Some sandwiches, movie theater pretzels and even milkshakes and salads will soon come with a first-of-its-kind salt warning symbol in New York City after officials agreed Wednesday to try a new approach to encourage healthier eating habits.
The city's Board of Health voted unanimously to require chain eateries to put salt-shaker emblems on menus to denote dishes with more than the recommended daily limit of 2,300 milligrams of sodium. That's about a teaspoon.
Applauded by public health advocates but slammed as misguided by salt producers and restaurateurs, the plan is a first in the U.S. and furthers a series of novel nutritional efforts in the biggest city.
"This really represents, to me, the next step in allowing usable information for our community to make better health decisions," health board member Dr. Deepthiman K. Gowda said. Members said they hoped the idea would spread to other locales and spur eateries to cut down on salt.
The average American consumes about 3,400 mg of salt each day, most of it from processed and restaurant food, studies show. Overconsumption of sodium raises the risk of high blood pressure and heart disease, the leading cause of death in the U.S.
CBS News medical contributor Dr. Holly Phillips said the type of transparency required by the new measure is extremely helpful when it comes to sodium because most Americans don't realize how much salt they're consuming.
"With salt this is particularly important because 75 percent of the salt we take in as Americans is essentially hidden," she told "CBS This Morning." "It's in restaurant food, it's in processed food that may not even taste salty. Only 10 percent of the salt we get comes from the salt shaker."
For instance, consumers may not realize how much sodium is in a Panera Bread Smokehouse Turkey Panini (2,590 mg), TGI Friday's sesame jack chicken strips (2,700 mg), a regular-size Applebee's Grilled Shrimp 'n Spinach Salad (2,990 mg) or a Subway footlong spicy Italian sub (2,980 mg). Even items that might not seem super-salty can be: A Red Robin monster-size salted caramel milkshake has 3,400 mg of sodium.
"Each one of these dishes has more than the total salt we're supposed to be taking in for the entire day in just one dish, so just giving people more information, labeling it can help," Phillips said.
Panera's CEO has expressed support for the city's measure; none of the other companies immediately responded to requests for comment Wednesday.
Some movie theaters might simply stop carrying salt-encrusted soft pretzels rather than slap a warning symbol on them, said Matthew Greller, a lobbyist for the National Association of Theater Owners. (Popcorn lovers needn't worry: Even big buckets are under the 2,300-mg limit, the association says.)
The requirement starts Dec. 1 for an estimated 10 percent of menu items at the New York City outlets of chains with at least 15 outlets nationwide. They account for about one-third of the city's restaurant traffic, health officials said.
While many chains provide sodium information on their websites, advocates say making it as prominent as a menu icon will boost awareness.
"This doesn't change the food but provides people with the information they need to make healthy food selections," New York City Health Commissioner Dr. Mary Bassett said.
The American Heart Association, the Center for Science in the Public Interest, and various doctors and nutritionists are enthused about the measure. Some experts and health board member Dr. Lynne Richardson even urged the city to set the warning limit as low as 500 mg.
But the Salt Institute, a salt producers' trade group, argued the new requirement was based on "the whims of bureaucrats," not solid science.
Some research, including an international study last year involving 100,000 people, has suggested that most people's salt consumption is actually OK for heart health, while both too little and too much sodium can do harm. Other scientists have faulted the study and say most people still consume way too much salt.
Restaurant owners say healthy-eating initiatives should focus on diet as a whole, not on particular ingredients or foods. They want the city to leave salt warnings to federal authorities.
New York State Restaurant Association President Melissa Fleischut said the city measure will burden eateries with redoing menu boards even as the federal government works on labeling rules that could require more changes later.
"This is just the latest in a long litany of superfluous hoops that restaurants here in New York must jump through," Fleischut said.
In recent years, New York City has pioneered banning trans fats from restaurant meals and forcing chain eateries to post calorie counts on menus. It led development of voluntary salt-reduction targets for various table staples and tried, unsuccessfully, to limit the size of some sugary drinks.
Restaurant representatives criticizing the salt proposal have noted that courts struck down the big-soda ban as overreaching by the health board. But the Health Department says it has clear authority to require warnings.