The U.K. Telegraph reported the story of 110 year old Mary Brown, of Surrey, who attributes her cenetenarian plus status to sprinkling all of her food with plenty of salt . Despite all the negative publicity issued by the Food Sandards Agency's anti-salt campaign , Mary kept to her regular consumption of salt and has lived far beyond the average life expectancy. We wish her continued life and good health.

This is not the first time we hear that salt contributes to continued good health in later years. One Canadian cardiologist wrote us that he felt the low salt diets often prescribed to the elderly led to chronic dehydration and hyponatriumia (salt defficiency). As a result. people became very drowsy and suffered a range of salt-defficiency-related metabolic disorders. Often, this led to instability in walking or standing and a significant jump in the risk of large bone or pelvic fractures - all due to a low-salt diet. The cadiologist in question had been treating patients for 65 years - more than a lifetime of experience. He finishes his letter by saying,

"Spending your golden years in a retirement home with a low-salt diet will convert your last years to a long chronic illness."

Despite her love for salt, 110 year old Mary Brown says, "Everything else should be taken in moderation, except family and friends.

Mort Satin sent in this blog.

This past week saw the announcement of the European Food Safety Authority (EFSA) Scientific Colloquium 9 - Nutrient Profiling for foods bearing Nutrition and Health Claims, to be held from 11 - 12 October 2007 in Parma, a city best known for its fabulous Parma Ham*, as well as the King of cheeses, Parmigiano Reggiano**.

Not surprisingly, the European food agency at the forefront of the nutrient profiling is the Food Standards Agency (FSA) of the UK. Concerned with the rise in obesity, the FSA looked for approaches to nutrition that had the potential to make it easier for consumers to make healthy choices. They argued that it was really the 'imbalance' in the consumption of individual foods that caused health problems, not the overall balance of the diet. It's really not the Mediterranean Diet, it's the fish…or is it the olive oil….the fruits and vegetables….the capers…..truffles…?

In other words, food is considered to be little more than an independent carrier of nutrients. Depending upon the 'balance' of these nutrients, foods would be characterized in a nutrient profile. That not being enough, the profiles would be accompanied by decision signals such as traffic lights that would make it even easier for the consumers to make an "informed" decision. Traffic lights are considered to be useful signals for any being at or above the intelligence of a magpie.

It now appears that, in Europe, this concept has reached a point of no return. The ultimate price that Europe, formerly the global pedestal of fine food, had to pay for nutrition and health claims regulation. The rest will be tedious bureaucracy.

In her landmark book, "The March of Folly," historian Barbara Tuchman defines the characteristics of folly as initiatives that: 1) are contrary to the self-interest of the society pursuing them; 2) are conducted over a period of time, not simply a burst of irrational behavior; 3) are conducted by a number of individuals, not just one deranged maniac and, most importantly; 4) are cautioned by a considerable number of people alive at the time who pointed out correctly why the initiative in question was folly.

In future blogs, we hope to examine the folly of nutrient profiling in detail. If foods were nothing more than carriers of nutrients the future of eating will be little more than a large, perfectly balanced food pill accompanied by a glass of water, and, if you really felt nostalgic, a glass of water and a gelcap of wine concentrate. Good food culture does exist and doesn't require a traffic light to legitimize it. Rather than invent a new model, perhaps it would have been better to copy another neighbor's successful model - but I guess that's not what the sweeping powers vested in public authorities do.

We will also look at the science of nutrient profiling. Our entire base of knowledge for nutrients in foods comes from chemical analysis. To make matters worse, the nutrient profiles reflect laboratory analytical results, not the bioavailability of nutrients in living systems. The impact of one food component upon the other in the gut is never determined for the profiles. Fiber decreases digestibility and consequently bioavailability - how is this factored into the profiles? In fact the profiles never consider indigestibility - a total disgrace from a nutrition science point of view and a matter that would make Dennis Burkitt, discoverer of Burkitt's Lymphoma and one of Britain's most intuitive scientists of the 20th century turn over in his Bisley, Gloucestershire grave.

