Many of us take mobility and roadway safety during winter for granted, yet without salt, we could not cope with winter. Using obvious poetic license the latest SaltGuru video "Coping with Winter " uses a lighthearted, but memorable series of images intended to make people think what it’s like in winter without the benefits of salt.

Speaking to an audience of academics, government officials and World Health Organisation staff at a salt reduction forum in London, the Food Standards Agency (FSA) chief executive Tim Smith acknowledged that UK salt intakes were still well above its target of 6g/day after seven years of vigorous campaigning. He claimed that the UK has “turned the tide” on salt consumption, basing his claim upon the disputed FSA analysis survey showing that average adult salt intakes dropped from 9.5g/day in 2001 to 8.6g/day in 2008. What he didn’t mention to his chosen sympathetic audience was that these figures have been openly disputed as being inaccurate and inconsistent1.

Even if those figure were correct, claiming to have turned the tide when they have only reached 25% of their stated goal in 8 years is reflective of the ‘DON’T BOTHER ME WITH THE FACTS’ ideology that has characterized the anti-salt advocates involved with the salt and health debate. His statement is doubly perplexing coming only a few days two reports by Nielson and Kantar WorldPanel on the retail sales of salt in the UK. Nielson claims an 18% jump in UK retail sales of salt in 2010 (including cooking, table and sea salt) while Kantar WorldPanel claims volumes were up 26.5%! Granted, some of this rise was due to consumers using table salt for home deicing last year, but Nielson also recorded a sharp rise in 2008/09, which could not be attributed to the weather.

So while there is no doubt that the FSA’s strategy of ‘naming and shaming’ companies has coerced many of them to lower the salt in their processed food formulations, have consumers compensated for this by topping up taste with the salt shaker? The neural mechanisms for salt appetite that we have evolved over the eons certainly indicates that this may be the case2. In fact, the Salt Institute has prepared a number of Newsletters on this very subject3, 4, 5. So despite Smith’s claims of turning the tide, the preponderance of scientific evidence appears to disagree with the notion that public policies can supersede our naturally evolved physiological mechanisms controlling our intake and liking of salt4.

Or is it possible that, with the new government installed in the UK, the FSA’s chief executive has signalled that they will be cutting back their anti-salt campaigning, but felt obliged to claim some sort of pyrrhic victory. It certainly seems that way, particularly since he stated how important salt was in preventing microbial growth, toxins and spoilage as well as its critical importance in baking.

It appears that the whole salt and health debate may indeed have seen the “tide turned.”

---

1) McCarron, D.A., Geerling, J.C., Kazaks, A.G. and Stern, J.S., “Can Dietary Sodium Intake Be Modified by Public Policy?” Clin J Am Soc Nephrol, 4, 1878–1882, 2009.

2) Geerling, J.C., and Loewy, A.D., “Central regulation of sodium appetite,” Exp Physiol 93: 177–209, 2008.

3) Satin, M., “Aldosterone: unlocking our understanding of cardiovascular risk,” Salt and Health Newsletter, 3(3). Summer, 2008.

4) Satin, M., “Salt Appetite Revisited,” Salt and Health Newsletter, 3(1), Winter, 2010.

5) Satin, M., “Salt Appetite,” Salt and Health Newsletter, First Quarter, 2010.

The impact of salt on health has been reviewed on a number of occasions over the years with mixed results. The latest meta-review of the evidence was commissioned by the German Ministry of Health just last year and concluded that population-wide salt reduction was not justified from a public health point of view. The controversial nature of the evidence will have great significance for international trade if salt reduction policies are ever enacted. This month's Food Technology Magazine features an OpEd I wrote on this issue.

When the World Trade Organization (WTO) was established in 1995, an international agreement on sanitary and phytosanitary measures (SPS) to reduce risks arising from additives, contaminants, toxins, or pathogens in foods took effect. Intimately linked to the SPS is an additional agreement on Technical Barriers to Trade (TBT), signed in the same year and designed to restrict the use of unjustified measures for the purpose of trade protection.

The aim of the SPS and TBT Agreements is to ensure that regulatory actions are not misused for protectionist purposes and don't result in unnecessary barriers to international trade. The intent is to reduce arbitrary decisions by requiring all health protection measures to be based upon an objective analysis of the preponderance of scientific evidence.

