This commentary isn't about salt. But the games being played with regard to the National Business Group on Health's Guide to Clinical Preventive Services, a document likely quite familiar with salt company HR managers, are the same kinds of "ends-justify-the-means" shennanigans that plague the salt and health discussion.

Junkfoodscience points out "unenthusiastic conclusions about the evidence in support of obesity screening and interventions" by the too-often-ignored U.S. Preventive Services Task Force (part of HHS), are the tip of a dangerous iceberg. As author Sandy Szwarc elaborates:

Even so, the NBGH Guide found them sufficient to support their recommendations, stating:

"The U.S. Preventive Services Task Force recommends that clinicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults....There is fair to good evidence that high-intensity counseling - about diet, exercise, or both - together with behavioral interventions aimed at skill development, motivation, and support strategies produces modest, sustained weight loss (typically 3 to 5 kg for 1 year or more in adults who are obese.

"Modest weight loss maintained for a year is hardly commanding evidence of long-term effectiveness for intense interventions. In fact, the dismal failure of any type of intervention in achieving long-term success was highlighted in the acclaimed, comprehensive review of more than 500 studies on dieting and weight loss by David Garner, Ph.D., and Susan Wooley, Ph.D.. They concluded: 'It is difficult to find any scientific justification for the continued use of dietary treatments of obesity.'"

Nevertheless, the Guide left out key sentences from the actual USPSTF report:

"The evidence is insufficient to recommend the use of moderate- or low-intensity counseling together with behavioral interventions to promote sustained weight loss in obese adults...The relevant studies were of fair to good quality but showed mixed results....studies were limited by small sample sizes, high drop -out rates, potential for selection bias, and reporting the average weight change instead of the frequency of response to the intervention. As a result, the USPSTF could not determine the balance of benefits and potential harms of these types of interventions."· The USPSTF concludes that the evidence is insufficient to recommend for or against the use of counseling of any intensity and behavioral interventions to promote sustained weight loss in overweight adults."

It reminds me of when the Dietary Guidelines Advisory Committee used just half a graph from Miller et al of Indiana University showing the variable blood pressure response to salt restriction -- some people's blood pressure falling more than others. But the original graph had simply been dissected and the portion showing that some people (about a quarter of the total) had a blood pressure INCREASE on lower salt was simply dropped. It wasn't politically correct.

While lots of scientists claim to employ "evidence-based" analysis, the assertion cannot be taken at face value. The truly disturbing thing here -- besides the science and health isssues involved, about which we claim no special knowledge -- is the intentional undermining of the federal government's science watchdog, the USPSTF. We need an honest broker like USPSTF so this preversion of its cautionary conclusions is perverse.

The New York Times' headline writer has done humanity a great service. Since the mid-1920s when American and Swiss saltmakers began iodizing salt -- and ending the scourge of Iodine Deficiency Disorders (IDD) -- public health authorities have been in agreement that fortifying salt with iodide or iodate is the best means to overcome IDD. But terms like "hidden hunger" and "micronutrient malnutrition" don't capture mindspace. With the visible manifestation of the enlarged neck, a swollen thyroid gland, goiter, now rare in many societies, there has been no good way to convey that IDD is not an aethetic problem as much as the cause of irreversible mental impairment. If an expectant mother doesn't get enough dietary iodine, her child can be penalized 10-15 I.Q. points because the brain doesn't fully develop. Iodized salt solves this deficiency problem for pennies a year.

"Raising I.Q." connects with people.

Iodizing salt stands along with basic sanitation and clean public drinking water as the greatest triumph of 20th century public health.

And iodized salt was the world's first "functional food," a topic much in the news today as food manufactures vie to engineer healthier foods.

With that for context, read the story in today's New York Times: "In Raising the World's I.Q., the Secret's in the Salt. " (free registration required) I especially liked the lede where one Khazah boy calling another stupid was quoted saying:

"What are you," he sneered, "iodine-deficient or something?"

Over the past 15 years -- the period during which UNICEF identified salt iodization as the top global child health priority -- Kiwanis International has raised more than $75 million to combat IDD. Now the Bill & Melinda Gates Foundation has begun investing, too. Groups like the International Council for the Control of Iodine Deficiency Disorders (ICCIDD) have been at this since the 1980s and after a major worldwide conference of salt producers in 2000, the salt industry has been integrally involved. In the wake of Salt2000, salt producers joined with ICCIDD, Kiwanis International, UNICEF, the World Health Organization, the Centers for Disease Control and Prevention and a few others to form The Network for the Sustained Elimination of Iodine Deficiency . Read more on our website .