The nutrient profiles give no indication of the interactions and dynamics taking place in the gut when normal diets are consumed. Dietary regimes incorporate particular food combinations and we have never determined how indigestibility of one component may affect nutrient availability of all other components in the diet. Because the nutrient data tables we use don't relate to this issue at all and, by use of these tables, we incorrectly presume that there is no such interaction - even though not single a nutritionist would agree with this. Thus, the inexorable march of folly rolls along.

*Pig meat profile #4276 (water 50,84%; protein 22,75%; salt 4,84%; fat 21,01%) ** Salt-cured cow milk curd profile #76383 (water 31.98%; protein 36.14%; salt 2.28%; fat 28.6%)

With the current woes of Wall Street feared trickling down to Main Street, at least some folks on Madison Avenue must be smiling. Marketers dream of converting dreary commodities into exciting products. And now, a "salt revolution" has come to our industry. "Everyone" is talking about salt, the media agree. For example, Amy Culbertson of the Ft. Worth (TX) Star-Telegram, publishes yesterday on Seattlepi.com , told readers:

Flor de sal hibiscus. Danish Viking-Smoked. Peruvian pink. Hawaiian red alaea. Black Cyprus. Australian Murray River.

Salts worth splurging on There are practically as many varieties of salt to choose from as there are oils and vinegars. Chefs are sprinkling them over ceviches, steaks and sometimes desserts; detailing their provenance on menus; offering tastings of them instead of filling saltshakers with them.

The salt revolution has really taken hold. No longer can you feel smug about cooking with kosher salt or sea salt instead of pedestrian old Morton. If you're cutting-edge, you'll be touting your French fleur de sel smoked over oak wine barrels.

But Culbertson wasn't satisfied, asking whether the highly-touted (and -priced) salts are more hype than hip. She interviewed a local restaurant owner, Jon Bonnell, owner/chef at Bonnell's Fine Texas Cuisine in Fort Worth, who told her:

"I think it's more about giving fun gourmet gifts than a genuine difference in taste," says Bonnell, who uses basic kosher salt for cooking at his restaurant. "That being said, however, I have six or seven different kinds of salts by my cutting board at home," listing as his favorites Danish smoked sea salt, Cyprus flakes and Australian pink salt.

And, if much of the appeal of the exotic salts is essentially theatrical -- well, dining has always been partly about theater.

Bonnell still uses kosher salt most frequently at home as well, but occasionally he'll grab a pinch of one of the exotic types when he's feeling playful. And it's the play factor that provides the intangible appeal of these colorful crystals. We humans have always been fascinated with gems and crystals, so it's no wonder these salts have such allure for cooks.

"It's kind of fun that even salt can be a playful ingredient these days," says Bonnell, who happily recalls a recent dinner at a boutique Napa Valley winery where heirloom tomatoes from the winery's garden were served with a half-dozen different salts for tasting, served in a gadget reminiscent of the carousel-style server restaurants used to use for baked-potato toppings. "That was pretty fun," he says.

Being "hip" may be mostly hype, but let's enjoy the ride!

British scientists at King's College, London appear to have found a new way to regulate hypertension which involves oxidation. Oxidation in the past has generally been regarded as harmful rather than good, but researchers now acknowledge that it is central to normal cell function.

Important for all tissues, the enzyme protein kinase G or PKG is particularly functional in the cardiovascular system where it plays a fundamental role along with nitric oxide in blood pressure regulation. What the researchers discovered was a way in which PKG can be regulated independently of nitric oxide which may open up new approaches to manage hypertension. Metabolic oxidants such as hydrogen peroxide can elicit bonding between two amino acids which activates PKG, which in turn, leads to lowering of blood pressure.

The research is published in the journal Science .