Import regulations that fall under the provisions of TBT or SPS Agreements are typically complex and frequently employ standards that create a high hurdle for imports. Exporters, whose own governments do not implement similar standards, find it difficult to understand the logic or need behind the regulations, so an objective evaluation of the science supporting them goes a long way in resolving disputes.

The core strategy of the recent Institute of Medicine (IOM) Committee report on "Strategies to Reduce Sodium Intake in the United States" is the FDA removal of GRAS (generally recognized as safe) status from salt and the regulation of the amount to be added to each food category. Removing the GRAS status of salt and regulating what is an essential nutrient and arguably the oldest and most ubiquitous food additive in the world will be a monumental task and will undoubtedly have enormous consequences for food and food trade around the world.

Several European countries are major exporters of traditional food products to the U.S. Breads, olives, ham, sausages and cheeses--produced through processes standardized centuries ago--are typical examples. These products and processes are so well established that many are protected with geographic origin designations. Not only are products such as Parmesan and Gorgonzola cheeses, olives, anchovies, prosciutto, and pepperoni consumed directly, but they are also key ingredients in many other products such as pizza and pasta dishes.

These traditional products were developed long before refrigeration. Many employ high salt levels for debittering (olives), curing (hard cheeses), mold culturing (blue-veined cheeses), water activity control (black forest and prosciutto hams, corned beef, salamis, etc.), and storage (anchovies, capers, fish roe, salt fish). The intent of the IOM report makes it unlikely that these traditional products will be permitted. While it is impossible to say whether low-salt variations of these products will achieve market success or whether salt replacement additives will themselves come under regulatory analysis for potential health issues, one thing can be predicted with a fair degree of certainty. Regulation of the salt content of foods will be carefully scrutinized regarding its impact as a non-tariff trade barrier.

For exporters of traditional French, Greek, and Italian foods, the health benefits of the high salt content Mediterranean Diet have been acknowledged for centuries. Despite Americans' stable consumption of salt for the past three decades, ischemic heart disease death rates in the U.S. have fallen precipitously. All of the above are rational reasons to invoke the SPS and TBT Agreements to challenge whether the regulation of salt in foods is an arbitrary measure and an unjustified barrier to trade or one supported by the preponderance of scientific evidence.

Supertasters are people who experience taste with far greater intensity over the average. It is estimated that about 25% of the population are supertasters and women are more likely to be supertasters than men as are Asians and Africans. The cause of this heightened response is thought to be due to an increased number of fungiform papillae or taste buds. Although one would think that the taste sensation would be an advantage if it is more sensitive, this is not always the case. An increased response to bitterness may severely limit the range of foods that are palatable. Vegetables have important phytochemicals that are protective of heart disease and cancer risk but their natural bitterness may turn supertasters off.

A potential unintended consequence of population-wide salt reduction has been highlighted in a paper by John Hayes and colleagues from Pennsylvania State University, published in the latest edition of Physiology and Behavior .

Hayes and colleagues examined the response of supertasters to varying amounts of salt in a wide range of foods. As indicated previously, these supertasters make up about 25% of the population and are genetically hypersensitive to bitter tastes, leading them to naturally avoid some vegetables and other foods that taste naturally bitter.

The researchers measured the liking and intake of foods with varying amount of saltiness among 87 healthy adults (45 men).

Supertasters reported greater saltiness in chips and pretzels and soup broth at levels comparable to regular-sodium products. They also found greater sensory enjoyment to growing salt concentration in cheeses (where sodium ions mask bitterness).

Despite adding less salt, supertasters consumed more sodium through food, as salt was more important to preference, both for its salty taste and masking of bitterness. This suggested to the researchers that supertasters appreciate increased salt in food formulations to mask naturally bitter foods particularly vegetables and other foods that may be deemed to be healthy.

Researchers at the Medical College of Georgia have documented a chain of events showing that excess fat can cause the body to retain more sodium and, consequently, more fluid resulting in higher blood pressure.

Their findings point toward a biomarker in the urine that could one day help physicians identify the most effective therapy for these patients.

Team leader Yanbin Dong said, "It's well established that obesity increases inflammation, salt sensitivity and high blood pressure," referring to the study in the American Journal of Physiology Regulatory - Integrative and Comparative Physiology .

Dong's team outlined the process that appears to start with fat producing more inflammatory factors, such as interleukin-6, or IL-6.

