Most consumers have placed great faith in their government health agencies and consumer activists’ abilities to keep them up to date with rational and meaningful nutrition data. Incredible amounts of money have been spent on labeling systems claiming to do just that.

Unfortunately, the reality is that the very institutions and people that consumers have depended on to provide them with this information have let them down miserably. An excellent example is the recent work coming out of the USDA that has demonstrated that our calorie counts on food labels are all wrong and have been so from the very beginning. See http://prn.to/OyfQOy

This is not a new revelation. Professionals in the food industry have known for decades that our understanding of calories is bogus. Calories are determined by a technique called oxygen bomb calorimetry – a fancy term to describe the complete oxidation of a food substance. The amount of heat produced is measured as calories. BUT THAT IS NOT THE WAY WE EAT FOOD. There is such a thing as digestibility! The structure of a food will affect its digestibility, and any undigested food will NOT be oxidized. But digestibility is never considered in the calorie listing on the label. I have complained about this for years at public meetings, only to be totally ignored by our public health bureaucrats. See http://bit.ly/PiHQ3t and http://bit.ly/M8tAKf . In the animal feed industry, this has been understood for decades, but not for human foods.

Why hasn’t the government accounted for this information known for decades? One reason – sloth! Accounting for digestibility means a lot more work, which they are not interested in doing. They have justified this by saying it is an unnecessary complication that consumers will not understand. As long as there was no public pressure to get it right, they didn’t want to rock the boat.

Why haven’t our consumer advocates told us about this? I can think of two reasons. Either they know so little about food that they were unaware that digestibility was never calculated in the calorie declarations or because of their ‘Merchant of Menace’ agenda, they preferred to have consumers believe that the calorie content of foods were higher than they actually were.

In fact, food digestibility has even greater implications. Foods that are less digestible have a lower bioavailability of all their nutrients, not just calories, so the entire label is wrong. Worse, in the dynamic digestions system we all have, eating low digestibility foods will hasten the passage of whatever else we are eating along with them through our system and will lower the bioavailability and calories of those foods as well. This is not rocket science! It is clear to anyone that takes the trouble to see what is going on.

Come to think of it, it’s not only time that our nutrient labeling system is overhauled; it’s time to replace those we depended on for years.

Today’s MoM (Merchant of Menace) health headlines blared out, “Diets High in Salt Could Deplete Calcium in the Body.” (http://tinyurl.com/brrsj89 and http://tinyurl.com/cae6oxv ) It was even reported that way throughout Asia. While this important issue is worthy of study, the reported conclusions of the research appeared to be driven more by an anti-salt ideology than by actual evidence. The giveaway was the statement in the University’s press release, “This is significant because we are eating more and more sodium in our diets, which means our bodies are getting rid of more and more calcium. Our findings reinforce why it is important to have a low-sodium diet and why it is important to have lower sodium levels in processed foods.”

Wrong!

The actual evidence shows that our salt consumption has remained unchanged since the 1950s (Bernstein & Willett, Am J Clin Nutr, 2011). Therefore, any growing impact resulting from calcium depletion cannot be attributed to increased salt consumption. In fact, we now eat less salt than we did 200 years ago (http://tinyurl.com/cmaaq4d ). The reason is that refrigeration has replaced salt as the primary means of food preservation.

What makes the press release even more bizarre is that the actual publication in the American Journal of Physiology stated that all the experimental research was carried out on opossum cells and genetically modified mice! The rest of the story on calcium loss in humans was pure hypothetical speculation! No fooling, opossum cells and GM mice. Would you say that the headline, “Diets High in Salt Could Deplete Calcium in the Body,” was somewhat exaggerated? Do you have any reason to trust what the University press releases say in future? Better to go back to the original study and eliminate all the gratuitous speculation and opinion and stick with the evidence. You will be better informed.

You can read many more exaggerations in the salt:health debate at http://tinyurl.com/7v48267 , where you will also have reference to all the peer-reviewed studies.