Active oxidant/anti-oxidant species are generated during normal metabolism. Fruits and vegetables have been shown to contain high levels of these compounds , which provide protection against harmful free radicals and have been suggested to lower the incidence and mortality rates of cancer and heart disease in addition to a number of other health benefits. Fruits and vegetables have repeatedly shown to be extraordinarily effective in reducing hypertension and have been considered critical in reducing the burden of cardiovascular disease .

Perhaps the latest research will clarify why.

This week, Local Authorities Coordinators of Regulatory Services (LACORS), a UK government body set up to provide advice and guidance to support local regulatory services, issued a report accusing British food manufacturers of "hoodwinking" consumers by manipulating serving sizes to minimize the amount of salt.

Are you kidding? Apparently LACORS feels the food industry is as obsessed with salt as it obviously is. Salt as the only nutrient of interest? What about the food industry's desire to showcase "good" nutrients? If a single chicken nugget is a smallish "serving" then the amount of protein is proportionately small. If serving sizes are wrong, don't blame salt; get regulators and FSA together and agree on proper standards. Don't obsess on salt.

Myopia reigns at LACORS.

LACORS ignored its basic mission: to promote sound health. It has embraced the Food Standards Agency's politically-correct salt-bashing campaign, ignoring entirely that campaign's flawed assumptions and utter lack of a health outcome metric. "Success" is salt reduction, argues FSA, simply assuming a health benefit. Studies in the US and Finland have put the lie to this easy assumption.

Contrast that to the Food Dudes program whose goal it is to increase fruit and vegetable consumption in the UK. They may have a miniscule budget and certainly lack the glitz and horsepower of the FSA, but Food Dudes understands the science: increasing intakes of fruit and vegetables will not only reduce cardiovascular diseases, but a great many other chronic diseases as well. It is a pity that they don't have the spotlight

LACORS is right on one point: the consumer IS being hoodwinked. But FSA and LACORS are doing the hoodwinking, not the food industry.

The August edition of IFT 's Food Technology , the most widely read journal in the food industry (monthly circulation of 35,000) just came out. The OpEd column, Perspectives, contains a hard-hitting look at those who pursue salt reduction instead of increased fruit and vegetable consumption as a means of controlling hypertension.

A Salty Red Herring describes how a diet high in fruit and vegetables leads to a much lower incidence of chronic disease and a decline in the majority of risk factors associated with cardiac disease and stroke. The Dietary Approaches to Stop Hypertension (DASH) diet, high in fruits, vegetables, and low-fat dairy products demonstrated that hypertension can easily be reduced, even in salt-sensitive people (Appel et al., 1997). However, with a diet high in fruits and vegetables, not only is hypertension dramatically reduced, but all other cardiovascular risk factors are reduced as well.

Despite the evidence of fruit and vegetables benefits, the article asks why do AMA, FSA, and CSPI continue to aggressively push salt reduction (partially reducing one cardiovascular risk factor in a small proportion of the population) and say so little about dramatically increasing the consumption of fruits and vegetables (reducing the impact of all risk factors for the total population)? In other words, why do they insist on chasing the salted red herring when a much more meaningful and beneficial resolution to many diet-related health problems is so obvious?

Mort Satin sent in this blog:

"Vitamins No Magic Bullet for Heart Health," "Study doubts antioxidant benefits for heart risk women," "Vitamins May Be No Match For Mother Nature," typical headlines resulting from a just published study in the Archives of Internal Medicine. I find it odd that there is such an uproar over the finding that individual nutritional elements, such as vitamins C and E or the antioxidant beta carotene in pill form do not contribute to health in the same way as when they are consumed as integral components of fruits and vegetables.

This study highlights a number of fundamental problems we encounter in modern nutrition-based medical research. We have come to rely very heavily on epidemiological studies, regarding them as functional rather than numerical relationships. Theories, policies and interventions are churned out of the health establishment based upon the tyranny of statistics rather than a knowledge of the underlying physiological mechanisms. That's how we end up with the swarm of "paradoxes," the French paradox, the Italian paradox, etc. Is it the wine, or perhaps the omega 3, 6, and 9 fatty acids? Should we focus on flax or concern ourselves with nutrient flux? Most importantly, can we isolate the one magic bullet that will rationalize the statistics we observed? With that one magic bullet, it would be child's play to promulgate a health policy and a simple intervention strategy. Unfortunately, life processes seldom revolve around single bullets.