When he and his colleagues exposed mouse kidney cells to the fat inflammatory factor, interleukin-6, they found increased salt reabsorption.

Whether the mouse reactions function the same way in humans remains to be seen, but it appears Dong may have found a way to gauge this activity in humans. Dong already is measuring obese people with and without hypertension as well as normal-weight individuals. A simple urine test could one day help identify those at risk for or experiencing this type of inflammation-based hypertension, he said.

The Dietary Guidelines Advisory Committee (DGAC) of the U.S. Department of Health and Human Services and the U.S. Department of Agriculture may increase health risks, including obesity, by ignoring sound science as they announce recommendations to reduce sodium consumption to 1,500 mg per day. It is reckless for the government to risk the health of Americans by relying on substandard levels of evidence and refusing to consider new evidence.

The rationale behind the recommendation is purportedly blood pressure reduction. While no one doubts that a small percentage of our population may experience modest blood pressure declines from salt reduction, it has not been scientifically established that a population-wide reduction will benefit overall health. Research indicates health risks for some on low salt diets, including higher risk of heart attacks. And new research shows that not a single modern society consumes such a low level of salt as that recommended (less than 4 grams of salt per day). This recommendation is essentially an unauthorized massive clinical trial using 300 million Americans as guinea pigs.

Recent research (Can Dietary Sodium Intake be Modified by Public Policy? David A. McCarron, Joel C. Geerling, Alexandra G. Kazaks, Judith S. Stern) involving data collected from more than 19,000 individuals in 33 countries has demonstrated that healthy humans, all around the world, consume sodium within a relatively narrow range (2700 mg- 4900 mg sodium) – a range controlled by a number of physiological mechanisms. The DGAC recommended level of 1500 mg is drastically lower and will result in unintended health consequences if Americans strive to reach the recommended target.

Most nutritionists agree that reduced sodium in food preparations will very likely increase the obesity crisis because individuals will consume more calories just to satisfy their innate sodium appetite and their search for eating satisfaction.

Perhaps the greatest failure of the Dietary Guidelines is their priority focus on single nutrients rather than the whole diet. Concerns over blood pressure would be better addressed if Americans would eat more salads, vegetables and fruits. Italians consume more salt than Americans yet they have better cardiovascular health because they eat a well balanced diet. They use salt to make healthy foods more delicious...without adding calories.

The public comment period on the Dietary Guidelines is June 15 to July 15.

Road weather information systems (RWIS) provide snowfighters with unprecedented access to crucial, real-time information enabling improved winter roadway operations, improved public safety, mobility and productivity. Like all road management improvements, innovative RWIS technologies reduce the exposure of road agencies and road users to certain liabilities.

The effect can be cross-cutting. The potential for improved safety, for example, raises realistic public expectations that better plowing and salting will cut the number of crashes, injuries and fatalities. These issues are examined in a new report issued earlier this month by Jaime Rall of the National Conference of State Legislatures, Weather or Not? State Liability and Road Weather Information Systems (RWIS) . The NCSL report is a resource for state legislators and state DOTs.

NCSL explains why this is an important question:

Weather significantly affects the traveling public and the transportation agencies that operate and maintain the nation’s roadways. Recent studies estimate that 24 percent of all crashes and 17 percent of traffic fatalities are weather-related—more than 1.5 million accidents per year, resulting in over 673,000 injuries and nearly 7,400 fatalities.1 Adverse weather also is the second-largest cause of non-recurring highway congestion, accounting for approximately 15 percent of traffic delays nationwide. Winter road maintenance alone accounts for about 20 percent of state DOT maintenance budgets. State and local transportation agencies spend more than $2.5 billion each year on snow and ice control operations, and more than $5 billion to repair weather-damaged roadway infrastructure.

Because RWIS systems deliver a benefit cost ratio between 2:1 and 10:1, RWIS adoption has been broad and rapid in the North American snowbelt; at least 44 states and DC have RWIS systems. The data from 33 states and three cities are integrated into the huge "anytime, anywhere" Clarus database available to all transportation users and operators.

The power of this information is a two-edged sword and state DOTs, says NCSL, are exposed to legal liabilities with regard to its public, particularly online, dissemination of this information (the problem isn't entirely mitigated if a third party like Clarus is involved), altered standards of liability for road agencies under their duty to respond to the new RWIS information and potential suits for agencies that choose not to use this useful tool.