The 24 hour news cycle just received a contribution from the British National Health Service regarding a World Cancer Research Fund report supposedly linking salt to stomach cancer (http://tinyurl.com/cy45xdu ). Unfortunately, the report did not distinguish if it was actually salt that was the link or the foods containing the salt. As an example, smoked fish has been linked to stomach cancer over the years and smoked fish contains salt, but more importantly it contains nitrosamines, which are known powerful carcinogens. So even though salt is in the food, it is not the link to cancer.

In fact, salt or sodium chloride is not listed in ANY of the carcinogen databases. However, if you look at World Cancer Research Fund’s little brochure on salt (http://tinyurl.com/bok7kgv ), you will see that they recommend the following alternatives to salt. Chilli powder, which is laced with the deadly chemical, Sudan IV, (http://tinyurl.com/dxdexdc ); ginger, which can harbor carcinogenic aflatoxins (http://tinyurl.com/d2fd2pr ); basil, which contains estragole, a known carcinogen and teratogen (http://tinyurl.com/28mclj ); and black pepper, which can contain N-nitrosopiperadine, a strong carcinogen (http://tinyurl.com/ccqsp5l ). In other words, the World Cancer Research Fund recommends four known carcinogens to replace salt!

Interesting advice.

The British newspapers headlined a report issued today by the World Cancer Research Fund (WCRF) that stated if people consumed foods according to the Dietary Guidelines, one-in-seven cases of stomach cancers would be prevented. Now, there are 6,000 cases of stomach cancer every year in the UK and the WCRF estimated that around 800 could be avoided if everyone stuck to their 6g of salt a day.

However, looking at British heath statistics, it has been variously estimated by researchers that approximately 46,227 cases of stomach cancer could be avoided if we gave up the carcinogens in coffee, tea, cocoa, meats, all fried, grilled, bbq'd and broiled foods, sugar and sweeteners.

Fortunately, as most people are unaware of this, they continue to consume these foods to their heart's content and have thus greatly reduced the total number of potential cases.

Harvey Levenstein, professor of history at McMaster University in Hamilton Ontario has just written a book entitled “Fear of Food - a history of why we worry about what we eat.” (See: http://tinyurl.com/ckyldhd ). In fact there is a legitimate medical condition called cibophobia or sitophobia, which causes a person to fear food, usually when it is prepared by someone other than themselves or if it contains an unfamiliar ingredient.

The fear of food has been around since we have chosen to allow others to prepare our foods. (See: http://tinyurl.com/bpyu6h7 ). The 1589 English Bread Assize was issued to protect consumers from flour contamination. One of the more famous books of the 19th century on food adulteration was written by Fredrick Accum in 1820, and described the fraudulent practices used in making bread, beer, tea, condiments and dairy products. This naturally heightened the fear that many had of foods being prepared by others.

The first regulation to control such practices was the Pure Food and Drug Act of 1906, also called the Wiley Act. As a result, food adulteration dropped dramatically. Nevertheless, many people still have a great deal of fear and suspicion of foods. Most of these are now driven often by the fear tactics of ‘consumer’ activists, who appear to be very long on rhetoric, but rather short on scientific evidence. Unfortunately, a great many journalists have abandoned solid research for the hype and headlines that these activists generate.

As a result, we have a population that is continuously bombarded with exaggerated threats posed by the dangers of foods. The old line, “Even paranoids have enemies,” may be cute but doesn’t vindicate paranoia. It is the same with any irrational fear, including cibophobia.

The book “Fear of Food” is a worthwhile read, especially since it also describes the negative role of organizations such as the American Heart Association in generating exaggerated and unjustified food fears amongst consumers in order to promote its own parochial goals. In fact, a full investigation of the tactics of the AHA would make an interesting book in itself. Keep that in mind the next time you eat supposedly heart healthy foods.

The Dietary Guidelines are a joint product of USDA and HHS. These Dietary Guidelines are reviewed, fully updated, and published every five years. The 2010 Dietary Guidelines must contain nutritional and dietary information for the general public and be based on the very latest scientific and medical knowledge.