It's great to see publicity like this story. Had it appeared a decade earlier, it would have touched the hearts of Americans then as it does now and made Kiwanis International's fundraising task a great deal easier.

Congratulations to all!

No doubt the UK's anti-salt publicity machine was feeling pleased with their success in generating headlines for a recent piece that suggested that infants need to cut their salt in half. That is, until junkfoodscience called their bluff.

We don't know if blogger-nurse Sandy Szwarc knew anything about the multi-million pound British anti-salt ad campaign featuring "Sid, the Slug," a cartoon reminder of one of the 14,000 beneficial uses of salt -- to kill slugs. Szwarc suggests the public "pour salt on it" -- the study in question. As she laments:

Such extraordinary claims require extraordinary evidence. Does this study hold up?

This study is said to be the "first ever meta-analysis of salt reduction studies in children." And it epitomizes every caveat of these types of studies. MacGregor and He "developed a strategy" of their own design to look for words in several databases and through reference lists at the end of articles to find studies of salt reduction in children. They only used studies published in English and of the 33 they found, decided to use 10 on children for this report. The studies all had different designs, with only one being a double-blind trail and only 9 were randomized; the studies varied in length from 2 weeks to 3 years; compliance with salt reductions appeared poor in two of the studies; we have no information on the racial/ethnic mix of the children and if it is representative of the general population; and only 3 measured 24-hour urinary sodium levels - which the researchers admitted is "the only accurate way to assess dietary salt intake." Simplifying what they did next, they pooled the data on blood pressures and net changes in salt intake, and used statistics to estimate the changes as needed to fill in missing data. Then, they applied two computer models to plot the results and more statistical analyses to reach their findings.

What they reported was that cutting salt intake by 42% reduced systolic blood pressures in the children by 1.17 mmHg. Most parents and children would consider such a salt reduction - nearly in half - to be extreme; while most doctors would debate the clinical significance of a mere 1 point reduction in blood pressure. Taking blood pressures in young children is an imprecise task at best and the children in these different studies were also at varying stages of development, with corresponding variable changes in blood pressures over the study durations, according to their growth and size.

The researchers stated that the "physiological need for salt intake in children has not been studied," but concluded anyway that "current salt intake in children is unnecessarily high and is very likely to predispose children to develop hypertension later."

They went on to declare that these results "provide strong support for a reduction in salt intake for children. [And] if continued, may well lessen the subsequent rise in BP with age and prevent the development of hypertension. This would result in major reductions in cardiovascular disease."

Their press release promised possible "massive population health gains."

·But this study did not examine a single child.

·It conducted no clinical research to learn how much salt is needed or might be harmful for children.

·It offered no clinical evidence to know if a lower blood pressure reading of 1 point means anything for children's health or is maintained as a child grows.

·It offered no proof that a blood pressure reading during childhood has any bearing on adult blood pressures or heart disease.

·And worse, it didn't follow a single child to see if there were any health effects from the salt restrictions they are recommending.

In other words, this study offered no clinically meaningful evidence, only speculations. ...

Shouldn't we have something tenable to go on before experimenting on an entire generation of children? I suspect most parents would think so.

She notes approvingly the award-winning expose of games-playing by the anti-salt crowd as documented in Science magazine and recent research showing that low-salt diets may be creating additional risk .

Beginning in 2007, the American Journal of Hypertension will have a new Editor-in-Chief, replacing its founder, Dr. John Laragh, a Time magazine cover story subject for his breakthrough work on blood pressure and heart disease. Laragh will be succeeded by Dr. Michael Alderman who has just completed his stint as president of the International Society of Hypertension.

In his parting editorial, Dr. Laragh says:

It is a pleasure for me to announce that Dr. Michael Alderman will replace me as Editor-in-Chief of the American Journal of Hypertension effective January 1, 2007. Dr. Alderman is a world-renowned epidemiologist who is unique among his peers because he has been especially interested in asking pathophysiologic questions in performing his population trials. This penchant led him to demonstrate, in a classic eight-year trial of 1717 hypertensive worksite employees, that the height of the entry ambulatory plasma renin level was directly related to the subsequent occurrence of a myocardial infarction (MI). At the same time, he found that no MI's occurred in the 251 patients who had low entry plasma renin levels. This led Alderman to do a confirming follow up study showing that dietary salt-depleted hypertensives with consequent higher renin values and lower urinary sodium values had proportionally higher heart attack rates than did those who ate more salt, and therefore had progressively lower renin values.

