This has been a busy week of maneuvering on reauthorization of the federal surface transportation program. Several new proposals were tabled, the House Committee unveiled its approach ... and the Obama Adminstration suggested putting the entire matter of until after the next election.

DOT secretary Ray LaHood argued in favor of a simple program extension with funding enough to replenish the depleted Highway Trust Fund that will run out of money in August if no action is taken. He counseled delay to avoid a "rush" although proposals for the authorization bill have been circulating for about three years. DOT provided no details, but announced its strategy hours before the House Committee, controlled by the president's party, put forward its approach.

A bi-partisan "Blueprint for Investment and Reform " announced the next day, June 18, noted that since the 160,000-mile National Highway System was created to supplement the 46,000 mile Interstate system, travel on these major roads has increased three times faster than roadway capacity and logistics costs to U.S. businesses has shot up from 8.8% of GDP in 2004 to 10.1% in 2008, imposing additional costs of $412 billion on the economy -- and in this, reversing 17 straight years where logistics costs had shrunk proportional to economic growth. The House transportation leaders announced their intent to meet the September 30 deadline.

Of course there are dozens of other proposals in circulation. Two new ones surfaced this week as well.

The National Transportation Policy Project announced its “Performance Driven: A New Vision for U.S. Transportation Policy ,” proposing to restructure federal programs, update the criteria for formulas, and create a performance-based system that directly ties transportation spending to broader national goals. These goals include economic growth, connectivity, accessibility, safety, energy security, and environmental protection. States would be measured on how greatly they improve access, lower congestion and petroleum consumption, reduce carbon-dioxide emissions, and decrease fatalities and injuries.

And a group of 61 Democrats has endorsed HR 2724 , the anti-highway “National Transportation Objectives Act.” It lays out six goals: energy efficiency and security; environmental protection; economic competitiveness; safety and public health; system conditions and connectivity; and equal access for urban and rural areas. The bill proposes 10 performance targets ranging from capping and reducing the amount of travel and promoting walking, biking and public transit to reduce greenhouse gas production by 40%.

The Salt Institute is pleased with the consistency among the plans in promoting the concept of system performance. We continue to press for full consideration of the need to fund and focus on roadway operations to promote safety and reduce congestion.

Over the past six months the public's priorities in food choices has shifted from "freshness, health and the environment" to "taste, price, healthfulness and convenience" according to dualing surveys, one by IPSOS and another by the International Food Information Council.

The IPSOS survey conducted six months ago and released June 11 was summarized by IPSOS Executive Vice President David Pring:

We are seeing a global consumer movement toward heightened consciousness of health, wellness and environmental factors in their food purchasing decisions....We are also seeing that taste, convenience and product difference – aspects that were probably more characteristic of food product drivers towards the end of the last millennium – are taking a back seat in a world now more focused on making a positive impact on freshness and health as well as the sustainability of the planet.

Wait a minute, IFIC would respond. Released slightly earlier, the 2009 IFIC survey concluded that, consistent with all past surveys, taste is the number one factor influencing food purchases, but price has increased steadily as the second most important factor. 87% of consumers consider taste to have some or great impact, price 74% (up from 64% four years ago), while healthfulness trails at 61% and convenience last of the four choices at 52%. Looking just at those who consider each factor of "great impact," taste is #1 with 53%, price next with 43% and healthfulness and convenience at 26%.

For ourselves, we see little evidence supporting the IPSOS headline that "Freshness, Health and the Environment Matter Most in the Kitchens of the World; Global Consumer Priorities Regarding Food Products Shift away from Taste, Convenience." Taste reigns!

What do you think?

Prominent food scientists, including a member of the federal Dietary Guidelines Advisory Commmittee (DGAC), reported to the IFT last week on the process underway to revise the Guidelines. Dr. Fergus Clydedale of UMass, the lone food scientist on the 2005 DGAC, and Dr. Roger Clemens of USC, the token food scientist on the 2010 DGAC, painted a bleak picture of the use of science and understanding of food technology. Clemens noted he has been relegated to food safety issues and, implied, kept at a distance from nutrition issues.

Clydesdale and Clemens addressed the IFT session on "The evolution of dietary guidance: Lessons learned and new frontiers."

