Trends in sodium content of meat-based vs meat-free menu items in 75 large chain restaurants in the United States 2013-2021

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 2013-2021. 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. Post-estimation margins estimated mean sodium. Analyses were conducted in 2025.

Results: From 2013-2021, 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 2013-2021. 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.

Keywords: Food Supply; Nutrition Policy; Plant-Based; Restaurants; Sodium, Dietary.