Fearmongering prevails. Fearing their diets may mean risk of chronic disease, consumers seek to lower their risks by using "healthy" foods, whose unhealthy ingredients are reduced or eliminated. But is seems there is no escape: health conscious, label-reading food purchasers should be fearful, too according to Wall Street Journal Health section reporter Melinda Beck. Beck asks "What's really in many 'healthy' foods?" She answers using salt substitutes as an example where consumers are misled into thinking "healthy" confers some health benefit to them personally. Regarding salt substitutes, she explains:

If you're trying to cut down on salt, check with your doctor before you start using a salt substitute. Most contain potassium chloride, which can exacerbate kidney problems and interact badly with some heart and liver medications.

With only a bit more research, Beck could have noted the other "healthy" additives used to replace salt. Besides potassium chloride, salt replacers include calcium chloride, magnesium sulphate (Epsom salts) and various metal ion replacers as well as various other proprietary chemicals.

Food manufacturers also try to reduce the natural salt content of their foods by using "salt enhancers" that include: 5-ribonucleotides, disodium guanylate, disodium inosinate, inosine 5-monophosphate, 5'-guanidylic acid, glycine monoethyl ester, L-lysine, L-arginine, lactates, Mycosent, Trehalose, L-ornithine, Ornithyl-β-alanine, monosodium glutamate and Alapyridaine (N-(1-Carboxethyl)-6-hydroxymethyl-pyridinium-3-ol).

Salt is a natural bitterness inhibitor. To give "healthy" -- but bitter -- low-sodium foods acceptable taste, food producers sometimes replace salt with 2,4-dihydroxybenzoic acid. Now that's real "health food"!

Dietary salt's use in food is as Winston Churchill said about democracy being "the worst form of government except all the others that have been tried."

The headline in yesterday's USA Today declared: "Food doesn't have to take up a huge chunk of your budget." Reporter Jayne O'Donnell reports that the Food Marketing Institute will release a report Sunday showing that more consumers are eating at home: 85% eat a home cooked meal three or more times a week, up from 75% in 2006 (personally, I find that astoundingly low, but, then, my wife's an excellent cook and backyard barbeque season is upon us so maybe my home-cooked lifestyle is abnormal).

Since the end of WWII, there has been a notable trend for Americans to eat more foods prepared outside the home, both in restaurants and packaged, processed foods, perhaps heated at home, but not "home cooked." Depending on FMI's definition, perhaps the country's current economic travails will blunt or reverse a parallel trend: a gradual erosion of round can sales of table salt: a reliable indicator of the amount of "home cooking" being done.

"The most standard of seasonings has gone gourmet," proclaims Condé Nast. The publisher of advisories for the well-heeled and well-traveled has produced a Salt Food Guide to help its upscale readers understand the variety of salts available to them through gourmet stores and, increasingly, in fine restaurants. See the slide show .

Packaged and processed foods sold in the United States started carrying standardized nutrition labels in 1994 when the Nutrition Labeling and Education Act (NLEA) took effect. The major goal was to increase access to nutrition information and improve consumers' ability to make healthful food choices. Since NLEA took effect, technological change has introduced new sources of nutrition information and the consumption of food away from home has continued to increase. But have these measures been effective?

A new report examines how the consumers' use of nutrition labels have changed over the decade by looking at the trend in use of various nutrition label components and demographic groups. The U.S. experience may help policymakers in other countries who are considering mandatory nutrition labeling to achieve public health goals.

The study reveals that in the decade from 1996 to 2006, consumer use of nutrition labels declined. It declined 3% for the Nutrition Facts panel, 11% for the ingredient list, and 10% for the panel's information about calories, fat, cholesterol, and sodium. In fact, only fiber and sugar did not decline over the 10-year period. Sugar held steady while fiber increased by 2% - a telling result.

The decrease in use of the nutrition label was greatest for individuals in the 20-29 year-old bracket.

If you are wondering how the government possibly misunderstood the information desires of consumers, you need look no further that the new UK Food Standards Agency (FSA) report "Consumer Priorities for Sustainable Development "

Not satisfied with spontaneous answers to questions about what is important to consumers when buying food, the FSA researchers prompted them with specific responses. They then combined both the spontaneous and prompted answer for the final result. For example, only 7% of UK consumers were concerned with salt, but after prompting, an additional 27% said they were concerned. This resulted in a grand total of 34%. Talk about fudging!

Is it any wonder we always fail to recognize the consumers' genuine desires?