Dr. Alderman's research rightly questions the popular wisdom of unselectively advising salt avoidance for all hypertensives, and for all normotensive people, - a popular public health strategy which will surely chronically raise all of their plasma renin values and may have other unintended adverse consequences. Furthermore, this research has clearly reaffirmed the existence of only two mechanistically different types of long-term hypertension, each one of which is caused and sustained by either a body sodium (plasma and ECF fluid-volume) excess or instead by a plasma renin-angiotensin excess. This construction is supported by evidence that the hypertensive states caused by a body salt excess or a plasma renin excess are each quite selectively correctable respectively by giving a natriuretic drug or instead an antirenin antihypertensive drug.

The beautiful and unique sounds of the Stradivarius and Guarneri violins have always been the subject of musical and mathematical mystery and the controversy. Was it the wood? Was it the glue? Was it simply the craftsmanship of the maker? These questions have been asked over and over again.

In a recent article entitled Lord of the Strings , in the December 2 edition of New Scientist, the latest analysis indicates that treating wood with salt water results in a violin that has many of the same qualities as a Stradivarius. This appears to be application number fourteen thousand and.....

Ten crashes in Ft. Wayne, IN have been blamed on an IN DOT anti-icing application of calcium chloride with a rust inhibitor which the agency confesses caused rather than prevented slickness. Four crashes caused injuries according to a sotry in the Ft. Wayne Journal Gazette .

Tragic, of course, but agencies are simply responding to public concerns that they find some "alternative" to using tried-and-true sodium chloride and such incidents are the inevitable result of experimentation with new materials and techniques. Let's be clear, however, anti-icing itself wasn't the problem here, nor was salt (sodium chloride) involved in any way.

The November issue of Food Technology is just out and the Op Ed Perspectives page is devoted to the important matter of the precipitous decline in the consumption of iodine in North America due to the increasing number of meals eaten away from home. The article reviews the history of salt iodization and its public health benefits. At the article's conclusion, I ask that the nation's burgeoning restaurant and food service industry to make a point of asking for and using iodized salt in their product formulations.

The American Council for Science and Health (ACSH) has struck another blow for science and sanity. ACSH president Elizabeth Whelan's column yesterday, "Are Foods 'Addictive' ?" laments the tactic of critics of "Big Food" who try to make customers the victim of a conspiracy -- unable to protect their interests (in this case, their health) and, unstated but implied, requiring protection through more government intervention. Not so fast, Whelan says.

The word "addiction" is used very loosely today -- as when people claim they are "addicted" to exercise, chocolate, or the Internet. But addiction is a medical term referring to compulsive, habitual use of a substance that has physiological effects but is not necessary for survival. Addictive substances produce tolerance (meaning that it takes an increasing amount of the substance to produce the desired effect) and physical dependence -- and unpleasant symptoms of withdrawal if use is discontinued. The nicotine in cigarettes fits all these criteria. Food does not.

There have been claims that eating high-fat or high-sugar foods overactivates drug-like substances in the brain called endogenous opioid peptides, leading to food cravings, overeating, and obesity. Food, it is argued, causes an increase in neurotransmitter levels just as addicting drugs do. Some animal experiments may support this idea, but other animal data and human observations do not. If overeating were induced through an opioid-like mechanism, one might expect that opioid-antagonists would be useful in treating overeating, but they are not.

If this sounds familiar to salt-interested readers, it should. More than 20 years ago the Center for Science in the Public Interest (CSPI) conflated salt with cocaine -- "another white powder we snort" -- and labeled salt addictive. This past summer, critics accused "Big Salt" of heading a "conspiracy" as we tried to mobilize resources for a definitive controlled trial of the question of whether the amount of salt in a person's diet is related to their health outcomes, particularly to cardiovascular mortality. We have only observational studies addressing this question to date and they tend to suggest just the opposite of our current policy. Existing studies show no health benefits for reducing dietary sodium and several have identified heightened risk.

Fortunately, over these past 20 years, we've seen serious scientists express revulsion and reject this fear-mongering. The Cochrane Collaboration grew from a core of concerned research scientists at Oxford University to become first the inventor and then a worldwide force for "evidence-based" medicine (now everybody claims their product is "evidence-based" even when they stray from the Cochrane Collaboration's evidentiary rules). Now groups like ACSH and blogs like JunkScience and Junkfoodscience have taken up the watchdog role protecting the public against those who would pervert science to advance their policy objectives.