Covering the session, BakingBusiness.com quoted Clydesdale saying: "A food scientist should not be regulated to just food safety on the Dietary Guidelines, and there should be more than one." The report continued:

Dr. Clydesdale said technology has helped society in many areas. He said he doubted people would like to go back to using typewriters or that teachers would like to go back to using chalkboards.

"We’re not going to go back to 78 r.p.m.s (records)," he said.

Dr. Clydesdale said he wondered why people do not embrace technology in the food system. He said he wondered why people wanted to cook the way people did 100 years ago.

The Dietary Guidelines could use input on how food science technology may help meet the Guidelines goals, Dr. Clydesdale said.

We'd prefer an evidence-based approach rather than the DGAC's current expert opinion process. Apparently so do the experts.

Being pro-environment is good politics. And lessening man's "footprint" is a major policy objective.

Some companies are playing the angles to capitalize on environment-related business opportunities , some with subsidies, some hoping for help from highly-placed friends. Whether it's getting subsidies for ethanol or fuel efficient cars or producing "alternative" energy without generatating reviled carbon, the government seems to be, increasingly, at the nexus of picking winners in the marketplace. And that government role means that those with friends "inside" exercise more leverage.

I won't rehash the scientific controversy over global warming; it's certainly a lightning rod issue. But in the area of alternative energy, there's always been the presumption that the sun will shine, the tides will rise, the wind will blow and Earth's subterranean geo-furnace will go on forever -- even if moderate climates change. Today's New York Times carries a story about a labor union what I'd call "protection racket" regarding building new solar facilities in California.

Maybe continuation of the sun, moon, the Earth's molten core and, especially, the wind is not a safe assumption according to Eugene S. Takle, a professor of atmospheric science at Iowa State University, and the director of the school’s “climate science initiative.” Takle told MarketWatch.com that his research, to be published soon in the Journal of Geophysical Research , has found that U.S. wind strength has declined by 15% to 30% over the past 30 years from the mid-1970s to 2005. Land use and better instrumentation (and climate change itself) account for the decline, he believes.

Ted Kennedy may have the clout to block construction of those windmills off his Nantucket estate, but the bigger threat to his lifestyle may prove to be that his yacht may be as becalmed as the windmills.

Earlier this week, the World Health Organization published a Global Status Report on Road Safety financed by NYC mayor Michael Bloomberg's foundation (Bloomberg announced the findings). The report found 85% of the countries in the world need more government regulations to improve safety. Less than half have addressed "all the five key risk factors reviewed -- speed, drink-driving, helmets, seat-belts and child restraints."

It's not just the bias for regulations on citizen (driver) behavior, characteristic of the mayor's style that is making the Big Apple the epitome of nanny-statism in the U.S., nor can one disagree with the appallling toll of roadway deaths and injuries, many of which are entirely preventable -- no, the problem is that the focus is ONLY on the driver when the problem also involves vehicles and roadway conditions.

When it comes to vehicles, their operators are lumped into the category of "vulnerable road users." In short, roads built for commercial mobility and commercial competititveness but congested with animal-driven vehicles, pedestrians and all manner of tuk-tuk-type vehicles traveling at slow and variable speeds, are a given. They need protection. They're victims, not part of the problem. It's a flawed mentality.

With regard to roadways, unsafe conditions in roadway engineering, pavement maintenance, signing, marking and, yes, winter maintenance in areas impacted by snow and ice , are also totally ignored. Managing traffic incidents and other special traffic-impeding events like work zones and sporting event traffic is similarly absent.

The Report laments that poorer countries haven't learned the lessons of their more developed peers. Unfortunately, much of that sad-but-wiser experience won't be gained in this report.

A recent study in the American Journal of Clinical Nutrition by Fumiaki Imamura et al examined adherence to the 2005 Dietary Guidelines for Americans to determine how compliance related to coronary artery disease outcomes. Their conclusion: some Guidelines are more important than others.

In fact, they documented that the salt Guideline doesn't work at all. Women who had better overall quality diets actually were LESS compliant on the salt (reduction) Guideline. The lowest third in terms of Dietary Guidelines compliance consumed much less than the recommended 2,300 mg/day sodium while the upper two-thirds in terms of overall dietary compliance actually consumed 12% MORE SODIUM. (table 3).