The report makes it clear that

RWIS can help DOTs avoid a “breach of duty,” without which there is no liability, by helping them meet their legal duties. When a DOT has notice of a dangerous condition, these duties include exercising reasonable care to either alleviate the condition or provide adequate warning to the traveling public. Because RWIS can help a DOT meet these responsibilities—for example, by supporting better informed maintenance decisions, automated road treatments and real-time traveler information—it can thus reduce exposure to certain liabilities.

RWIS also creates new duties: Undertaking a new practice or service that affects public safety creates a duty to perform it with reasonable care." In sum:

RWIS might also affect what constitutes a standard of reasonable care for the traditional duties of state DOTs, raising expectations for how DOTs handle dangerous situations. There are earlier decisions in which the lack of advanced RWIS-type technologies was mentioned. In 1982, for example, the Supreme Court of Michigan held the state DOT not negligent because, among other factors, “the technology available at the time of the accident was not advanced to such point as would permit the installation of a flashing sign which would be automatically activated upon the actual appearance of ice on [a] bridge…” Now, however, real-time detection and automated
warnings are available.

The report makes a series of recommendations on how agencies can manage these new liabilities.

A decade ago, road safety and mobility policy pinned its hopes on technology to abate the appallingly high highway fatality rate. That bright promise has been laboring, not languishing, but clearly needs a boost to achieve the vision of harnessing wireless technology and on-board vehicle communications to overcome distracted driving and make our roads both safer and reliably free-flowing. A new DOT white paper, Achieving the Vision: From VII to IntelliDrive , suggests adding a new component to the strategy -- road weather information (RWIS) data -- to break through the policy "chicken and egg" conundrum of whether to invest first in "smart roads" or rather in "smart cars."
The white paper outlines a research strategy for the next five years incorporating RWIS information. Noting that RWIS systems are an increasingly common infrastructure enhancement, the white paper opines:

For both road weather and environmental applications, vehicle systems may be a powerful source of new data. In the case of road weather, for example, vehicle-based data can supplement conventional weather data, primarily collected in the atmosphere, to provide more relevant and pervasive information about roadway surface conditions. For instance, activation of automatic stability control systems on multiple vehicles in a common location could indicate slippery pavement that needs treatment. Similarly, vehicle-based data may provide new information sources that could enable new transportation management techniques that are sensitive to environmental impact. For example, data generated from IntelliDrive systems may provide system operators with detailed , real-time information on the location, speed, and operating conditions of vehicles using their system. This data could enable transportation agencies to manage system operations more efficiently -- for example, by adjusting traffic signal timing to accommodate the predominant directional flow of traffic, which can save fuel and reduce environmental impact.

For snowfighters, this means that tools developed to help them speed their lifesaving emergency service of restoring roadway safety and mobility will have broader application. As slippery roads trigger the anti-skid brake systems and in-pavement "loops" detecting traffic flow document the congestion of snow- and ice-covered roads -- the primary impairment to winter safety and mobility -- these same tools used by snowfighters in managing their operations will provide a key input into our national vision for safer roads and more reliable roadway mobility.

Most salt reduction advocates maintain that we are eating more salt now than ever before in history. They don't have any data to back up this claim, but they were never particularly fastidious about getting real evidence. However, the question of how much salt we ate in the past intrigued me, so I decided to seek out reliable evidence from other sources. It struck me that the military were always meticulous in maintaining and preserving their archives, so I decided to see if I could find out the daily salt rations provided to soldiers over the last 200 years. I hit pay dirt!!

During the War of 1812, the daily salt ration for the Continental army was 18g of salt/day (1).

The United States declared war on England on June 18, 1812 to protest the undue control of the British government over the lives of Americans. Captured US forces were first shipped up to Canada and thereafter crammed into ships for the long, cold voyage to England and the prison camps of Chatham and Portsmouth. Each man was given a daily ration of a pound and a half of coarse bread (8-10 g salt), some boney beef, 9 g of table salt and one or two turnips a week. American prisoners of war described their treatment by the British as "ungenerous, inhuman and unmerited oppression." (2)

The Mexican War ration was established in 1838 and also contained 18g of salt/day.

The Civil War rations enacted by Congress in 1860 and 1861, increased the variety of foods in the ration but maintained the 18g salt/day.