For the 2010 Dietary Guidelines, the Dietary Guidelines Advisory Committee (DGAC) was appointed to conduct an analysis of the latest scientific information on diet and health and to prepare a report summarizing its findings. As far as electrolytes are concerned (specifically salt or sodium), the process appeared to be highly flawed. Rather than independently and objectively assessing ALL of the scientific and medical data currently available, the DGAC merely adopted the conclusions of the 2005 Dietary Guidelines. Was there no additional new evidence to consider?

In 2005, the DGAC made its salt/sodium recommendations by simply adopting the figures from the Dietary Recommended Intakes (“DRIs”), published in 2004 by the Institute of Medicine (“IOM”) (1). But this document stated, “..because of insufficient data from dose-response trials, an Estimated Average Requirement could NOT be established and thus a Recommended Dietary Allowance could NOT be derived.” Nevertheless, despite acknowledging a lack of dose-response evidence, the document went on to make totally arbitrary recommendations - recommendations that are followed to this day (2) - recommendations that have since been shown to be all wrong (3).

How could this happen?

Looking deeper into the matter, it appears that one common thread links ALL the decisions to adopt flawed recommendations in the original DRIs, and then base two subsequent sets of Dietary Guidelines on those figures. Believe it or not, the Chairperson of the 2010 DGAC’s subcommittee on electrolytes did exactly the same job for the 2005 US Dietary Guidelines! But it doesn't stop there. That individual was also the Chairperson of the IOM Panel on Electrolytes the original DRI’s!

In other words, in what was supposed to be a fully independent analysis, the very same individual repeatedly evaluated his own recommendations! What did anyone expect the outcome to be? It's no different than a judicial appeal process that asks the same judge to evaluate his own previous judgement! Any ethical judge would recuse himself from the process.

You simply cannot have an independent, objective analytical process featuring the same person creating the original standards, then being asked to evaluate his own recommendations and then five years later, being tasked once again to evaluate his prior evaluation. Yet, that is exactly what happened.

What is worse is that all the US public health institutions, as well as public health institutions around the world have uncritically adopted these recommendations. This has resulted in what may be the biggest delusion in modern public health history!

References

1) Institute of Medicine, Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate, v.-xiii (2004).

2) Both the Dietary Guidelines and the 2005 Dietary Guidelines contain the same sodium limit range of 1500-2300 mg/day. Because a Recommended Daily Allowance could not be determined, the IOM set DRIs that are the basis for the sodium limits in both the 2010 Dietary Guidelines and the 2005 Dietary Guidelines. See IOM, Dietary Reference Intakes: Water, Potassium, Sodium, Chloride, and Sulfate (2004).

3) Maillot M, Drewnowski A. A Conflict between Nutritionally Adequate Diets and Meeting the 2010 Dietary Guidelines for Sodium. Am J Prev Med. 2012;42(2):174-179.

We are now living longer than we ever have in history. Between 1940 and 2040 the population above the age of 85 will increase 40-fold. In fact, one of the fastest growing segments of the US population is people over the age of 85. They accounted for about 12% of all elderly people in 2000 and are expected to grow to 20% by the year 2040 (1).

Because of this meteoric rise in the number of elderly people, geriatric problems are on a steep and steady rise. Dehydration, falls, fractures, cognition, attention deficits and sensory disorders are now becoming much more commonplace.

The latest information on the subject was presented last week at the 20th annual meeting of the Society for the Study of Ingestive Behavior held in Zurich, Switzerland. In a presentation entitled, “Salt appetite across generations: aged and middle-aged,” researchers Khadeja Hendi and Micah Leshem of the Department of Psychology, University of Haifa, confirm that, in the elderly, impaired thirst results in a greatly increased the risk of dehydration. However, salt appetite does not diminish with age. In light of the risks to cardiovascular health and longevity from consuming any less than 6.5 g or more than 15 g of salt per day, increasing intake in the elderly prone to dehydration should be examined (2). Their findings show that the healthy salt appetite in most aged may be harnessed to sustain hydration status. This should serve as an additional reminder to assisted living care givers to be very cautions before recommending a ‘low-salt’ diet for the elderly.

