Salt and Health newsletter

Richard L. Hanneman
Salt Institute
Salt and Health newsletter
Winter 2006

While implementation presents an immense challenge, a focus on implementing salt reduction ignores the basic question: why do it at all? What evidence do we have that reducing dietary sodium will lower the risk of heart attacks and strokes as forecast? A strong consensus has emerged that health outcomes are the appropriate metric and that how we lower blood pressure makes a difference. While a major federal government trial of various drug therapies has been completed, no trials of lifestyle interventions have been undertaken to determine the safety and efficacy of interventions like salt restriction in improving cardiovascular outcomes or all-cause mortality. Only a limited number of observational studies have been reported on the question of whether those on low-salt diets have achieved the long-predicted lowering of heart attack incidence. It turns out that these few studies show that salt restriction does not improve health outcomes at all.

Richard L. Hanneman
Salt Institute
Salt and Health newsletter
Spring 2006

We trust government to provide scientifically-sound health advice. This trust is jolted when each day’s headlines announce another refutation of time-honored treatments, another medication or medical device withdrawn from the market, or another long-held dietary recommendation disputed loudly among the experts. Why are pills and policies plagued with confusion, contradictions, and controversy? The Task Force on Community Preventive Services, in practice, government public health decisions are often “…driven by crises, currently ‘hot’ issues, and concerns of organized interest groups,” and as a consequence, “policies and programs are frequently developed around anecdotal evidence and expert opinion rather than empirical evidence” We need evidence-based, outcomes-oriented public health policies will provide major societal benefits. Health policies that are not based in credible evidence serve to misdirect resources into “politically correct” interventions, with little or no benefit to the public for whom they were created. Such policies will disappoint in their results and undermine the credibility of public health leaders. We need policies based on the quality of the evidence, not the quantity of voices demanding this action or that. Consensus standards define how we should consider scientific evidence.

Richard L. Hanneman
Salt Institute
Salt and Health newsletter
Winter 2007

Obesity is a major public health concern and some anti-obesity dietary recommendations suggest salt reduction among the interventions to control weight. There is no evidence that non-caloric salt contributes to weight gain except for entirely transitory "water weight." Two large, federally-funded clinical trials, TOHP II and DASH, have documented that reducing salt intake does not improve weight loss or blood pressure control where a high quality diet known to lower blood pressure is utilized. The evidence exonerates salt as a cause of obesityand even assigns it a positive role in encouraging an increase in healthy pursuit of physical fitness. In the vast majority of cases, overweight and obesity result from energy input exceeding energy output. Salt Institute. Salt and Health newsletter, Winter 2007.

Richard L. Hanneman
Salt Institute
Salt and Health newsletter
Spring 2007

Confusion in the study of nutrient effects in relation to disease outcomes in the past has been reflected in health policy and dietary advice. The promotion of increased or decreased intakes of specific nutrients may well improve single medical conditions in some settings and in some individuals. We now recognize, however that emphasis on these narrow approaches is misplaced, diverting time, effort, and tax dollars that could be directed toward practices with population-wide benefits. Dietary recommendations must be based on strategies that have the greatest likelihood of accomplishing the purposes for which they are designed. Public and voluntary health organizations are gradually moving from the tenuous database of single-nutrient studies to that of dietary patterns, integrating new, more stable, and more comprehensive findings into practical and practicable recommendations.

Morton Satin
Salt Institute
Salt and Health newsletter
Summer 2007

An aggressive 30-year anti-salt campaign in Finland is credited by advocates of universal salt reduction with proving that lowering population dietary salt intakes will achieve long-predicted benefits in terms of improved cardiovascular health and longer lives. Finland, indeed, cut salt intakes from 14 grams/day to 8 grams/day (North Americans generally consume about 8 grams a day). But these advocates always report Finland's "achievement" without comparing it to the worldwide health advances and the cardiovascular progress of Finland's neighbors. Compared to Western Europe and North American populations, using World Health Organization data, Finland's health gains pale; all other countries' health improved more than Finland's -- without reducing dietary salt.

Morton Satin
Salt Institute
Salt and Health newsletter
Fall 2007

Consumers are misled by single-nutrient dietary advice. Intelligent consumer dietary choices require context, much as foods themselves should be chosen in the context of the whole diet. Label symbols or food scores, by isolating a single variable, make it difficult for consumers to understand nutrition and exercise wise choices.

Morton Satin
Salt Institute
Salt and Health newsletter
Winter 2008

Humans require dietary salt to live and thrive, but some have suggested that the human appetite for salt is an acquired taste, not something physiologically engineered into our bodies to ensure we get enough of this essential nutrient. New neurological research into the "wiring" of our brains shows that salt appetite is "hard-wired" into our systems and that low-salt diets trigger hormonal releases to stimulate our bodies to seek additional salt.

Morton Satin
Salt Institute
Salt and Health newsletter
Spring 2008
Our bodies require that every day we consume a tasty white granule to make sure our bodies can absorb insulin, needed to control our metabolism. Sugar, right? No. Salt. When the body doesn't get enough insulin, it cannot absorb glucose. This insulin resistance triggers diabetes in a process known as the "metabolic syndrome." Dietary therapy is routinely used to prevent or manage insulin resistance. The government's ACCORD trial examined dietary strategies to combat insulin resistance including a low-salt diet. But low-salt diets stimulate the production of the hormone renin in the kidney which increases insulin resistance. Once again, the myopic focus on salt reduction for hypertension ignored the multiple metabolic effects of reducing dietary sodium, increasing the health risk of those who took their doctor's advice to cut back on salt.

Morton Satin
Salt Institute
Salt and Health newsletter
Summer 2008
Elevated blood pressure is a risk factor for cardiovascular events like heart attacks and strokes. Populations with lower blood pressure have lower cardiovascular mortality. But blood pressure is a less powerful risk factor than the lesser-known hormone aldosterone. Low-salt diets trigger production of aldosterone which causes cardiovascular injury without raising blood pressure. Studies in Japan and Israel show that consumption of the U.S.-recommended 2,300 mg/day sodium diet provides an insufficient amount of salt to block the production of aldosterone.