"Reactionary." That's the word that best captures the loud defense of the status quo in science. And, as the old saw goes about courtroom strategy for lawyers: If you have the law, argue the law; if you have the facts, argue the facts; if you have neither the law nor the facts argue at the top of your lungs. Perhaps the humor offers an insight into why institutional defenders of the status quo in medical science have turned up the volume in condemning high quality new science that challenges the conclusions of their earlier, often lower quality conclusions.

One of the best new blogs I've read in months examines this phenomenon in two posts this weekend. Junkfoodscience.com , in "Say it isn't so - Part 1 " looks at the Women's Antioxidant Cardiovascular Study (WACS), noting:

It is predictable. A flurry of press releases and articles appear everytime a major study is released that debunks "pop science" - what everyone "knows" to be true - and threatens the research or agendas of special interests. These stories attempt to confuse us, spin the science, or restate the beliefs more emphatically. Many times, they even claim to have new research supporting their position, when they don't!

Registered Nurse Sandy Szwarc, RN, BSN, CCP, pointed out that WACS

followed nearly 16 other major clinical trials released earlier - including the Heart Outcomes Prevention Evaluation (HOPE), Atherosclerosis Folic Acid Supplementation Trial (ASFAST), and the Norwegian Vitamin Trial (NORVIT) - all firmly demonstrating no benefit of folic acid or vitamin supplementation in heart disease, and that lowering homocysteine levels does not translate to real-life reductions in heart disease. And more importantly, has no effect on the most important end point of all: death.

As a Medscape review noted, the clinically measureable evidence is overwhelmingly consistent.

Immediately, the institutional status quo leaped into action, papering the media with the contrary story, to wit (from Reuters):

Folic acid can cut heart attack risk: experts

Can taking folic acid supplements reduce the risk of heart disease and stroke? British researchers believe it can. After analyzing evidence from earlier studies, a team of scientists in Britain said on Friday there is enough research that shows folic acid lowers levels of the amino acid homocysteine and reduces the odds of cardiovacular [sic] disease.

Now, I"m not going to wander from the confines of salt and health to comment on the benefits of folic acid supplementation; there are plenty of experts to thrash that out. What seems worth mentioning, however, is the tactic of the defenders to deflect serious consideration of the WACS and the other 16 studies. And you can read in more detail on Junkfoodscience.com. Szwarc describes how David Wald, a colleague of Malcolm Law, well known for his low-quality "meta-analyses" of the blood pressure effects of salt restriction, for context, launched a high-volume attack on the mounting number of clinical trials using older, lower-order observational studies he had done reaching the contrary conclusion (his news release implied the studies were new and of superior quality).

In today's "Part two ," Szwarc turns her attention to the same phenomenon in the current debate over obesity. Anyone who challenges the orthodoxy that obesity is the root cause for virtually all nutrition related medical conditions has a hard time having their voice heard. Again, it's not a primary issue for our focus, but the process of defending the status quo is frighteningly consistent. As she explains:

Nothing compares to the all-out, massive, well-organized efforts to preserve the "obesity crisis" that began last year after senior research scientists inside the CDC's National Center for Health Statistics exposed the war on obesity - begun by their own director of the CDC, Julie Gerberding, and Secretary of Health and Human Services, Tommy Thompson - as a grossly exaggerated and fabricated scare campaign.

She continues:

the study, looking for correlations between weight and premature death that had been created to lay the foundation for billions of dollars in government and industry "obesity" initiatives, and popular with an enormous throng of marketing and political interests all using the "obesity crisis," had been derived from poor data and had flagrant methodological flaws. How bad was it? It didn't even account for aging, the single biggest risk factor for death, in its computer model!

But, back to the story of tactics used to defend the status quo. Szwarc explains:

Within hours of the release of this potentially devastating study in the Journal of the American Medical Association, special interests - notably, doctors from Harvard School of Public Health, along with the American Cancer Society, American Heart Association and the CDC - quickly rallied press conferences and media releases to deny and spin the findings and attempt to discredit them in the minds of the credulous public. They made noises about it failing to consider smoking, of reversing causality and attributing higher deaths among thin due to the fact they are sick or old, and of not considering the long-term effects of obesity. These spin doctors assumed, correctly, that the media would simply repeat their assertions and not a single reporter would go to the actual study to realize they were nonsense.

Flegal and her associates had analyzed the data in a myriad of ways and had accounted for smoking, chronic diseases and preexisting health problems, involuntary weight loss, and long-term obesity ... and each time the results were the same.

