On January 11 of this year, you announced an ambitious program dubbed the "National Salt Reduction Program." This program was patterned after the Food Standards Agency salt reduction program in the UK, which you characterized as a success. Considering the economic, social and infrastructural problems that New York City faces, you clearly believe that a population-wide reduction of salt intake is a very high priority issue. Yet, the issue of population-wide salt reduction remains deeply mired in controversy. The majority of meta-analyses on the subject do not conclude that population-wide salt reduction is warranted. Some even state that there may be an unintended consequence resulting from such an action.

As you are so devoted to this program, I believe that you should have an opportunity to openly demonstrate the depth of this commitment. It would certainly not be the first time that political leaders have stood up to demonstrate the courage of their convictions. In 1991, in an effort to stave off international criticism regarding Peru's polluted fishery, President Alberto Fujimori dined on local ceviche in front of news cameras to demonstrate his faith in the quality of their fish. It is of no consequence that he came down with cholera the next day - the important thing is he had the courage to stand up for what he believed in.

As a public leader, I feel that you should have the same opportunity and hope that you would demonstrate the same degree of courage. I propose that you go on a 1,500 mg sodium/day diet, as recommended by the CDC and I will maintain my 3,500-4,500 mg sodium/day level for a full month. During that time, we should have our blood chemistry (renin, aldosterone, cortisol, etc.), blood pressure, arterial pulse wave velocity (a measure of arterial stiffness) and urinary sodium levels checked weekly. I would further invite Drs. Larry Apell, Chairman of the Dietary Guidelines Sub-Committee on Electrolytes and Michael Jacobson of the Center for Science in the Public Interest, two individuals who have repeatedly stated that humans do not require more than 500 mg of sodium/day to join in this demonstration by consuming that 500 mg sodium/day for one month as well and undergo the same tests.

Finally, I propose that Dr. Mehmet Oz use his good facilities to manage the clinical tests and report the results on his television program.

Mr. Mayor, I have no doubt that you wish to do what is right. I do as well, however, we are operating from a totally different set of peer-reviewed data. A task as simple as the one I suggest may well resolve this issue to everyone's satisfaction and will set the salt and health debate upon a course that should benefit all citizens.

Yours sincerely,

Morton Satin

Technical Director

Salt Institute

Alexandria, VA 22314

This year has brought an avalanche of salt reduction papers in the medical journals, together with supporting editorials and letters from well-known and influential anti-salt activists. The effort appears to have been coordinated and I would not be at all surprised if WASH (World Action on Salt and Health) and CSPI (Center for Science in the Public Interest) were associated with it.

The rather odd thing is, despite all the published text calling for stronger regulatory action to reduce salt due to all the projected morbidity, mortality and health care costs this would result in, not a shred of actual new evidence was published. The papers published were simply statistical models based upon evidence we know was highly flawed. Obviously, the laudatory op eds and letters that followed were more a show of desperation trying to shore up the flimsy house of cards.

I sent a letter to the Annals of Internal Medicine criticizing the current state of affairs, where leaders in public health policy appear to have become so political that they no longer demand evidence to develop public policy. It is a sorry state of affairs when academics resort to statistical models with fancy nine dollar words instead of simply going out and getting the data which is easily available. The letter can be seen here . Scroll down the page to the letter and click the "more" link to see the full content.

Caught up in this frenzy of scientific folly and compulsion to regulate, New York Assemblyman Felix Ortiz introduced Bill A10129 stating that no restaurant should be allowed to add salt to the food they prepare. I blogged this item and he is apparently rethinking his position coming out with the inevitable statement that he was totally misunderstood by all – that’s not what he meant…..he really meant…..not too much salt…..maybe not on Tuesdays or Thursdays…..only at Happy Hour……or no more rice in the salt shaker…… or something equally stupid!

In fact, Ortiz was highly criticized by Bloomberg for his bill with Bloomberg saying he was only working with manufacturers to gradually reduce salt over time. You know, “slowly, slowly, catchee monkey.” That way no legislation has to be developed and if it all goes south and people start exhibiting signs of cardiovascular illness, metabolic syndrome or stress or reduced cognition or alzheimer’s (all possibilities described in the medical literature), then no one has to take responsibility for it. He can simply say “We were only suggesting salt reduction – it was the industry that actually did it!”