science in the Public Interest (Jacobson), Washington, DC; and Libin Cardiovascular Institute of Alberta (Campbell), the University of Calgary, Calgary, Alta.
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Katharine Jenner
From The George Institute for Global Health (Dunford, Webster, Woodward, Neal), The University of Sydney (Dunford, Neal), Sydney, Australia; the Department of Nutrition, University Versailles St-Quentin and A. Paré Hospital, Boulogne-Billancourt, France (Czernichow); the Department of Epidemiology (Yuan), McGill University, Montréal, Que.; Wolfson Institute of Preventive Medicine (Jenner), Queen Mary, University of London, London, UK; Clinical Trials Research Unit (Ni Mhurchu), The University of Auckland, Auckland, New Zealand; Center for Science in the Public Interest (Jacobson), Washington, DC; and Libin Cardiovascular Institute of Alberta (Campbell), the University of Calgary, Calgary, Alta.
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Cliona Ni Mhurchu
From The George Institute for Global Health (Dunford, Webster, Woodward, Neal), The University of Sydney (Dunford, Neal), Sydney, Australia; the Department of Nutrition, University Versailles St-Quentin and A. Paré Hospital, Boulogne-Billancourt, France (Czernichow); the Department of Epidemiology (Yuan), McGill University, Montréal, Que.; Wolfson Institute of Preventive Medicine (Jenner), Queen Mary, University of London, London, UK; Clinical Trials Research Unit (Ni Mhurchu), The University of Auckland, Auckland, New Zealand; Center for Science in the Public Interest (Jacobson), Washington, DC; and Libin Cardiovascular Institute of Alberta (Campbell), the University of Calgary, Calgary, Alta.
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Michael Jacobson
From The George Institute for Global Health (Dunford, Webster, Woodward, Neal), The University of Sydney (Dunford, Neal), Sydney, Australia; the Department of Nutrition, University Versailles St-Quentin and A. Paré Hospital, Boulogne-Billancourt, France (Czernichow); the Department of Epidemiology (Yuan), McGill University, Montréal, Que.; Wolfson Institute of Preventive Medicine (Jenner), Queen Mary, University of London, London, UK; Clinical Trials Research Unit (Ni Mhurchu), The University of Auckland, Auckland, New Zealand; Center for Science in the Public Interest (Jacobson), Washington, DC; and Libin Cardiovascular Institute of Alberta (Campbell), the University of Calgary, Calgary, Alta.
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Norm Campbell
From The George Institute for Global Health (Dunford, Webster, Woodward, Neal), The University of Sydney (Dunford, Neal), Sydney, Australia; the Department of Nutrition, University Versailles St-Quentin and A. Paré Hospital, Boulogne-Billancourt, France (Czernichow); the Department of Epidemiology (Yuan), McGill University, Montréal, Que.; Wolfson Institute of Preventive Medicine (Jenner), Queen Mary, University of London, London, UK; Clinical Trials Research Unit (Ni Mhurchu), The University of Auckland, Auckland, New Zealand; Center for Science in the Public Interest (Jacobson), Washington, DC; and Libin Cardiovascular Institute of Alberta (Campbell), the University of Calgary, Calgary, Alta.
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Bruce Neal
From The George Institute for Global Health (Dunford, Webster, Woodward, Neal), The University of Sydney (Dunford, Neal), Sydney, Australia; the Department of Nutrition, University Versailles St-Quentin and A. Paré Hospital, Boulogne-Billancourt, France (Czernichow); the Department of Epidemiology (Yuan), McGill University, Montréal, Que.; Wolfson Institute of Preventive Medicine (Jenner), Queen Mary, University of London, London, UK; Clinical Trials Research Unit (Ni Mhurchu), The University of Auckland, Auckland, New Zealand; Center for Science in the Public Interest (Jacobson), Washington, DC; and Libin Cardiovascular Institute of Alberta (Campbell), the University of Calgary, Calgary, Alta.
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Article Figures & Tables

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    Figure 1:

    Mean salt content per 100 grams and per serving for fast foods by product type. Lines extending from the mean (boxes) indicate the range of values for the category. Breakfast = savoury breakfast items, chicken = all chicken products.