Considered as a whole, the authors concluded:

No significant association was identified between the DGAI as a measure of diet consistent with the 2005 DGA and narrowing of coronary arteries after a mean 3.3 year follow-up period in post-menopausal women with established cornonary artery arthersclerosis.

The study found that "no womeno[of the 224 in the study] reported complete adherence to all dietary recommendations" consistent with other studies. On the other hand,

not all components have an equal weight in describing diet-disease relations....not all dietary recommendations are equally related to disease progression. Our findings highlight the need for the development of more sophisticated approaches to the assessment of dietary recommendations on disease progression and other chronic disease outcomes.

Amen.

A former National Heart, Lung and Blood Institute employee, DebbieN, blogging on Slow Food Fast , showed her true colors earlier with her "Salt Rant" post. She has now opened a discussion about the science underlying her former agency's support for universal sodium reduction.

DebbieN's post "Misunderstanding Salt Research: Bon Appetit's Shamfeul 'Health Wise' column" yesterday doesn't fully avoid the name-calling and attempted intimidation that has characterized past attempts to suppress discussion of the science. She lashes out at John Hastings, author of a skeptical piece in Bon Appetit , noting that as "a former editor of Prevention and health column contributor to O, the Oprah Magazine, is someone you'd expect to be reasonably accurate in reporting health research findings." But she at least continues through her rant to address some meaningful issues. Would that the Dietary Guidelines Advisory Committee did the same, but that's another post.

Yesterday, I posted comments on DebbieN's post, but her blog is moderated and she has not seen fit to approve my comments. Even without reading her original post, you can get the flavor of her representations. In my signed comment, here's what I said:

Your post provides so many "targets of opportunity."

John Hastings posed the right question: if an intervention modifies one of many risk factors but does not modify health risk (or even worsens that risk) then we should reconsider advice to follow that recommendation. But let me skip ahead first.

I am president of the Salt Institute. We do not "demonize salt moderation." We endorse moderate salt intake recommendations as were part of the Dietary Guidelines until 2000 when they abandoned "moderation" in favor of specific (lower) intake levels.

Studies of health outcomes of those lower levels show 20-37% greater cardiovascular mortality among those reporting they consume the lower, recommended levels -- these data from the editor-in-chief of the American Journal of Hypertension. See a discussion on our website at: http://www.saltinstitute.org/Issues-in-focus/Food-salt-health and http://www.saltinstitute.org/Articles-references/References-on-salt-issues/SI-references-on-issues/SI-references-on-food-salt-health-issues .

It is the proponents of "moderate" low-salt diets who are misleading the discussion by claiming that a 60% reduction in salt is "moderate." A 60% reduction is not only not "moderate" -- it is unsustainable in free-living subjects.

The health outcomes question CAN be studied. NHLBI has already proved the protocol -- the Trials of Hypertension Prevention -- only it measured the wrong outcome (BP not CV mortality).

The DASH Study you mention is very important for the blood pressure argument (but not for health outcomes). Its findings, however, are that for those with high blood pressure, the systolic BP fall on the DASH Diet was 11.4 mmHg. When hypertensive subjects were put on a diet with 60% less salt, their SBP declined 11.5 mmHg. Thus, the "DASH effect" is 11.4 mmHg and the "salt effect" is 0.1 mmHg.

I could go on, but read the website and, even better, read the referenced medical journal articles to better understand the scientific controversy that John Hastings had the courage to describe.

The June SI Report (html 52.21 kB) highlights Salt Institute leadership contributed to the success of two important symposia recently. In Waterloo, Ontario, scientists examined road salt management practices and how they impact the environmental quality of urban stormwater runoff. In Anaheim, California, a panel of iodine nutrition experts explained to the Institute of Food Technologists the impending need for U.S. food producers to begin use of iodized salt. The newsletter also reported insights from the new consumer attitudes survey by the International Food Information Council (IFIC) and several medical studies on salt and health.