Furthermore, in older people, mild hyponatremia is the most common form of electrolyte imbalance and has been shown to be associated with walking impairment, attention deficits and a much higher frequency of falls. Indeed, there have recently been a number of publications that found a direct relationship between mild hyponatremia and falls, bone fractures, unsteadiness and attention deficits (3, 4). Falls are a major socioeconomic problem in the elderly. About 30% of people over 65 fall every year (5, 6). Fall-related injury in the elderly is associated with numerous psychological and physical consequences and is a leading cause of death and disability. Falls are also associated with bone fracture in 4–6% of cases and death occurs from complication of fall in around 2% of cases mostly in patients with hip fracture (7). Almost 5.3% of all hospitalizations in people aged 65 years or older are due to fall related injuries (8).

Mild hyponatremia in the elderly is no longer considered as an asymptomatic condition. Evidence clearly points to significantly increased attention deficits, loss of cognitive function, increased falls and fractures – a cascade of conditions resulting in a highly diminished quality of life and a reduced life span. It is a significant threat that can be treated by simply adding salt to the diet.

The elderly should very carefully consider any broad, sweeping recommendations to go on a low salt diet. A well balanced diet, replete with salads, vegetables and fruit is the best approach to enjoying a healthy, active retirement.

References

1) www.merck.com/mkgr/mmg/contents.jsp also CDC figures

2) Alderman, MH, and Cohen, HW, Dietary Sodium Intake and Cardiovascular Mortality: Controversy Resolved? Am J Hypertens, 25 (7), 727-734, (2012).

3) Gankam Kengne, F., Andres, C., Sattar, L., Melot, C., and Decaux, G., “Mild hyponatremia and risk of fracture in the ambulatory elderly,” QJ Med, 101, 583–588, (2008).

4) Renneboog, B., Musch, W., Vandemergel, X., and Manto, M. U., “Mild Chronic Hyponatremia is Associated with Falls, Unsteadiness, and Attention Deficits,” The American Journal of Medicine, 119, 71.e1-71.e8, (2006).

5) Graafmans, W.C., Ooms, M.E., Hofstee, H.M., Bezemer, P.D., Bouter, L.M., Lips, P., “Falls in the elderly: a prospective study of risk factors and risk profiles,” Am J Epidemiol, 143, 1129–36, (1996).

6) Sattin, R.W., “Falls among older persons: A public health perspective,” Ann Rev Public Health, 13, 489–508, (1992).

7) Sattin, R.W., Lambert, D.A., DeVito, C.A., Rodriguez, J.G., Ros, A., Bacchelli, S., et al, “The incidence of fall injury events among the elderly in a defined population,” Am J Epidemiol, 131, 1028–37, (1990).

8) Alexander, B.H., Rivara, F.P., Wolf, M.E., “The cost and frequency of hospitalization for fall-related injuries in older adults,” Am J Public Health, 82, 1020–23, (1992).

Today’s news has trumpeted the success of New York’s trans fat ban (http://goo.gl/QngCo ). While the trans fat ban may have indeed been a success, our understanding of what constitutes a public health success has been an utter failure. The trans fat ban was put into place 5 years ago to benefit the health of New York City’s consumers. The one and only goal of the trans fat ban was to decrease levels of low density lipoproteins (LDL) or ‘bad cholesterol’ and triglycerides – health outcomes that are easy to analyze. Yet, the NYC Department of Health has never released a report showing the impact of the trans fat ban on consumer health outcomes. I have regularly called the Department of Health during the last five years, only to get a response saying the report will come soon – a typical, ‘the check is in the mail’ response.

Why have they not done the study? A lame excuse has been that LDL and triglyceride reductions are the result of many factors, so it is hard to figure out what is going on. If that was the case, why such hoopla about trans fats and none if the other factors? No, there are two reasons why we have not seen the NYC health outcomes report. Either the Dept of Health fear that the outcomes are not significant and would rather not bring attention to the matter or they have done the study and do not wish to release the figures. Either way, the trans fat ban cannot be considered a success until its impact on the health of consumers has been demonstrated. Nothing else will do.

Showing that the level of trans fat has dropped is NOT a measure of success. Success can only be measured as the actual impact on the health of consumers. As of this moment in time, we have no such data. Anyone who declares the ban a success at this time has no appreciation of the intended beneficiary – the consumer.