Another primary problem is the lack of knowledge concerning the contradictions we observe between laboratory studies and clinical trials. As an example, most people believe that the majority of vitamin C is lost during processing because laboratory analysis indicates the ascorbic acid is gone. What has actually happened is that the ascorbic acid is converted into dehydroascorbic acid, which doesn't show up on the standard laboratory analysis. However, dehydroascorbic acid has virtually the same health benefits as ascorbic acid. The laboratory analysis says the vitamin C is gone, it has ceased to be, it is no more, however, our astute bodies tell us it's not - another example of the "in vitro, in vivo paradox."

The same paradox is evident in the countless dietary studies carried out, sponsored by the National Institutes of Health. Many of these studies begin with the notoriously inaccurate, self-professed food survey - the 24-hour recall ("I don't remember eating that Twinkie," said the adiposed adolescent). Once this questionable set of data on intakes is collected, it is usually put through clever computer programs such as the Minnesota Nutrition Data System software which converts these stated intakes into nutrients, based upon the ubiquitous, but inadequate USDA tables and other data on proprietary food preparations. The USDA tables disregard the issue of digestibility (or more correctly, indigestibility). These tables and the numerous computerized nutrient data programs that derive from them, assume that everything is fully digested - 100% bioavailability. This is, of course, wrong. The most digestible protein, egg albumin is only about 95% digestible, while celery can be down to 65-70% on a dry matter basis. This means that a significant portion of micronutrients may not be available.

We brush aside the impact of indigestibility of individual foods as well as the impacts of one food upon another. This is strange since we have long accepted the positive, synergistic effects of foods taken together, such as bread and milk, where the essential amino acids complement one another. Why deny the flip side of indigestibility? If you eat your eggs together with a few florets of broccoli, how much of the egg nutrients do you actually digest? Without knowing with precision which nutrients are absorbed in what amounts, data is churned out, often to several decimal places, for us to ruminate and develop theories upon. Garbage in, garbage out. On top of that, a lack of appreciation of the impact of micronutrients generated by gut microorganisms confounds our conclusions even further. So we end up observing what was taken in and observing the final outcome, but not knowing much about what actually happened in the process. Not a very sound basis upon which to promulgate health policies and interventions. It highlights the disconnect between what is observed in the laboratory (i.e. the USDA tables) and what actually happens in real life.

This unfortunate combination of poorly executed analysis, imprecise knowledge of physiological mechanisms and the unremitting drive to find a singular explanation to statistical relationships results in policies, advice and interventions that do not stand the test of time. We have seen this with hormone replacement therapy, salt reduction programs and we see it again with prescribed vitamin regimes. No wonder we see headlines such as, "Vitamins May Be No Match For Mother Nature."

Speaking yesterday in San Francisco, Sen. Hillary Clinton took a shot at the Bush Administration for allegedly abusing science. Lisa Neff of the Associated Press reported:

Clinton argued that the executive branch has put ideology over evidence at the expense of the nation's health and economic viability. "Scientists have been muzzled. Information has been taken off government-sponsored Web sites. The leaders of our country have dismissed scientific research and advancements," Clinton said. "They have denied the factual basis of so much that we take for granted."

While the rhetoric may be politically-correct pablum, this is the first we've seen of a presidential candidate seeking to elevate the visibility of the issue.

We extend our support and best wishes to those who would improve the quality of science, but note that those who've been attacking the Administration for manipulating science have recorded themselves steadily against the President's several iniatives to establish objective data quality standards as part of the federal regulatory review process.

Perhaps Sen. Clinton is trying to "triangulate" on the issue in the manner of her husband -- who, after all, signed into law the Data Quality Act, toothless though that's proved to be.

