Abstract
INTRODUCTION: Reducing meat intake could improve planetary and human health, but high sodium in commercially prepared meat-free foods may undermine some health benefits of reducing meat intake. This study characterized trends in sodium content of meat-based versus meat-free foods in large chain U.S. restaurants and examined mean sodium differences and portions of items qualifying for a high-in-sodium warning label.
METHODS: Data came from MenuStat.org, a longitudinal database of menu items from U.S. restaurants collected annually from 2013 to 2021. The analytic sample included 24,147 items from 75 restaurants. Linear regression for panel data assessed trends in mean per-item sodium overall and by meat category (meat based/meat free), adjusted for restaurant type, menu category, children's item, and energy. Postestimation margins estimated mean sodium. Analyses were conducted in 2025.
RESULTS: From 2013 to 2021, mean sodium content was high, with no significant changes among meat-based or meat-free items. Meat-free items accounted for 22.1% of items and had lower mean sodium than meat-based items (-301 mg; 95% CI= -365, -238), consistent over time, across restaurant types and nearly all menu categories. Across all years, 13.4%-17.2% meat-based and 3.7%-5.9% of meat-free items would qualify for a high-in-sodium warning label by exceeding 100% of the sodium Daily Value.
CONCLUSIONS: Across 75 large chain restaurants, the sodium content of menu items did not change from 2013 to 2021. Meat-free items were lower in mean sodium than meat-based items but were still high in sodium. Efforts to shift toward plant-forward diets should be paired with stronger sodium reduction policies.