A Panera Bread restaurant on May 5, 2015 in Chicago,...

A Panera Bread restaurant on May 5, 2015 in Chicago, Ill. Credit: Getty Images

The New York City Board of Health on Wednesday approved a first-in-the-nation measure to require chain restaurants to post warning labels on menus about some foods' high sodium content.

The city has been a "pioneer" in health notices on menus -- including calorie-count labeling that has been widely adopted elsewhere -- and a salt-content warning is a "real step forward for public health," Health Commissioner Dr. Mary Bassett told reporters after the meeting.

"We think that a warning label is a very simple, straightforward way to convey necessary information for people to make healthier decisions," she said.

Even a salt caramel milkshake can have more than the recommended daily dose of sodium, Bassett said.

Beginning Dec. 1, a black-and-white salt shaker icon must appear next to meal options with more than the recommended daily limit of 2,300 milligrams of sodium, which equals about a teaspoon of salt. The regulation affects about 10 percent of offerings at fast-food chains and restaurants.

The board approved the salt warning labels unanimously. The American Health Association applauded the move. The New York State Restaurant Association was among the groups that opposed it.

"It is disappointing the Department of Health has decided to go forward with sodium menu warning labels when more comprehensive federal regulations take effect next year," said Melissa Fleischut, the association's president and CEO. "The establishments that fall under these new regulations will be forced to construct costly new menu boards in consecutive years."

Fleischut added, "This is just the latest in a long litany of superfluous hoops that restaurants here in New York must jump through. Every one of these cumbersome new laws makes it tougher and tougher for restaurants to find success."

The board Wednesday also repealed a Bloomberg-era consent form for an oral suction circumcision ritual practiced in some ultra-Orthodox Jewish communities.

In approving the repeal, city officials are using community outreach to educate parents about herpes and other health risks associated with the bris ceremony known as metzitzah b'peh.

The consent form, introduced in 2012 under former Mayor Michael Bloomberg, showed parents acknowledged the risk of herpes contraction in the ritual in which a religious officiant uses his mouth to remove blood from the incision.

Since 2000, a total of 18 cases of infant cases of herpes linked to the ritual have been reported to the Department of Health.

Since the informed consent rule took effect, two religious officiants -- called mohels -- were found to have spread herpes through the procedure, Bassett said. In one of the cases, the parents had signed a consent form, she said.

The vote to repeal the consent form was 9-1 with one abstention.

Many in the ultra-Orthodox Jewish community believed the form was government overreach, and its use had proved difficult to enforce.

It is being replaced in part by Department of Health brochures -- available in English and Yiddish -- that are circulated at hospitals as well as obstetricians' and pediatricians' offices so doctors rather than mohels could be the first to inform parents about the health risks.

"Make a safe bris for your baby," the brochure reads while reminding parents the choice is ultimately theirs.

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