Suppose, as some experts advise, that the new national dietary guidelines due this spring will lower the recommended level of salt. Suppose further that public health officials in New York and Washington succeed in forcing food companies to use less salt. What would be the effect?

A) More than 44,000 deaths would be prevented annually (as estimated recently in The New England Journal of Medicine ).

B) About 150,000 deaths per year would be prevented annually (as estimated by the New York City Department of Health and Mental Hygiene).

C) Hundreds of millions of people would be subjected to an experiment with unpredictable and possibly adverse effects (as argued recently in The Journal of the American Medical Association ).

D) Not much one way or the other.

E) Americans would get even fatter than they are today.

Don’t worry, there’s no wrong answer, at least not yet. That’s the beauty of the salt debate: there’s so little reliable evidence that you can imagine just about any outcome. For all the talk about the growing menace of sodium in packaged foods, experts aren’t even sure that Americans today are eating more salt than they used to.

When you don’t know past trends, predicting the future is a wide-open game.

My personal favorite prediction is E, the further fattening of America...

Tierney reviews research and conclusions from prominent salt experts Drs. David McCarron and Michael Alderman and concludes:

Before changing public policy, Dr. Alderman and Dr. McCarron suggest trying something new: a rigorous test of the low-salt diet in a randomized clinical trial. That proposal is rejected by the salt reformers as too time-consuming and expensive. But when you contemplate the potential costs of another public health debacle like the anti-fat campaign, a clinical trial can start to look cheap.

We agree.