For years, I have gone on record highlighting the benefits of the “Mediterranean” diet . This was no second or third party pitch I was making. Having lived in Italy for almost 20 years, I have ample ‘first-hand’ experience of the diet and its many health benefits. At the same time, it was clear to me that this healthful diet was being misrepresented to fit the agendas of certain individuals and organizations in the health and consumer segments.
There is no doubt that everyone loves a winner and the hands-down favorite diet all around the world promoting good health is the Mediterranean diet, so naturally all the diet talking heads tried to pitch it in their favor. Lots of salads, vegetables and fruits, plenty of grains (bread and pasta), good cheeses, a lot of fish and a small amount of meat – that’s how all the Mediterranean diet promoters characterized it. And there is no doubt, the cardiovascular figures of Mediterranean residents are amongst the best in the world.
But all the pretenders in the medical institutions and the consumer group sector neglected to mention one very important aspect of the Mediterranean diet – it’s very high salt content. That can only mean one of two things. Either, they had no idea of what the diet actually was but pretended they did, or they knew it was a very high salt diet but purposely lied about it because it did not fit their agenda. After all, the urban myth was that high salt diets contributed to cardiovascular disease and if the Mediterranean diet was revealed to be high in salt, it would prove to be very embarrassing to their salt reduction agenda. Either way, it makes me wonder how consumers can still have any faith in the medical establishment when it comes to nutritional advice.
Aside from my personal experience of the food in Italy, there was a highly regarded publication by C. Leclercq and A. Ferro-Luzzi describing the high salt content of the Italian diet (1). This 20 year old paper was just reconfirmed by a recent study of A. Venezia et al, published in the May edition of the European Journal of Clinical Nutrition . And still, the Southern Italians continue to enjoy good cardiovascular health.
And salt is not a bystander to this good health paradigm. A key determinant of good health is the consumption of a sufficient amount of salads and vegetables. These foods contain the bulk of the essential water-soluble micro-nutrients we consume. You don’t get as many water soluble nutrients from any other source in the diet. And it is salt that makes salads and vegetables so tasty. Salt is what encourages a good, well-balanced diet. That is why we evolved to like salt as much as we do – because it keeps us healthy.
The doom and gloom prophets, the food police and the nutrition con artists are all preaching that our diet is killing us. Fortunately, most of us are blissfully unaware of this so we continue to enjoy life and thrive better than at any time in the entire history of mankind – just check out the health statistics on the CDC website .
(1) C. Leclercq and A. Ferro-Luzzi, “Total and domestic consumption of salt and their determinants in three regions of Italy,” European Journal of Clinical Nutrition, Mar, 45(3), 151-9, (1991).
(2) A Venezia, G Barba, O Russo, C Capasso, V De Luca, E Farinaro, F. Cappuccio, and P Strazzullo, “Dietary sodium intake in a sample of adult male population in southern Italy: results of the Olivetti Heart Study,” European Journal of Clinical Nutrition, 64, 518-524 (May 2010).
In a previous blog "Abolish FSA - Without Delay !" I mentioned that the new UK government was thinking of making major changes to the Food Standards Agency (FSA). Well, today, the UK government has ended speculation about the future of the Food Standards Agency (FSA), announcing that the body will retain its food safety remit but be stripped of responsibility for nutrition policy and labeling.
Under the plans, the Department of Health (DoH) will become responsible for nutrition policy while the Department for Environment, Food and Rural Affairs (Defra) will oversee labeling and food composition policies.
The FSA was known to advance an activist agenda totally driven by misinformation rather than concrete evidence. Their role in nutrition policy will not be missed.
On June 15, 2010, Agriculture Secretary Tom Vilsack and Health and Human Services Secretary Kathleen Sebelius announced that public comments would be accepted on the Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010 (Advisory Report). Individuals and organizations were encouraged to provide written comments and oral testimony could also be provided at a public meeting to be held in Washington, DC, on July 8, 2010 .
I submitted the Salt Institute’s comments (pdf 91.39 kB) that were accepted by the USDA for oral testimony. The oral testimony was well received and was cited in several articles as well as releases issued by other groups .
Aldosterone plays a major role in the maintenance of electrolytes and fluid balance and subsequent blood pressure control. Epidemiological studies that explore the connection between hypertension and cancer have found a higher rate of cancer-related mortality in hypertensive patients that have an elevated level of aldosterone. Recent research indicates that this may be the result of aldosterone-mediated damage to chromosomes and DNA in kidney cells.
For most people, the renin-angiotensin-aldosterone system is activated when our salt consumption drops below current levels. Although cardiovascular issues were always considered to be a possible unintended consequence of salt reduction, this study is one of the preliminary indications that an increase in cancer-related mortality may be a consequence as well. The Salt Institute will maintain a watching brief on the clinical research carried out in this area.
In my recent blog, “Good Tidings ,” I mentioned that Food Standards Agency (FSA) chief executive Tim Smith claimed that the UK has “turned the tide” on salt consumption, basing his case 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. However, there was a strange tone in his public address that led me to believe that something was afoot. I got the impression that, with the new government installed in the UK, the FSA’s chief executive was indicating that they would be cutting their anti-salt campaign, which is which is why I felt that the tide had turned.
Well, there was more news on this front this week. On Monday, July 12, the Guardian wrote that Andrew Lansley, the British Health Secretary indicated that the Food Standards Agency may be abolished entirely. As part of the changes, the FSA's regulatory role – including safety and hygiene –would be reassigned to the Department for Environment, Food and Rural Affairs (Defra) from whence it originally came.
There were the inevitable cries of foul – that the government could not get rid of a much needed watchdog agency , but I for one couldn’t be more pleased. The FSA was the poorest possible model of a watchdog agency and it's about time it was abolished.
The function of a watchdog agency is to make sure everyone is honest – everyone – a hard task to accomplish when the agency itself was dishonest and used taxpayers' money to advance an activist agenda totally driven by misinformation rather than concrete evidence. The agency completely ignored every bit of science that did not support their agenda, as though it didn't exist. They tried to bundle together bits and pieces of poor, incomplete information or opinion and pass it off as a real evidence - talk about putting lipstick on a pig! The FSA became the chief promoters of the big lie on the benefits of salt reduction.
Yes, we may need certain watchdog agencies - not pawns of any interest group, but honest scientists who can objectively evaluate scientific evidence and who have enough backbone and honesty to forgo advancing gratuitous solutions until sufficient evidence is available, rather than giving half-baked advice that will never benefit anyone except themselves.
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.