Tables

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    Table 1:

    Salt content of fast foods by product type, overall and by country

    Product categorySalt content, g/100 g, mean (SD; range)
    Australia
    n = 325
    Canada
    n = 466
    France
    n = 137
    New Zealand
    n = 340
    UK
    n = 523
    USA
    n = 333
    Overall
    n = 2124
    Savoury breakfast items
    n = 157
    1.3 (0.3; 1.1–1.8)1.5 (0.3; 1.0–2.3)1.2 (0.4; NA*)1.1 (0.2; 0.7–1.5)1.4 (0.4; 1.0–1.9)1.8 (0.5; 0.5–2.5)1.5 (0.4; 0.5–2.5)†
    Burgers
    n = 211
    1.3 (0.3; 0.7–1.9)1.3 (0.3; 0.6–2.0)1.2 (0.2; 0.9–1.6)1.4 (0.4; 0.9–2.0)1.1 (0.3; 0.4–1.7)1.3 (0.3; 0.8–1.8)1.3 (0.3; 0.4–2.0)‡
    Chicken products
    n = 168
    1.6 (0.5; 0.9–3.2)1.6 (0.6; 0.8–2.8)1.5 (0.3; 0.9–2.2)1.6 (0.4; 1.0–2.1)1.1 (0.3; 0.6–1.6)1.8 (0.4; 0.9–2.9)1.6 (0.5; 0.6–3.2)†
    French fries
    n = 41
    0.8 (0.1; 0.7–1.0)1.4 (0.6; 0.6–1.9)0.5 (0.0; 0.5–0.5)0.7 (0.4; 0.3–1.1)0.8 (0.2; 0.5–1.0)0.6 (0.0; 0.6–0.6)0.9 (0.4; 0.3–1.9)§
    Pizza
    n = 1108
    1.4 (0.3; 0.6–2.2)1.6 (0.4; 0.8–2.4)1.5 (0.2; 1.1–2.0)1.4 (0.4; 0.8–2.9)1.2 (0.3; 0.5–2.0)1.7 (0.3; 1.0–2.4)1.4 (0.4; 0.5–2.9)†
    Salads
    n = 151
    0.5 (0.2; 0.0–1.0)0.8 (0.4; 0.0–1.5)0.3 (0.3; 0.0–1.2)0.3 (0.2; 0.0–0.6)0.5 (0.4; 0.0–1.8)0.5 (0.3; 0.0–1.1)0.5 (0.4; 0.0–1.8)§
    Sandwiches
    n = 288
    1.0 (0.3; 0.4–1.6)1.4 (0.4; 0.6–2.1)0.8 (0.4; 0.4–1.7)1.2 (0.3; 0.7–1.8)1.0 (0.4; 0.5–2.0)1.2 (0.3; 0.6–1.9)1.1 (0.4; 0.4–2.1)†
    Overall
    n = 2124
    1.3 (0.4; 0.0–3.2)1.4 (0.5; 0.0–2.8)1.1 (0.6; 0.0–2.2)1.3 (0.4; 0.0–2.9)1.2 (0.3; 0.0–2.0)1.5 (0.5; 0.0–2.9)1.3 (0.4; 0.0–3.2)†
    • Note: NA = not applicable, SD = standard deviation.

    • ↵* Only two savoury breakfast products were available in France (n = 2).

    • ↵† Analysis of variance, p < 0.001.

    • ↵‡ Analysis of variance, p < 0.05.

    • ↵§ Analysis of variance, p < 0.01.