During the Spanish American War very few changes were made to army rations with the exception of a slight increase potatoes and a decrease in wheat flour and beans. Again, the salt ration was kept at 18g/day.

During World War I - the daily army reserve ration included a one-pound can of corned beef containing (10g salt), two 8-ounce tins of hard bread (4g salt), and 4½g of table salt for a combined total of 18½g salt. (3)

During World War II, the salt ration for American prisoners of war in Germany was 20g salt/day and the ration for Italian POWs interred in South Africa was likewise 20g salt/day. (4)

The bottom line is that we are now eating about half that amount of salt.

============

(1) Rations: The History of Rations, Conference Notes, Prepared by The Quartermaster School for the Quartermaster General, January 1949.

(2) James Adams, Dartmoor Prison, A Faithful Narrative of the Massacre of American Seamen, to Which is added a Sketch of the Treatment of Prisoners During the Late War by the British Government (Pittsburgh, S. Engles, 1816).

(3) “Special Rations for the Armed Forces, 1946-53", By Franz A. Koehler, QMC Historical Studies, Series II, No. 6, Historical Branch, Office of the Quartermaster General, Washington D.C. 1958.

(4) American Prisoners Of War In Germany, Prepared by Military Intelligence Service War Department, November 1945, Restricted Classification Removed - STALAG 17B (Air Force Non-Commissioned Officers).

Salt has certainly captured a great deal of news in the past 10 days. Since the release of the IOM report on "Strategies to Reduce Sodium Intake ," we have been deluged with countless media reports and numerous requests for interviews. With so much going on, you can't help but wonder how consumers are reacting to all the hype.

It is interesting to examine the reader comments that often follow a news article. The identities of most of the authors who comment are not readily apparent, so it is understandable if their remarks are a bit spirited and sometimes off the point. Many use the occasion to vent their anger and frustration over issues that may not be directly related to salt and health.

As a result, it is sometimes hard to get a sense of how consumers are really reacting to the coordinated attack on salt by our medical institutions and the initiatives under way by many large food companies to reduce the salt content of the products. In other words, how can we tell what's happening where the rubber meets the road?

Two new reports that came out yesterday may give us some insight.

The first was a report in the Food Navigator entitled, "Low-sodium products declined in popularity, says NPD . The NPD Group is a leading provider of reliable and comprehensive consumer and retail information for a wide range of industries. Harry Balzer is vice president of The NPD Group and chief industry analyst specializing on food and diet trends. Balzer and The NPD Group have been tracking the eating and drinking patterns of Americans for nearly 30 years.

The article describes the NPD research, which examined US consumer behavior over the past 30 years and found that, although consumers increasingly say they are concerned about the amount of sodium in their diets, the number of people actually buying products that claim to have low or no sodium has steadily declined. Quoting from the article, “Chief industry analyst at the NPD Group Harry Balzer said: “In my 30 years of observing Americans eating behaviors, there is often a gap between what consumers say and what they do. It’s easier to aspire to a positive behavior than to actually do it."”

The second report was the latest Rasmussen Report just released. The headline read “55% Oppose Government Limits On How Much Salt Americans Consume ." The data from a national telephone survey shows that just 33% of Americans think the government should set limits on how much salt Americans can eat. Most adults (55%) disagree and don't think it's any of the FDA's business. Another 12% are not sure.

It's clear that the huge, coordinated effort by salt reduction advocates around the world have had a very limited impact on the public thus far. That is not to say that the situation will not change, however, we are now getting to a point where some basic truths will start to emerge. In fact, the issuance of the IOM report "Strategies to Reduce Sodium Intake " has transparently revealed what I have been saying for years now – that the IOM fully intends to put the population of the United States into the largest clinical trial ever carried out in history without the knowledge or consent of the people. As stated in their report, a central element of their strategy will be to gradually lower salt intake in stages and then check if any particular stage has demonstrated unintended negative consequences for the population. That is what a clinical trial does! And with very few exceptions the media, which have made the transition from watchdogs to lapdogs, have gone along with it, hook, line and sinker.