Will reducing population salt intakes save the thousands of lives promised by public health agencies in the U.S. and the U.K.? The only country to achieve a significant reduction in salt intake is Finland and researchers Karppanen and Mervaala published the outcomes in the journal, Progress in Cardiovascular Diseases . Not only did they claim that the significant reduction in salt consumption led to a dramatic decrease in cardiovascular disease, but they went further and attributed the 4.5 year increase in longevity to it as well.

Since this was the first medical study to actually look at a broad-based national salt reduction with health outcomes over a 30 year period, I thought it would be worth comparing with other countries.

This comparison appears in our latest edition of the Salt and Health Newsletter . The Global Cardiovascular Infobase , makes possible a clear comparison of patterns of ischaemic heart disease (IHD) in all countries. As it turns out Finland, the only country to significantly reduce salt consumption, experienced the weakest reduction in Ischemic heart disease over the last 30 years. In fact, Canada, a country where no salt reduction took place, started at the same point as Finland, but ended up with double the heart disease reduction. That certainly doesn't say much about the positive impact of salt reduction, quite the contrary.

To check out the situation with life expectancy, I accessed the International Data Base of the US Census Bureau . Here again Finland, the only country to severely cut its salt intake, ended up with a rather small increase in logevity compared to the other countries.

Based on this Finnish study, we can say with confidence that despite an almost 50% reduction in the consumption of salt in Finland, there are no health benefits attributable to this intervention.

Information Today reported that on July 19, the US House of Representatives approved measures directing the National Institutes of Health (NIH) to provide free public access to agency-funded research findings within 12 months of their publication in a peer-reviewed journal. Of course, agency-funded research is taxpayer-funded research, so you would think that NIH would be happy to accommodate this idea. Not quite.

When first asked to do this on a voluntary basis, less than 5% of the eligible research was made available. Why is there this reluctance to make the results of publicly-funded medical research more widely available?

Most of the resistance comes from the scientific publishing companies, who would like to maintain their full rights over published materials for as long a period as possible, so that they can maximize the return on their investment into these publications, which includes the peer-review and editing infrastructures. Those opposed to this measure, such as Professional and Scholarly Publishing Division of the Association of American Publishers , and a coalition of academic and society publishers from within the DC Principles Coalition of scientific publishers, wrote a letter to members expressing strong concern with the language in the appropriations bill .

My sense is that scientists, who are constantly on top of the latest developments, will not wait 12 months to see the results of ongoing research, they will continue to buy the journals as they always have. It is highly unlikely that this development will negatively affect the current system of peer review and quality editing.

There are several benefits to having this information openly available 12 months after publication as highlighted in an open letter to Congress by a group of 26 Nobel Prize winners. Greater availability will also allow scientists in developing countries, scientists in other disciplines, industry researchers and interested lay people, most of whom could not ordinarily afford to subscribe to these journals, free access to the information. This is a very large constituency that should never be overlooked when considering the opportunity to advance medical science.

The Journal of the National Cancer Institute has just published "The U.S. Food and Drug Administration's Evidence-Based Review for Qualified Health Claims: Tomatoes, Lycopene, and Cancer" . FDA's Claudine J. Kavanaugh and colleagues found no credible evidence that lycopene, either in food or in a dietary supplement, was associated with reduced risk of cancer.

The articled prompted commentary from Sandra Szwarc at Junkfoodscience:

We've often reviewed the inferior evidence surrounding fruits and vegetables and their abilities to prevent major chronic diseases, including the 2004 comprehensive examination of the scientific literature done for the Produce for Better Health Foundation campaign, 5-A-Day, under the National Cancer Institute. That year, a study led by Walter Willet, M.D., DrPH, professor of epidemiology and nutrition at Harvard School of Public Health in Boston, MA, was also published. It had followed 71,910 women and 37,725 men for 15 years and found no relationship between fruits and vegetables and cancer, or any statistically significant associations with major chronic disease or cardiovascular disease.