Reporters who'd read the journals where this controversy had been raging could have learned that the "obesity is deadly" studies done by researchers from Harvard, the American Cancer Society and CDC that were being so vehemently defended, had looked at self-reported data from select groups of people that weren't representative of the population and had excluded nearly 90 percent of the deaths in their analyses to get the results they wanted. Among other such studies, you'll find all sorts of other shenanigans.

Let's not blame the media entirely. As much as we should hope reporters would ask the tough questions and look critically at the evidence itself and not just accept what one side of an issue says it means, the real -- and largely hidden -- story here is the enormous lengths that defenders of the status quo have gone to dredge up lower quality studies or those focused on only one portion of a broad problem to emphasize their argument. And the volume! Turn down the hyperbole. Let's discuss science and get that right; then we can turn our attention to getting the policy right to build on that science.

The same process has been playing out in the salt and health issue. Investigative journalist Gary Taubes won the top award from the National Association of Science Writers for his article "The (Political) Science of Salt " appearing in the prestigious magazine Science.

We all need to pay attention to these tactics. Thanks, Ms. Szwarc.

Almost on cue and in response to the Business Week story this week, the November 17 issue of Science magazine reports that the underlying premise of the "wild fix" to "salt the seas" was a "False Alarm: Atlantic Conveyor Belt Hasn't Slowed Down After All ." It turns out that the cooling of the Gulf Stream -- and consequent deposition of its salt-dense contents further to the southwest rather than between Norway and Greenland -- was just another blip on nature's uneven and imperfectly understood cycle. The concern had been that with the warmer Gulf Stream failing to go as far north, that Europe would suffer a disastrous Ice Age (all caused by global warming).

Many scientists had doubted the theory and it certainly throws cold brine on hopes raised by Business Week that a new market for salt would be to dump shiploads of salt into the North Atlantic. Oh, well...

Ray Keating, chief economist for the Small Business and Entrepreneurship Council just posted a Thanksgiving-themed opinion column of this title.

Personally, I tend to think of pumpkin pies for Thankgiving. Perhaps that's why the piece caught my eye. It's worth a read. Keating makes the point that there are "seemingly countless individuals and businesses that must coordinate their efforts to make sure pie lovers are happy on Thanksgiving." He simply reviews the recipe for a cherry pie and the production processes that produce the "shortening, flour, salt, sugar, margarine or butter and, of course, cherries." (full disclosure: Keating cites the Salt Institute for his information on salt).

Keating references Adam Smith's "invisible hand" to explain how myriad self-interests combine to produce a public good. I was reminded, even more, of R.W. Grant's classic, The Incredible Bread Machine, which has just been re-published (see the online reviews at Amazon.com ).

Enjoy your pie, whatever ingredients you use (mine will be pumpkin!) -- you'll surely be using salt. And be thankful for the competive marketplace that has produced such abundance at historic bargain-basement prices -- whether of pies, of salt or of any of a million items in daily commerce.

Now here's a virtually limitless NEW market for salt: Adam Aston in this week's Business Week identifies five "wild fixes for a warming planet." Number 5 is

SALTING THE SEAS

Scientists worry that freshwater from melting Arctic ice and Greenland's glaciers will dilute and disrupt the Gulf Stream as it loops through the North Atlantic. In the past, when this conveyor belt of warm water has stalled, Northern Europe was sent into a mini-Ice Age. To keep the current flowing, Robinson suggests that tanker loads of mineral salt could be dumped into the sea at key points along the Gulf Stream. Since saltier, denser water sinks, staggered deliveries of salt could jolt the cycle and keep the current going. Risks: Altering ocean chemistry on this scale could have catastrophic effects on sea life. Will we have a choice, though? "I'm as dubious about geo-engineering as anyone else," says Robinson. "But the fact is, with climate change we're already doing it."

We've got the salt and the ships. Who'd have thought we could make money by taking salt OUT of the ocean and then putting it back in? It's like WPA, digging holes and filling them back up -- for a good cause!

Most American historians with any sensitivity to the strategic significance of salt will recognize that Saltville, VA, in the far southwestern corner of the Old Dominion, was the scene for two major battles as the Confederacy fought to protect its sole source of this crucial mineral and the Union tried to tighten its economic blockade.

Retired Virginia Tech chemistry professor Jim Glanville has done more than any person to restore the luster of Saltville's rich heritage, including a steady publicity effort. His latest media foray appeared in today's Richmond Times-Dispatch, entitled "A similar tale predates Pocahontas " in which Glanville tells the story of an early Indian "chieftainess" who married a European (acually, one of two recorded).

