National Restaurant Association · Foods Across portfolio Healthy Choice soups General Mills Across multiple categories Heinz Tomato ketchup Bagel Bites Kellogg’s Committed since

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National Restaurant AssociationAssociation

Joy Dubost Ph.D. R.D.Director of Nutrition & Healthy Living

December 10, 2010

The National Restaurant Association is the official representative of the restaurant industry, with more than 400 000 member locations across all segmentsthan 400,000 member locations across all segments

Quick service

Casual dining

Fine dining

Contract food ser ice48% 52%

Contract food service

Allied membersAssociation Membership mix independents vs. chains

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National Restaurant Association• Purpose and Value

– to address the breadth and depth of the challenges faced by the restaurant industry by providing leadership to our members

• Advocacy and representation• Tools and solutions• Education and networking• Research and insights• Responsible stewardship

• 91% have fewer than 50 employees - mainly comprised f ll b i

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of small businesses

945,000

12.7 million

Locations

Employees

Food & Healthy Living

• Vision – To create an environment that encourages

voluntary, flexible options for restaurateurs to address today's healthy living challenges —and to develop a comprehensive, holistic approach to healthy living that encompasses a multitude of solutions

Ed t

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• Educate• Engage• Partner

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What’s New?• Menu options

– Offering additional choices for adults and children that:• Reduce calories, portion sizes, fat and sodium • Increasing fruits, vegetables, whole grains

– Association, PMA, & Intl Food Distributors are working to achieve a goal of doubling the use of produce in the foodservice sector over the next 10 years

– Working with CIA to develop healthier menu items, including reducing sodium

– Menu items listed as “healthy” grew by 65% between

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Menu items listed as healthy grew by 65% between 2009-2010 (Mintel Menu Insights)

– Over 50% of chefs stated that lower sodium menu items is a hot trend for 2011 (“What’s Hot Survey”, Association, 2010)

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Announced this week, HDF has launched a new “Sodium Savvy” feature on the website which identifies over 60 restaurants (nearly 10,000 locations) with menu

options that contain less than 750 mg of sodium.

From Fast Food to Upscale Dining

8IN COLLABORATION WITH:

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Menu Labeling

• Support from the National Restaurant Association and the Coalition for Responsible Nutrition Information

• Support from Center for Science in the Public ppInterest and over 77 health and consumer groups

• Bipartisan decision makers in Congress

• Establishes a uniform national standard

• Pre-empts state and local menu labeling requirements

N t iti i f ti

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• Nutrition information • In writing and available on the premises to consumer upon request

• Calories; % calories from fat; total fat; saturated fat; cholesterol; sodium; total carbohydrates; sugars; dietary fiber; protein; likely trans fat

SodiumSodium

Technical Challenges & Opportunities

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SodiumSalt (NaCl) has multiple unique functions• Taste• Enhances other flavors

• Provides binding strength in meatsI t d• Reduces bitterness

• Microbial safety• Promotes development of color

in cooked meat products, cereals, and bread

• Controls fermentation in cheese and related products

• Improves tenderness• Reduces cooking loss in meats• Strengthens gluten in bread

dough for uniform texture, grain and dough strength

Other sodium salts• Bicarbonate – leavening in cheese and related products

• Minimizes ice-crystal formation in frozen products

• Promotes firm texture in processed meats

gbaking

• Ascorbate – vitamin C source• Lactate and sorbate –

preservation• MSG – umami taste• Citrate – pH regulation

Technical Opportunities and Challenges

Opportunities• Shift food intake pattern

Education

Challenges• Reformulation costs

– Product development – Education• Reduce intake

– Portion control– Consumption frequency– Alternative promotion

• Reformulation– Gradual changes for

consumer acceptance

p(ingredient supply)

– Consumer acceptance (needs research)

– Concept to Commercialization

– Resource reallocation (e.g., may exceed $ 0.5 MM / product)

• Ingredient costs• Distribution costs– Introduce line extensions,

e.g., reduced sodium products

Distribution costs• Regulatory statutes and

costs• Consumer demands and

timelines incongruent with technology

Courtesy of Robbie Burns, Nutrition Implications LLC , October 2010

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Key Points on Sodium

• There is no substitute for sodium chloride (salt)• More research is needed to understand human salt taste

mechanism• Many non-chloride salts (citrate, bicarbonate) are

involved in food functionality but have not been researched regarding effects on BP

• Current technologies only allow for gradual reduction to ensure good taste. Every food system is different – not a one size fits all approach

• Reduced sodium products must meet high consumer expectations in order to be successful

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Sodium Reduction is a PriorityCompany ExamplesCampbell’s Pepperidge Farm

SoupsV8 juice

ConAgra Foods

Across portfolioHealthy Choice soups

General Mills Across multiple categories

Heinz Tomato ketchupBagel Bites

Kellogg’s Committed since 2001

Kraft Foods Across categories over 2 years

Nestlé SA < 100 mg/100 kcal

PepsiCo 25% - Key global snack brands by 2015

Sara Lee Implemented over 5 years

The supply chain to restaurants must be able to provide reduced sodium products

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A Few Examples of Restaurants

• “Stealth Health”

• Sodium Savvy – Healthy Dining Finder• Sodium Savvy – Healthy Dining Finder

• National Salt Reduction Initiative

• Au Bon Pain• Starbucks• Subwayy• Uno Chicago Grill

Current Research

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Average Intake of SodiumULAIAI

Source: NHANES 2003-2006, n=18,063 with complete, reliable 24-hour recall interview 17

Average Intake of Sodium

Source: NHANES 2003-2006 using NCI method to determine usual intake18

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- Ranking 1-10Foods Mean ± SE % Rank

