Earlier this year a New Jersey startup "food manufacturer," Bon Vivant International , began marketing "NutraSalt an all-natural, low-sodium sea salt," claiming "66 percent less sodium than other salt products."

Well, I guess this "food manufacturer" makes other things than food. Food grade salt is required to have at least 97% sodium chloride. So NutraSalt cannot be food grade salt.

The founder claims: "The product can be sold as table salt and as an ingredient to food-service companies and food makers."

It would be interesting to know which "food-service companies and food makers" are using non-food-grade salt. Inquiring minds want to know.

Scientists generally accept that 24-hour urine samples are the most accurate means of measuring sodium intake -- the "gold standard" for dietary sodium just as randomized controlled trials are the "gold standard" in the hierarchy of levels of evidence.

With that as background, how should we understand the claim by the Heart and Stroke Foundation (Canada) which "revealed" today that "500,000 kilograms of salt have been removed from the food supply in the last four years by companies participating in the Health Check program." HSF's health policy director equated the amount to "20 dump trucks of salt."

On its surface, the claim is that the total food sold over the past four years bearing a Health Check logo contains a half million kilos less salt (that figures to 550 tons of salt). Every year, Canadians consume about 130,000 tons of salt. So over four years, Canadians consumed a half billion tons of salt (520,000). In other words, this effort is claimed to reduce Canadians' salt intake by 0.1%.

But is it true? The claim can only be evaluated if we also know the answers to these questions:

  1. Compared to the baseline four years ago, what was the composition of the foods bearing the HSF label? If the quantities and/or configuration of the sales differed, what can be said about the 500,000 gram number? If people, for example, are eating less of these foods (because they don't taste good or cost more) the number is invalid. But even more:
  2. Compared to baseline, what other foods are Canadians eating and in what quantities? If they are eating less salt in Health Check foods, are they simply eating that salt in other foods?

No, the entire exercise is entirely bogus.

What we need to test the proposition (and we're all for the test!) is to track the total sodium consumption for a representative sample of Canadians randomized to consume a diet including as much as possible all the Heart Check foods and compare that over a year or two, with those randomized into a control group which eats whatever they want. The outcome would be ascertained by frequent collection of 24-hour urine specimens and the analysis done in blinded fashion.

Evidence suggests that physiology determines sodium consumption, not package labels. If an individual consumes "low salt" foods, they may simply eat additional quantities of food (and extra calories) to satisfy this innate "salt craving" automatically determined by the body to reflect that individual's varying need. That's why research shows such a consistent pattern of salt intake between populations and over time .

Most visible among their food industry peers in claiming "credit" for reducing salt in their product lines, ConAgra Foods and Campbell Soup both have declining customer satisfaction scores from baseline, according to the American Customer Satisfaction Index released today. ConAgra, in fact, finished dead last among the 13 named larger companies (and below the "all others" category).

On a 0-100 point scale in the ACSI, food manufacturers averaged 83 points with Campbell Soup lagging in 12th place with 82 and ConAgra dropping 6 points to 78. Leaders were H.J. Heinz with 89 followed, at 87, by Hershey, Quaker (PepsiCo) and Mars.

ACSI produces indexes for 10 economic sectors, 44 industries, and more than 200 companies and federal or local government agencies. Among all industries , manufacturers earned 81.5. Laggards were newspapers, cable/satellite TV companies and airlines (63 and 64). They, together with telephone companies (69), were the only private sector businesses with customer satisfaction as low as the federal government at 69.

ACSI is sponsored by the American Society for Quality, the University of Michigan's Ross School of Business and Cloes Fornell International.

William Grimes book Appetite City: A Culinary History of New York , reviews the City's rich ethnic heritage evolving out of humble beginnings as Nieuw Amsterdam. He cites the increasing popularity of "ethnic" dining as the City's greatest achievement as a "food city."

By ironic coincidence, the book appeared a year ago, when the City launched an initiative that would eviscerate the sale of ethnic foods in Big Apple grocery outlets and decimate ethnic dining in the city. The health department, basing its campaign more on political correctness than sound science, is trying to persuade grocers and restaurateurs to provide shoppers and diners only low-sodium versions of the foods they love. Imagine a low-salt salt bagel. How about a corned beef on rye or hot pastrami? No, can't have that, they're cured in saltwater. Choose your favorite ethnic cuisine and you'll find it impossible to enjoy without salt; it's the quintessential ingredient in ethnic foods.

Literally millions of immigrants entered the US through New York City and, for example, there are 3.3 million Italian-Americans in the New York metro area and extensive number who themselves or whose families emigrated from Greece or other Mediterranean countries -- whose diet is deemed the healthiest in the world (pdf 592.83 kB) . Even though newly-reelected, I doubt Mayor Bloomberg wants to tell them to turn their back on their ethnic culinary heritage -- or encourage them to dine in Hoboken, Hempstead or Yonkers.