The Spring issue of Salt and Health (pdf 318.77 kB) is published The misuse of the word “toxic” by media, some medical doctors and CSPI is examined within the context of long standing accepted definitions and parameters of the term. Concrete examples are illustrated in regards to replacing a natural substance, sodium chloride, with complex industrial chemicals such as: 5-ribonucleaotides, L-lysine, L-arginine, lactates, mycosent, MSG and trehalose. This newsletter leaves the reader to more intelligently ponder what health implications of such a broad-based replacement of salt with an arsenal of untested synthetic chemical products could possibly do to an unsuspecting population.

An article in Politico , a widely read DC paper, recently warned that President Obama and Congress are ramping up to impose a new era of public health activism unlike anything ever seen.

Michael Jacobson of CSPI gushed about the opportunities presented by this president, saying, “He has expressed more interest in preventing diseases and promoting health than any previous president. It is not a breath of fresh air. It is a tornado…This is really a rare opportunity to make progress on so many issues.” Jacobson’s favorite issue appears to be population-wide salt reduction.

According to Politico the president is “filling top posts at Health and Human Services with officials who, in their previous jobs, outlawed trans fats, banned public smoking or required restaurants to provide a calorie count with that slice of banana cream pie.”

In fact, many people were nervous after former NYC Public Health Commissioner Thomas Frieden was named director of the CDC. Frieden led the charge against trans fats, soft drinks and salt in the city. And Joshua Sharfstein, a new deputy commissioner at the FDA, created a Salt Task Force to study the “impact of excessive salt intake” in Baltimore, ignoring the scientific data which debunks the premise of population-wide salt reduction.

This doesn’t clearly divide along partisan lines. Some conservative members of Congress want to prohibit “junk food” under the federal food stamp program. While SI actively promotes a quality diet and certainly wouldn’t encourage anyone to eat “junk food” as a diet staple, we realize the slippery slope of bureaucrats deciding what is and is not junk food.

According to the Center for Consumer Freedom: “Get ready, because the ‘nanny state on steroids’ is going national.”

The Spring issue of Salt and Highway Deicing (pdf 279.28 kB) newsletter is out.

Lack of sufficient storage is often a major issue for agencies that use rock salt for winter maintenance activities. Bret Hodne, Superintendent of Operations, Public Works for the City of West Des Moines, IA, past chair of the American Public Works Association's Winter Maintenance subcommittee and one of APWA's Top Ten Public Works Leaders, explains how his city and more than 20 neighboring jurisdictions jointly operate a large salt storage facility that allows them to take early season salt deliveries. The discounts they qualify for make the economics pay off for them.

The first results of a major study on the effects of water softeners reveal that untreated hard water can rapidly lead to clogged showerheads — in some cases, after as soon as a year and a half of regular use. The Water Quality Association (WQA) announced June 4 in a press conference that just after one week of accelerated testing with hard water, more than three-fourths of showerhead nozzles became heavily clogged. On the other hand, showerheads using softened water performed nearly as well as on the day they were originally installed.

The results reported on are part of a larger research project being conducted by the Battelle Memorial Institute, an independent nonprofit science and technology research organization in Columbus, OH. The WQA, together with key stakeholders, including the Salt Institute, oversees the Water Quality Research Foundation (WQRF), which is funding the study.

In addition to the showerhead tests, analysts are examining the longevity of clothes washers, water heaters and dishwashers using hard water versus softened water. Battelle also is conducting tests to determine how much energy savings softeners can provide homeowners. The final research report is scheduled for September 2009.

We have previously reported on the growing importance of the hormone aldosterone in blogs Aldosterone I , Aldosterone II and Aldosterone III , in addition to a dedicated Salt and Health Newsletter . The most recent issue of the Annals of Internal Medicine echoes our sentiments on the subject. Authors J. R. Sowers, A. Whaley-Connell and M. Epstein write on the growing recognition of the role of aldosterone in the pathogenesis of metabolic syndrome, type II diabetes, resistant hypertension and associated cardiovascular and chronic kidney disease.

Available evidence appears to indicate that the quickest and most direct way to elevate aldosterone levels in the body is to cut your salt intake to the levels recommended in the Dietary Guidelines for American , i.e. the equivalent of 1500 – 2300 mg sodium per day. We can only hope that one day, the Dietary Guidelines Advisory Committee will acknowledge all the credible evidence in the scientific literature rather than only that which serves their salt reduction advocacy.