Food Sources of Sodium (mg/d) and Percentage Contribution to the U.S. DietAll Aged 2+ Yr (n = 16,822)

TOTAL (ALL FOOD GROUPS) 3422.1 ± 28.4 100.00

Yeast breads and rolls 296.0 ± 6.4 8.65 1Cheese 258.7 ± 5.8 7.56 2Frankfurters, sausages, luncheon meats 230.7 ± 6.9 6.74 3Condiments and sauces 180.5 ± 8.1 5.27 4Crackers, popcorn, pretzels, chips 153.6 ± 4.1 4.49 5Pork, ham, bacon 149.0 ± 7.9 4.36 6Pork, ham, bacon 149.0 ± 7.9 4.36 6Biscuits, corn bread, pancakes, tortillas 140.2 ± 5.4 4.10 7Cake, cookies, quick bread, pastry, pie 116.8 ± 3.7 3.41 8Soup, broth, bouillon 105.7 ± 4.6 3.09 9Tomatoes, tomato/vegetable juice 97.4 ± 3.9 2.85 10

Top Ten Food Sources 50.51Source: NHANES 2003-2006 using one-day intake

- Ranking 1-20Foods Mean ± SE % Rank

TOTAL (ALL FOOD GROUPS) 3422.1 ± 28.4 100.00

Food Sources of Sodium (mg/d) and Percentage Contribution to the U.S. DietAll Aged 2+ Yr (n = 16,822)

Milk 85.3 ± 2.9 2.49 11Salad dressings, mayonnaise 80.7 ± 3.7 2.36 12Poultry 76.7 ± 3.0 2.24 13Ready-to-eat cereal 72.9 ± 2.1 2.13 14Mixtures mostly grain 69.5 ± 5.3 2.03 15Margarine and butter 53.2 ± 1.6 1.55 16Olives, pickles 46.5 ± 2.2 1.36 17Potatoes (white) 40.0 ± 2.1 1.17 16Legumes 39.9 ± 2.7 1.17 19Beef 39 5 ± 1 9 1 15 20Beef 39.5 ± 1.9 1.15 20

Top Ten Food Sources 50.51

Top Twenty Food Sources 68.17

Top Thirty Food Sources 75.54

Top Forty Food Sources 77.79

Source: NHANES 2003-2006 using one-day intake

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T i l d i h ith• Typical sandwich with lunch meat = 1344 mg sodium

• Is 1500 mg of sodium realistic and sustainable?

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Average Intake of PotassiumNo ULAIAI

Source: NHANES 2003-2006 using NCI method to determine usual intake22

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Average Intake of Potassium

Source: NHANES 2003-2006 using NCI method to determine usual intake23

The Relation of Dietary Sodium Intake toBlood Pressure and Cardiovascular Events

CVD↑

SBP↑

CVD

2.0

1.0

Sodium Intake (grams/day)1 2 3 4 5

CVDSBP

In normotensive persons a ↓ in sodium intake of 160 mmol (3.68 g) produces a 1.2 mmHg ↓ in Systolic BP: JAMA, 2010

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Recent Sodium Data

• Sodium consumption has remained consistent over the past 46 years

• Studies indicate average 24-h urinary sodium is 3565-3680 mg/d– 38 studies in the U.S. dating from 1957 to 2003 (AJCN, 2010)– 33 countries dating from 1984 and 2008 involving nearly 20,000

people revealed no evidence of a change over time (Clin J Am Soc Nephrol, 2009)

• very diverse populations and eating habits– Scientists believe this is evidence of a “normal” range of dietary

sodium intake in humans – set point

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Research SummaryMean usual intake of sodium in Americans (2+ years) is 3,421 mg/day

Percentage of the population exceeding recommended intakes of di i hi hsodium is high

Mean usual intake of potassium in Americans (2+ years) is 2,613 ± 16 mg/day

Percentage of the population meeting recommended intakes of potassium is very low

Effects of reduced sodium intake on morbidity and mortality unknown need for population based RCTsunknown – need for population based RCTsNeed to put sodium reduction in perspective with other nutrition related issues

Blood pressure is multi-factorial – weight, physical activity, sodium, potassium, genetic variation

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Question: How concerned are you with your personal sodium intake?

The Majority of Americans are NOT Concerned with their Sodium Intake

Extremely concerned

11%

Somewhat concerned

30% Not very

Not at all concerned

19%

More likely to be concerned:•Ages 55+•African-Americans (vs. Caucasians)•Those with a BMI indicating obesity

Neither concerned nor unconcerned

18%

yconcerned

23%

n=1005

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Four in Ten Consumers Believe that Low-Sodium Products do NOT Taste as Good

Question: To what extent do you agree or disagree with the following statements regarding sodium?

Scale: 1=”strongly disagree,” 2=”somewhat disagree,” 3=”neither disagree nor agree,”4=”somewhat agree,” 5=”strongly agree”

Strongly disagree

9%

Somewhat agree31%

Strongly agree8%

Low or reduced sodium products do not taste as good.

More likely to agree low-sodium products do not t t d9%

Somewhat disagree

21%Neither disagree nor

agree31% 28

taste as good:Males (44%) vs. Females (36%)

n=1005

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Summary• Sodium is a critical ingredient for flavor, texture, and safety

• The National Restaurant Association supports voluntary efforts to reduce sodiumreduce sodium – On-going efforts to reduce sodium in menu items

• To be effective, any approach to reducing sodium intake must be incremental and take into account the eating preferences of consumers and the multiple uses of sodium in the food supply

Ed ti i iti l• Education is critical– Increase demand for lower sodium menu items

• Need to place proper emphasis on total diet to address health and wellness

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Thank-You