Grace X. Ma, director of the Center for Asian Health, said restaurants in low-income African American and Latino communities in North, South, and West Philadelphia were recruited because Chinese take-out is such a diet staple in those neighborhoods, often eaten several times a week, and because high blood pressure is so prevalent among those communities, with nearly half of African American adults and 30 percent of Latinos in Philadelphia with hypertension.
Over the last 18 months, cooks and owners from 221 Chinese takeout restaurants attended classes with a professional Chinese chef, who demonstrated how to use less salt by using more spices, reduced-sodium soy sauce, and less sauce. The program, which included a single cooking class, focused on two of the most popular dishes: chicken lo mein and shrimp and broccoli.
Won Cheng Ho, owner of Wing King, a humble takeout corner-kitchen at 22d and Reed Streets, took the class and proudly produced his certificate.
A sample tasting of those two dishes at Wing King were flavorfully seasoned without being noticeably salty or heavily sauced.
For most dishes, the restaurant uses sauces and herb blends to season, without adding salt, Cheng Ho said. And he has been using less salt in soups. But he is not yet using low-sodium soy sauce, which is more expensive than regular soy sauce.
The owner at Choy Yung Inn, at 22d and Cross Streets, appeared less concerned about sodium content than satisfying the angry customers berating him while a cook scrambled behind the bulletproof wall. When asked about the low-sodium initiative, there was no recognition.
Giridhar Mallya, the director of policy and planning for the health department, acknowledged the challenges of a voluntary program, and the difficulties of monitoring the results. But he said he was surprised by the number of restaurants that agreed to participate.
The vast majority of the 240 restaurants that were approached accepted. Only 20 restaurants declined, Mallya said, crediting the Chinese Restaurant Association, a group trusted by the restaurant owners, for the strong buy-in.
"Many of us know that too much sodium is a problem," said Steven Zhu, the association's general secretary. "But this program helped us to understand what we could do to lower sodium content and help our customers be healthier."
Packaged and restaurant food accounts for more than 75 percent of the salt we consume, Mallya said. And some Chinese takeout dishes exceed the amount of sodium recommended for an entire day, he said. The goal of the initiative was to reduce the amount of sodium by 10 to 15 percent.
The Center for Asian Health and its partners studied the restaurants' purchasing and cooking habits, as well as the salt content of meals before the classes. They found that chicken lo mein had an average of 3,200 milligrams of sodium, and shrimp and broccoli averaged 1,900 milligrams, based on 20 restaurants sampled. U.S. dietary guidelines recommend less than 2,300 milligrams per day.
Nine months later, follow-up visits to 20 restaurants - with independent testing of both dishes without the owners and chefs' being aware - found that the sodium levels were reduced by 20 percent, Mallya said. Even with that reduction, the chicken lo mein still exceeds the U.S. guidelines per day.
"I think our first cohort of results are very promising," said Ma of the Center for Asian Health. "We have a long way to go."
"We are trying to create a reward system so that the restaurants that made a change will be posted and acknowledged," after repeated "compliance" checks, she said. The next steps are to increase restaurants' access to affordable, low-sodium ingredients, and to lower the salt content of additional dishes, she said.
"We believe this partnership can improve health and build bridges of understanding and hope," Ma said.
Contact Michelle Dembo at 215-854-4214 or firstname.lastname@example.org.