A new analysis released today by the U.S. Department of Agriculture reported fewer Americans using federally-mandated nutrition information, especially sodium. The 2005-2006 NHANES study of 9,416 representative consumers found about 7 in 10 use the Nutrition Facts label, about the same as a decade ago. For sodium, only 66% consulted the label in 1995-1996 and that number declined 10% to 60% in 2005-2006. Among nutrients, only cholesterol fell more, 11%. Among all the listed nutrients, fiber was the only one where consumers registered increased concern as reflected in label use.

The label was mandated in 1994; sodium labeling had been in effect a decade before that.

Over the past ten years, 5% more reported "never" using the label. For salt/sodium, the increase in "never use" increased by 10 points from 12% to 22%. A decade earlier, 36% "always/often" used the sodium label; that eroded to 34%.

It would take another study to tell us why consumers are shunning nutrition information, but the pattern is consistent. Eleven percent fewer are using label health claims (37% "never") and even the ingredient list (32% "never"). With the multiplicity of advisories and the fact that scientists dispute the health consequences of cholesterol and sodium (and other nutrients), consumers are overwhelmed and doubtful about the advice they're being given. That's why the new Dietary Guidelines should adopt an "evidence-based medicine" approach in lieu of the expert panel approach of past reviews.

In the article, "Technological issues associated with iodine fortification of foods ," authors Winger, Konig and House describe some of the potential interactions of iodine compounds with foods. This article is of considerable interest because it goes into a range of possible problems associated with high-level iodine fortification - that is, the addition of iodine compounds directly to the finished foods.

Although the authors attempt to make it clear that the negative consequences of iodine fortification of foods would only occur at high levels of fortification and would never be the result of using iodized salt, they do not unequivocally state that, for all intents and purposes, whole formulated food products would never be iodized at levels that would impact the color, flavor or functionality of those foods.

If whole, formulated foods will never be iodized to those levels which can impact on the quality of the food, then the whole issue becomes moot and should not be confused with the use of iodized salt in food products.

Iodized salt can be used in formulating all food products without any fear of reducing quality.

Perhaps it would have been useful for the authors to have made that simple statement of fact.

The New Zealand Bakery Association has blasted FSANZ, warning that its new requirement of iodized salt in bread "will be expensive, claiming there are not a lot of facilities to process iodised salt in the country." The bakers apparently duped foodnavigator.com writer Charlotte Eyre on that point and another: that "iodine is a nutrient commonly found in salt."

Noting that "half truths are the most insidious," the Salt Institute responded, defending the FSANZ decision and pointing out that:

1. Plain salt has 1/100th the amount of iodine of iodine-fortified salt; it may be detectable in a lab, but it's insignificant nutritionally.

2. Salt iodization is not expensive; it costs pennies per year per person.

3. New Zealand may not have "a lot of facilities to process iodised salt," but it's a small country, well-served by Salt Institute member companies Dominion Salt of New Zealand and Cheetham Salt of Australia whose few plants make virtually all the food salt in the country and which can easily accomplish the required iodization virtually with the flip of a switch.

Surely the bakers have better fights to fight.

The UK Food Standards Agency just commissioned a research contract to study the impact that front-of-pack nutritional labeling has on people's food choices. The goal of this project is to gain an insight into the way in which consumers approach purchasing decisions. Of course, the ultimate goal is to assist consumers in making healthier choices.

The problem is that consumers will be considering labels on individual foods and, as a result, evaluating the merits of products outside the context of the whole diet. The project will look at shoppers' understanding of the main types of front-of-pack nutrition labels used in the UK (traffic lights, Guideline Daily Amounts, and traffic light color-coded GDAs) and how they use them. What the project will not even attempt to determine is how consumers incorporate the front-of-pack nutritional labeling information into the context of their whole diet on a daily basis - which is, of course, the most important change because that is how we derive our nutrition on a daily basis.

The program has the unfortunate potential to focus on the means of communicating information and bits of data while ignoring the greater importance of perspective and context. In other words it has the potential of ignoring the forest by focusing on individual trees.

As an example, a consumer could come across a mayonnaise, or a salad dressing preparation which, by itself, would require a red light on the label. If, however, that dressing encourages the consumer to eat a serving or two of healthy cruciferous vegetables, what decision should the consumer make? Avoid the dressing and the vegetables? Certainly not!

But that is a conclusion one might make if the dressing is taken out of the context of the whole diet. An unintended consequence resulting from a focus on one tree rather than the forest.

It will be interesting to see the results of this research, which will be hopefully available by the end of 2008.