    • View popup
    Table 2:

    Salt content of the same fast food products sold in different countries

    Company; productCountry; serving size and salt per serving (salt per 100 g), g
    AustraliaCanadaFranceNew ZealandUnited KingdomUnited States
    Burger King*
    Double Whopper3592.9 (0.8)3732.5 (0.7)——3672.7 (0.7)3552.3 (0.7)NA2.7 (NA)
    Double Cheese2132.6 (1.5)1892.4 (1.3)——1872.6 (1.2)1732.4 (1.4)NA2.5 (NA)
    Domino’s
    Hawaiian Pizza651.0 (1.5)————671.0 (1.5)700.7 (1.0)——
    Kentucky Fried Chicken
    Zinger Burger1973.0 (1.5)——2072.6 (1.2)1863.1 (1.7)NA3.0 (NA)——
    McDonald’s
    Big Mac2002.4 (1.2)2092.6 (1.2)2212.3 (1.0)2022.7 (1.3)2142.1 (1.0)2142.6 (1.2)
    Chicken McNuggets981.1 (1.1)1141.7 (1.5)1071.3 (1.2)881.0 (1.1)1050.6 (0.6)951.5 (1.6)
    Pizza Hut
    Hawaiian Pizza881.3 (1.5)841.0 (1.1)——821.1 (1.3)730.8 (1.1)1021.5 (1.5)
    Subway
    Club sandwich2121.8 (0.9)2402.7 (1.1)2381.3 (0.5)2202.7 (1.2)2542.3 (0.9)2472.9 (1.2)
    • Note: NA = not available.

    • ↵* Known as “Hungry Jack’s” in Australia.

    • View popup
    Table 3:

    Salt content, overall and by company, of fast foods by product type

    Product categoryCompany; salt content, g/100 g, mean (SD; range)
    Burger King*Domino’sKFCMcDonald’sPizza HutSubway
    Savoury breakfast items1.4 (0.3; 0.4–2.3)—2.5 (0.0; 2.5–2.5)1.4 (0.4; 0.1–2.4)—1.3 (0.2; 0.7–1.6)
    Burgers1.2 (0.3; 0.4–1.9)—1.4 (0.3; 0.8–2.0)1.2 (0.3; 0.7–2.0)——
    Chicken products1.8 (0.7; 1.2–2.8)1.8 (0.8; 1.0–3.2)1.6 (0.5; 0.8–2.9)1.3 (0.4; 0.6–1.9)1.5 (0.5; 0.9–2.0)—
    French fries1.2 (0.4; 0.0–2.4)—0.9 (0.5; 0.0–3.8)0.7 (0.2; 0.0–2.5)1.3 (0.5; 0.3–3.5)—
    Pizza—1.3 (0.3; 0.5–2.1)——1.5 (0.4; 0.6–2.9)—
    Salads0.5 (0.3; 0.0–0.9)0.8 (0.2; 0.6–0.9)0.6 (0.3; 0.0–1.3)0.6 (0.3; 0.0–1.5)1.1 (0.4; 0.5–1.8)0.3 (0.2; 0.0–1.1)
    Sandwiches1.4 (0.1; 1.3–1.6)1.2 (0.5; 0.4–2.0)1.4 (0.3; 0.7–2.1)1.3 (0.4; 0.6–2.0)1.7 (0.3; 1.3–2.1)1.0 (0.3; 0.4–1.9)
    Overall1.3 (0.5; 0.0–2.8)†1.3 (0.3; 0.4–3.2)†1.4 (0.5; 0.0–3.8)†1.1 (0.5; 0.0–2.5)†1.5 (0.4; 0.3–3.5)†0.9 (0.4; 0.0–1.9)†
    • Note: NA = not available, SD = standard deviation.

    • ↵* Known as “Hungry Jack’s” in Australia.

    • ↵† Analysis of variance, p < 0.001.

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The variability of reported salt levels in fast foods across six countries: opportunities for salt reduction
Elizabeth Dunford, Jacqueline Webster, Mark Woodward, Sebastien Czernichow, Wen Lun Yuan, Katharine Jenner, Cliona Ni Mhurchu, Michael Jacobson, Norm Campbell, Bruce Neal
CMAJ Jun 2012, 184 (9) 1023-1028; DOI: 10.1503/cmaj.111895

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The variability of reported salt levels in fast foods across six countries: opportunities for salt reduction
Elizabeth Dunford, Jacqueline Webster, Mark Woodward, Sebastien Czernichow, Wen Lun Yuan, Katharine Jenner, Cliona Ni Mhurchu, Michael Jacobson, Norm Campbell, Bruce Neal
CMAJ Jun 2012, 184 (9) 1023-1028; DOI: 10.1503/cmaj.111895
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