We live in interesting times. As you can imagine, the last week was a very busy one filled with numerous television, newspaper and radio interviews. After the IOM press conference to release their report on "Strategies to Reduce Sodium Intake," a key message that we felt was necessary to get out, was the admission on the part of the lead author that the Committee studying the matter never considered the science behind the salt and health issue - but only the strategies required to reduce salt in foods. This was a rather strange admission, since the major part of the IOM Committee consisted of epidemiologists and physicians rather than industry professionals who actually had some knowledge about food formulation. The centerpiece of the IOM 'Strategy' was the recommendation for the FDA to start regulating the salt contents of processed foods and foods prepared in restaurants and foodservice establishments. This would be a dramatic reconsideration of what is an essential nutrient and the oldest and most ubiquitous food ingredient known to humankind. One would expect that a move of this magnitude would be based upon a substantial body of uncontested scientific evidence, but that is very far from the case.

One of the interviewers from a Los Angeles radio station asked me how I might dare to challenge the medical authorities on this matter. I thought it best to ask him for a clarification. Was he referring to the medical authorities that recommended hormone replacement therapy for women and 30 years later admitted that such a strategy had disastrous consequences for women? Or was it the medical authorities that emphatically stated that the consumption of any more than one egg a week would lead to a very ugly and early death from cholesterol-blocked arteries - only to completely recant this advice 20 years later? Or perhaps he was referring to the medical authorities that decreed that frequent PSA measurements were the answer to prostate cancer, only to come out with their most recent recommendations that perhaps it's best not to do PSA tests at all because they can be misleading? Precisely which medical authorities was he referring to? The interviewer admitted that he got the message and dropped the question.

During the course of the actual press conference, I pointed out to the senior author that the impact of salt on health has been reviewed on a number of occasions over the years with mixed results. The latest meta-review of the evidence was commissioned by the German Ministry of Health just last year and concluded that population-wide salt reduction was not justified from a public health point of view. Indeed, it would have been wise for the US to do the same before going ahead with strategies to reduce sodium. Because of the controversial nature in which the evidence has been interpreted, I went on to ask if the international trade implications of salt regulation in food was ever considered in the deliberations of the IOM ‘Strategies’ Committee. The lead author appeared stunned at this question and admitted that the question of trade never entered into their deliberations.

In establishing the Sanitary and Phytosanitary Agreement (SPS) on trade, the United States was one of the leading countries to insist that unjustified measures could not be used to limit trade between countries. Countries would not be able to ban products for public health or safety issues unless it was proven beyond doubt that these measures were fully justified on a sound, scientific basis. For example, because Italians and Greeks have excellent cardiovascular health, exporters of many traditional high salt foods from these countries may find full justification under the World Trade Organization SPS Agreement to declare the regulation of salt in food as a non-tariff barrier to trade and launch an action against the US at the WTO. Since the US has never carried out a large-scale trial on the overall health impacts of salt reduction, and since the sum of evidence remains controversial, the WTO is likely to consider such a complaint valid.

As I said, we live in interesting times.

Relieving the pressure on water authorities to deliver the quality and quantity of water needed for California city-dwellers, winter snows and the state of California's snowpack has allowed the CA Department of Water Resources to increase the 2010 allocation of State Water Project deliveries to 30%.

As recently as February 26, the allocation was a puny 5% reflecting a three-year drought. April snows in the Sierras are responsible for total winter snowfall far above normal. This year, the state received 132% of its normal snowfall; last year, it was only 80% of normal. As late as early April, the allocation had been set at 20%. The state reservoir system had been dangerously low, as this graphic shows (click for a larger version ). Even with the heavy snow, Lake Oroville, the key reservoir, remains at 55% of capacity.

A final snow survey will be done this week and final allocations made.

This won't lead to any short-term changes in the politics of California's water and the struggles of citizens with hard water threats to their home plumbing and appliances, but it's welcome news nonetheless.

The proverb avers: failing to plan is planning to fail." So true. The Federal Highway Adminstration has a new Primer on Safety Performance Measures for the Transportation Planning Process . It's worth a read.

Recently, the American Highway Users Alliance issued an important report on the economic costs caused by the paralysis or congestion caused by failed snowfighting efforts . It mirrors results from earlier studies (1999 and 2004) commissioned by the Salt Institute.

The new FHWA report points out that these economic costs of impaired mobility are overshadowed by the economic savings generated by safe roads. Safety benefits in 85 US metro areas are 1.3 to 4 times greater than congestion costs. Again, the Salt Institute has commissioned the definitive study of the safety benefits of proper winter maintenance, the Marquette Report .