But, time and again, the media makes little more than a whisper when studies are published questioning claims surrounding the "emerging" science of functional foods and supplements. For instance, how many heard about the May study in the journal Cancer Epidemiology, Biomarkers & Prevention on lycopene and prostate cancer? Researchers based at the National Cancer Institute and Fred Hutchinson Cancer Research Center had examined 692 cases of prostate cancer diagnosed among 28,000 men enrolled in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, an ongoing, randomized National Cancer Institute trial to evaluate cancer screening methods and to investigate early markers of cancer. They found no association between serum lycopene and total prostate cancers or aggressive prostate cancers.

No doubt it was a coincidence, but the recently-approved House ag appropriations bill contained language (Section 746) prohibiting FDA from authorizing qualified health claims for conventional foods. Including tomatoes.

USA Today turned 25 this week and ran a series of articles about changes in the world in the past quarter century. In their list of "25 Top Medical Events " was no mention of salt at all, not even recognition that during that time frame there's been a 50% increase in the number of infants born protected against the scourge of mental retardation. This achievement is due almost entirely to the massively successful global campaign to iodize salt.

One of the 25 was of some interest, however. Ranked 16th was the odyssey of hormone replacment therapy. USA Today says:

Hormones begone

Hormone therapy was once thought to be a fountain of youth for postmenopausal women, but a landmark study in 2002 found that estrogen plus progestin raises the risk of breast cancer, heart attacks, stroke and blood clots. Women stopped taking the hormones in droves, and today, they're prescribed only for relief of hot flashes and other symptoms.

As tragic as is the HRT story, it's important lesson is to teach us to demand high quality science on health outcomes before we launch a major population health recommendation. Before the government began to advise all Americans to reduce dietary salt, it should have looked at the health outcomes studied. Had it done so, we could have avoided the expensive delays -- and potential risks -- of having the "salt hypothesis" blow up in its face as HRT already has. Too bad.

The pernicious impact of advocates' use of junk science is to undermine public confidence in all science, argues an articulate letter in yesterday's Wall Street Journal. William Heller of Greenwood, Indiana, quotes an earlier WSJ op ed piece by Richard Grinker on claims that vaccinations cause autism. Grinker opines: "The antivaccine movement may be evidence that public confidence in science is eroding. . . ." Heller continues:

Proponents of the view that vaccines cause autism provide anecdotal trial "evidence" while the other side cites scientific study after scientific study that shows no such connection. A Gresham's Law effect of junk science and opinion debasing real science seems in evidence. The same factors are at work in the climate change debate. There are reams of scientific data that debunk the carbon dioxide theory of global warming, but the only data that seem to get media play is the junk science of the global warming alarmists.

Useful perspective. Bad science driving out good.

Two terms don't always mean what we believe they do: "research " and "evidence-based." Take the research just published in the Journal of Epidemiology Community Health entitled: "Evidence-based Public Health Policy and Practice: Could targeted food taxes improve health?"

That's the question posted by Junkfoodscience author Sandy Szwarc who attributes the authors' "yes" answer to creation of a mathematical computer model which, necessarily, includes countless "arbitrary decisions and assumptions" and, unnecessarily, introduces a false sense of certainty about relationships where none may, in fact, exist. The phrase springs to mind: figures don't lie, but liars can figure. In the case of this study, she observes:

For their model, the authors in this study attempted to predict the number of lives saved by assuming that lowering salt and saturated fats in the diet (assuming low-fat diets work by lowering blood cholesterol levels) would reduce deaths from cardiovascular disease and strokes. For example, they estimated that every 3 gram/day reduction in salt intake would lower incidence of heart disease by 9-10% and strokes by 12-14%. Their estimated health benefits for low-fat diets were based on the assumption that every 1 mg/dl reduction in low-density lipoprotein ("bad cholesterol") would reduce heart disease by 1%.