As Virginia prepares to celebrate the 400th anniversary of the arrival of the Jamestown settlers in 1607, Glanville recounts the documented vist -- a full 40 years earlier -- of 15 Spanish conquistidores who sacked the fortified Indian village erected at Saltville to obtain salt from the saline springs there. The Spanish boasted of burning 50 huts and killling 1,000 defenders, though Glanville considers this hyperbole. In any case, the "first battle of Saltville" was 290 years before the Civil War clash.

A news analysis, with this title, by Denise Grady published in yesterday's New York Times should be required reading by the nation's public health nutrition community. Grady points to public health campaigns that "have drilled that message into the national psyche." Her example: angioplasties and coronary stents. She could have been talking about salt. She continues:

Ideally, treatments, operations and diagnostic procedures should be thoroughly tested before they come into routine use. Bu that is not always the case. ...

Some treatments -- like opening a closed artery -- appeal so strongly to common sense that it becomes irrestible to go ahead and use them without waiting for scientific proof that they are effective. ...

As the treatments start to catch on, people assume they must work, and it becomes difficult or impossible to study them in the most definitive way -- by comparing treated patients with an untreated control group. If most people think a therapy works, who wants to be the control? Doctors may balk at controlled studies, too, calling it unethical to withhold the treatment from patients in the control group.

Grady recognizes that her example is just that, a single instance of a widespread phenomenon of pseudo medical advice lacking "gold standard" testing through randomized trials to prove improved health outcomes -- just as is the case now with encouragement to reduce dietary salt.

And today's news that FDA has (once again) approved silicone breast implants suggests that FDA understands the need to revisit arguments based on Chicken Little pseudo-science. Responding before controlled studies confirm the problem can compound the ultimate solution by creating controversy as medical experts learn the earlier "fix" is wrong, but the public has already been indoctrinated on the basis of the premature "solution."

Grady reminds us:

Medical history is strewn with well-intended treatments that rose and then fell when someone finally had the backbone to test them, and the scientific method trumped what doctors thought they knew.

Hormone treatment after menopause, which works for symptoms like hot flashes, was widely believed to prevent heart disease and urinary incontinence. But carefully done studies in recent years have shown that hormones can actually make those conditions worse.

Stomach ulcers were once attributed to emotional stress and too much stomach acid, and were treated with surgery, acid-blocking drugs and patronizing advice to calm down. Then, in the 1980s, two doctors who were initially ridiculed for proposing an outlandish theory proved that most ulcers are caused by bacteria and can be cured with antibiotics.

For decades, women with early-stage breast cancer were told that mastectomies offered them the best chance of survival. But in 1985, a large nationwide study showed that for many, a lumpectomy combined with radiation worked just as well.

"As a nation, we're not doing ourselves any favors by going after the next new thing without doing the studies," said Dr. James N. Weinstein, chairman of orthopedic surgery at Dartmouth and a researcher at its Center for the Evaluative Clinical Sciences, which studies how well various medical and surgical procedures work.

When established treatments turn out to be useless, or worse, harmful, Dr. Weinstein said, "everybody's going to lose trust in the system."

With regard to salt, the FDA and NHLBI may have succeeded in brainwashing the public, but, ultimately, science will prevail. Government pronouncements don't change physiology. The essence of the scientific method is that current "knowledge" is bombarded with new facts and new analytical methods as they are developed and, guess what, the old orthodoxies are often overturned or modified.

What we need to sort out the controversy among medical experts regarding dietary sodium is a controlled trial of the health outcomes of various levels of dietary sodium. We need to know if lowering the average population sodium intake will save lives or put our population at higher risk of heart attacks and cardiovascular mortality as the latest studies have found.

Looking for a Christmas gift that's perfect for a young person who you'd like to know about salt? Consider The Story of Salt by Mark Kurlansky with wonderful illustrations by S.D. Schindler. It's a digestable version of Kurlansky's Salt: A World History. (No, we get no royalties; this is an unsolicited testimonial). Says the School Library Journal:

"Kurlansky uses salt as the lens through which to present a new perspective on history. [T]he author mixes science, history, and personal anecdotes, resulting in a fascinating look at this amazing substance. Schindler's humorously detailed pen-and-ink drawings with colorful washes enliven the narrative and help to convey the wealth of information in the text. A lively and well-researched title, with exemplary art."