As you read this report, we hope you'll be struck with two facts: 1) performance measures are what drives performance by making possible an understanding of the difference which different interventions produce and 2) that the current crop of performance measures are too blunt an instrument for the delicate operation of timely and effective winter maintenance. The state and federal databases being used may be suitable for many purposes, but their infrequent updating renders then useless for snowfighting planning and operations management. They measure most of the right variables, but an annual figure identifying an at-risk location is inadequate to identify the relationship between, for example, severe winter weather and the consequent snowfighting operations and the safety outcomes.

Special studies like the Marquette Report and a new study underway in Ontario can pinpoint the benefit of applying salt and plowing winter roads, but none of the recommended data sets can produce time- and weather/snowfighting-sensitive data.

A few years ago, a survey of state DOT Safety Management Plans found that none included snowfighting operations among the proven technologies to keep roads safe. That was a travesty then; its even worse today when ever more people depend on highways to deliver safely themselves and the goods and services they demand.

We need every jurisdiction to implement a winter operations component into their community and state/provincial roadway safety plan to identify not only WHERE crashes occur, but WHEN, as in during winter storms on untreated roads.

During the 2008 presidential campaign, candidate Obama complained about how scientists and policymakers in the George W. Bush Administration were perverting the free expression of science. While our choice of examples may have differed, we were in hearty agreement that the government had turned its back on science in the one area we track intensively: science pertaining to salt and health. In fact, the Salt Institute was forced to ask the federal courts to prevent the executive branch from ignoring the data quality standards of the federal Data Quality Act – and the courts demurely determined that the executive branch was immune to judicial oversight in the way it uses scientific data – the final arbiter of its own DQA compliance.

Unsurprisingly, one of President Obama’s early initiatives was to issue, in March 2009, a Memorandum on Scientific Integrity with a promise to have a plan in place to correct the problem by mid-2009. The plan has not yet been released. Examples of impaired integrity in government use of science continue.

One of the most vocal proponents of improving scientific integrity has been Bush-bashing investor George Soros (disclosure: at one time, Mr. Soros was a part-owner of a Venezuelan salt production facility). Soros’ Open Society Institute funded a study to document the threat to scientific integrity within the federal government (“The Scientists in Government Project”) run by George Washington University . The Federation of American Scientists , Government Accountability Project , Scientists & Engineers for America and Union of Concerned Scientists also provided support.

The Project just released its report, Strengthening Science in Government: Advancing Science in the Public’s Interest , and it makes the case that citizens should be very concerned about the integrity of science as portrayed by government scientists. And, we would add: and science controlled and funded by those same government scientists.

The Report takes as its theme Albert Einstein’s observation about the duty of scientists: “One must not conceal any part of what one has recognized to be true.” Tellingly, the Report also quotes a senior manager at the Centers for Disease Control and Prevention (CDC) complaining that “We need supervisors who have the courage to speak up for the science.” (Indeed, when the agency head assiduously leads in the opposite direction).

The Report effectively articulates the challenge:

The (Einstein quote) statement above serves not only as a guiding principle of good science, but as a framework for effective, science-based policy-making. The best public policies are built on a foundation of rigorous data and analyses, widely shared among scientists and the public. The fundamental obligations of a science-based society – advancing the public health, protecting the workforce, safeguarding the environment, developing appropriate energy technologies, defending the nation, and much more – depend on a full and open exchange of ideas, methods, findings, and interpretations.

New scientific knowledge constantly builds on existing scientific knowledge. When information is readily shared, new findings can be analyzed and new hypotheses vetted in an ongoing process that continually generates opportunities for further study and analysis. Science flourishes when scientific ideas are given a fair hearing by colleagues, debated on their merits, tested through replication and further research, and revised in light of new understanding.

***

Beyond the merits of advancing science, the open exchange of ideas is also cherished because it is concordant with the ideals of a democratic society. Freedom of information is a core belief in the American system.

***

An analysis of the approach to science taken by the five White House administrations that preceded that of President Barack Obama explains, “It is naïve to believe that scientific findings are the sole determinant of policy . . . Much of the funding, direction and use of American science is determined by the federal government and the political biases of the dominant party invariably influence the decisions that get made.

***

Policy decisions may be based on science, but they are not purely scientific. Preferences and political considerations shape decisions about regulation, research priorities, service delivery, and program development and evaluation. Nonetheless, the integrity of the science and the validity of the data that informs these decisions must be preserved.