Without the need to go any further, it'a already clear these assumptions contradict and exceed the actual clinical evidence on the ability of "heart healthy" low-salt diets and low-fat diets to prevent deaths from cardiovascular disease and strokes. In fact, as we've examined , even the latest Cochrane review of 39 clinical trials conducted in multiple countries over the course of three decades on the ability of "heart healthy" dietary interventions (reducing saturated fats and salt) and lifestyle interventions found: "Contrary to expectations, these lifestyle changes had little or no impact on the risk of heart attack or death..."

You'll want to read the whole blog, but, in summary, she notes the various assumptions about several variables including food consumption, then returns to the salt example:

Most disturbingly absent from their computer model was consideration of any potential harmful effects of compelling "heart healthy" diets. (emphasis in original)

Salt reduction, for example, doesn't appear entirely benign, according to growing medical research. The European Society of Cardiology Guidelines for the Management of Arterial Hypertension, for instance, reported recent research showing low-salt diets can have negative effects: activating the rennin (sic)-angiotensin system and the sympathetic nervous system, increasing insulin resistance and hypodehydration (especially with the elderly). This, they concluded, could lead to increased risks for cardiovascular disease. Similarly, people who might benefit from salt in their diets wouldn't be helped, but weren't included in their computer model, either. Salt also improves the flavor of many nutritious foods, helping to prevent nutritional deficiencies especially among vulnerable populations, such as children and elderly.

We've blogged before ( 1 2 3 4 5 6 7 8 ) on the disturbing gap between true "evidence-based" health policy-making as defined by the Cochrane Collaboration and the damaging abuse of the term by authors or editors trying to fabricate news from the end product of computer models whose results reflect the programmer's biases more than the data of the study itself. We've seen this abuse in the Intersalt Study, the DASH-Sodium Study and in an alarming number of national dietary guidelines which seize the mantle of being "evidence-based" while ignoring the discipline inherent in proper application of that term.

A June 26 story on "Sodium Shakeout: Salt and Health " by Kimberly J. Decker in Food Product Design discussed the salt and health issue, referring to a resolution approved a year ago by the American Medical Association.

"Sodium has been in discussion for many years, and the problem is that it's a very controversial discussion," agrees Markus Eckert, technical vice president, flavors, Mastertaste, Teterboro, NJ. "There have been studies for many years already showing that it can lead to cardiovascular health issues." However, "there have been other published studies that followed subjects on low-sodium diets for several years and found that, actually, the risk for cardiovascular health issues is higher here than for regular diets."

In one such study, published in 2006 in the online version of the American Journal of Medicine (119(3): 275.e7-275.e14), researchers at the Albert Einstein College of Medicine of Yeshiva University, Bronx, NY, studied survey data from the second National Health and Nutrition Examination Survey (NHANES II) and found that, among 7,154 survey participants, those who consumed less than 2,300 mg of sodium per day were actually 37% more likely to have died from CVD. The researchers acknowledged it wasn't a clinical trial, nor did they propose that the results dictate sodium nutrition policy. They did point out that their findings cast some doubt on across-the-board advice to lower sodium consumption.

Decker summarized for her food industry subscribers:

So, following the AMA's 2006 sodium statement, the Institute of Food Technologists, Chicago, offered a voice of reason by noting that we do not now consume substantially more (or, alas, substantially less) salt than we have over the past quarter century. Other food industry organizations, such as the Grocery Manufacturers/Food Products Association, Washington, D.C., and the Salt Institute, Alexandria, VA, issued rejoinders of their own, with the latter's president, Richard L. Hanneman, going so far as to call the AMA's recommendations "scientifically unjustified and a waste of time and money." Ouch.

Ouch, indeed. Thanks to IFT for its efforts to sort out the controversy. Actually, sodium intakes have been generally unchanged not just for the past quarter century, but for the hundred or so years that we've been able to measure intakes with some accuracy. We need a "truth squad" to prevent anti-salt zealots from trying to distract the public health policy discussion from its proper focus on whether lowering dietary sodium would provide any health benefit to the population. There's no evidence on the table that it would, just computer-generated model projections based on flawed assumptions drawn from intermediate variables. Yes, ouch. That hurts all of us.