If you're not regularly reading the blog Junk Food Science , you're missing some good stuff. Today's post is another gem: "Seeing the evidence: tighter control of blood sugars in type 2 diabetics " isn't about salt, but as poet-philosopher George Santayana famously observed: "Those who cannot learn from history are doomed to repeat it." There's an important lesson here.

In this case, blogger Sandy Szwarc reviews a recent meta-analysis of the health outcomes of high quality trials of interventions more tightly controlling blood sugars . Forget for a moment the literature showing that low-salt diets increase insulin resistance , the point is the process of substituting well-publicized, lower quality studies as summarized by expert "consensus" for reliance on the available quality data. That is a pattern we've seen in the salt and health controversy as well. The blog's well worth reading, but, bottom line, Szwarc summarizes:

To this day, no sound clinical study has ever shown that treating type 2 diabetics to achieve even lower blood glucose levels provides added benefits that outweigh the harms. Treating a number that is a symptom of a disease doesn’t mean the disease process has been changed. Lowering health indices in elderly patients to match those of healthy 20 year olds doesn’t mean their risks will be lowered to those of 20-year olds again. And minimizing the risks associated with extremely high lab values doesn’t mean that “how low can you go” is better for patients.

Busy medical practitioners rely heavily on experts’ assessments of research findings, but those assessments are fraught with biases. As Dr. John P. Ioannidis, M.D., at the University of Ioannina School of Medicine in Ioannina, Greece, and with the Institute for Clinical Research and Health Policy Studies at Tufts-New England Medical Center, Tufts University School of Medicine in Boston, cautioned : “Empirical evidence on expert opinion shows that it is extremely unreliable.” As we also see time and again, the analyses and conclusions made by study authors and industry experts often differ from what the data actually shows. Bias doesn’t always come from financial conflicts, but can come simply from a belief in a popular scientific theory. It can lead even medical professionals to see only what supports a theory: confirmation bias .

Myths can take on lives of their own even in medicine unless we look objectively and carefully at the evidence. Only with unbiased discussions can we ever hope to turn evidence-based medicine into evidence-based medicine.

Pray for poetic philosophy -- and hard data.

The American Journal of Medicine published an article this week showing the utter failure of 30 years' efforts to improve the healthfulness of Americans' lifestyle habits. The findings suggest policy-makers need to be much humbler and likely less strident in their efforts to "improve" diet and other lifestyle choices. The current approach just isn't working.

In "Adherence to healthy lifestyle habits in US adults, 1988-2006," Dana King and colleagues at the Medical University of South Carolina use the government's own NHANES database to demolish the notion that advice to maintain a healthy weight, get more exercise and eat more fruits and vegetables are effecting positive change in Americans' behavior. The only "dietary" advice that's being followed is that more people are drinking alcohol -- and many would dispute that getting more people to drink alcohol is a national health priority (even on that, excessive drinking increased among non-Hispanic whites; only Hispanics slightly moderated their excess intake. But larger percentages of all groups began drinking (this was seen as a positive health development). Smoking incidence was unchanged (although Hispanics' smoking increased).

The number of obese Americans increased from 28% to 36%. Those exercising 12 times or more per month declined from 53% to 43%. And fruit and vegetable consumption plummeted from 42% to 26%. Those adhering to all five major lifestyle recommendations was cut nearly in half, dropping from 15% in 1988 to 8% in 2006. Unexamined were other minor advisories like curtailing salt intakes -- which also are unchanged over the period -- but, in this case, unchanged is an improvement over the five major recommendations where siginificant slippage continues.

The observation period began right after implementation of the 1980 Dietary Guidelines. With public acceptance levels like this, the Dietary Guidelines are looking like investments in Chrysler and General Motors. Where's the outrage? We've instilled concern, even fear, about eating. The public is convinced that the advice they've been given will make them healthier. But, as pretty as the model appears on the showroom floor, nobody's buying it.

We need to "stimulate" fresh approaches to our approach to the Dietary Guidelines for Americans to "bailout" our failed attempts for the past 30 years.