But the report then goes on to explain the "pressures on scientists" employed by government (or hired by government scientists, we'd add):

A "unique challenge" for them is that "they may be expected to represent and advocate for official agency positions, regardless of their personal perspective on an issue. Conversely, they may be barred from presenting conclusions or analyses that are inconsistent with an agency’s stance, even if they are speaking as private citizens."

Okay. We agree on the statement of the problem. And we hope the supporters of the report are sincere. Let’s see if the “solution” is more government-knows-best or whether the new Administration is willing to be measured by the metrics of its lofty rhetoric.

Early indications from CDC on the salt issue haven’t been encouraging, but hope springs eternal.

Last fall, New Yorker science writer and former NY Times correspondent Michael Specter released an important book entitled Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens our Lives . In the NY Times book review, Janet Maslin captured the essence his thesis: "Firing Bullets of Data at Cozy Anti-Science ."

When the IOM produced its report earlier this week on how to implement salt reduction, questions at the news conference about the impacts on health and international trade in processed foods evoked artful non-answers. The authoring panel's chair conceded that the group had not examined the science on whether such a policy would improve public health. And she admitted that the group had not considered how the U.S. would defend its action against the World Trade Organization should FDA be so foolish as to adopt the IOM recommendation.

Though Specter's book deals with a myriad of junk science issues, it is silent on salt. Specter takes jab at celebrity know-nothings like Britain's Prince Charles and targets Dr. Andrew Weil's promotion of vitamin supplements as raising a larger concern -- undermining valid science by equating it with pseudo-science. Says Specter: “The idea that accruing data is simply one way to think about science has become a governing tenet of the alternative belief system....When Weil writes about ‘a great movement toward evidence-based medicine’ as if that were regrettable or new, one is tempted to wonder what he is smoking.”

We expect that a scientist with the appropriate credentials will act like a scientist, not a shaman. But on salt, the quasi-religious fervor has an unstable foundation of pseudo-science and the denialism of the politico-medical establishment -- as rendered in the IOM report -- is, indeed, "hindering scientific progress" and, arguably, "threatening our lives."

Let's "fire bullets of data at the cozy anti-science" behind the IOM report and ask ourselves what data are available to explore the two key questions:

1. While salt intake is related to blood pressure, the relationship is heterogeneous and, more importantly, blood pressure is only one of several important health risk factors impacted by changes in salt intake (others being insulin resistance, plasma renin activity, aldosterone production, sympathetic nervous system activity,etc.) so the proper end point is not BP but rather some "hard" end point like cardiovascular mortality or all-cause mortality or incidence of heart attack, etc. Dr. Alderman, former president of the International Society of Hypertension and current editor-in-chief of the American Journal of Hypertension , summarized this argument in a JAMA piece a couple months ago. The only controlled trial of this question showed low-salt diets had worse outcomes. The observational studies are split with most showing no health benefit of reducing dietary salt.
2. Any health impact of dietary salt depends not on the amount of salt (sodium) in any particular food, but rather on the amount of sodium in the diet. No studies have been done to establish that persons choosing diets replete with "low-salt" foods instead of those foods with "regular" sodium content are able to reduce and sustain their total sodium intake. On the other hand, evidence by Drs. Joel Geerling and David McCarron have found a physiological signal for "salt appetite" based on the body's need for sodium and that this "need" results in sodium intake levels within a relatively narrow range which is unchanged over time and independent of government dietary guidance.

So, to quote the McCarron-Geerling paper's title: "Can Dietary Sodium Intake Be Modified by Public Policy?" Let's get the evidence before we launch a madcap -- and anti-scientific -- effort to make a massive, untested change in our national diet.

Back to the larger point and in conclusion, this from Kevin Shapiro's review of the Specter book in Commentary magazine:

In Specter’s parlance, “denialists” are those who reject the substantive technological benefits of modern science—medicines and vaccines to treat and prevent illnesses, or techniques to enhance the quality and quantity of agricultural yields. At the same time, they cling to an unsubstantiated faith in the advantages of “natural” alternatives such as vitamins, supplements, and organic foods. The term e-ncompasses a diverse array of quacks and crackpots, ranging from New Age celebrities like Andrew Weil to reactionary patricians like Charles, Prince of Wales. What unites them is a hostility to reason that, when amplified in society, threatens the ability of scientists to pursue real solutions to such problems as disease, hunger, and malnutrition.