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!”

"Healthy Choice" marketer ConAgra Foods announced publication today of a new study in the American Journal of Health Promotion that shows how unbalanced has been the debate on salt reduction.

Using data from the National Center for Health Statistics, National Academy of Sciences and the Bureau of Labor Statistics, Timothy Dall, et. al. of The Lewin Group documented that reducing calories by less than 5% would produce economic benefits of about $100 billion. Adopting the most anti-salt interpretation of the medical evidence (i.e. Ignoring evidence that sodium reduction would produce no net health benefit), the authors found that reducing salt by more than double that amount (>12%) would yield benefits of $5 billion. Dall declared: "One of the most revealing finding was just how big an impact of 100 calories less per day can have compared to the more modest benefit of sodium reductions." (And, he failed to note that the sodium reduction was two-and-a-half times more severe than the curtailed calories).

Put another way, using the Dall analysis, reducing calories by less than half the magnitude being advocated for salt reduction would put national economic savings at $243 billion a year.

ConAgra's diet foods reduce both calories and sodium, but as Dall concedes: "Although many adults could benefit from cutting back on both sodium and calories, the return on investment for long-term health is clearly greater for calories."

Prominent food scientists, including a member of the federal Dietary Guidelines Advisory Commmittee (DGAC), reported to the IFT last week on the process underway to revise the Guidelines. Dr. Fergus Clydedale of UMass, the lone food scientist on the 2005 DGAC, and Dr. Roger Clemens of USC, the token food scientist on the 2010 DGAC, painted a bleak picture of the use of science and understanding of food technology. Clemens noted he has been relegated to food safety issues and, implied, kept at a distance from nutrition issues.

Clydesdale and Clemens addressed the IFT session on "The evolution of dietary guidance: Lessons learned and new frontiers."

Covering the session, BakingBusiness.com quoted Clydesdale saying: "A food scientist should not be regulated to just food safety on the Dietary Guidelines, and there should be more than one." The report continued:

Dr. Clydesdale said technology has helped society in many areas. He said he doubted people would like to go back to using typewriters or that teachers would like to go back to using chalkboards.

"We’re not going to go back to 78 r.p.m.s (records)," he said.

Dr. Clydesdale said he wondered why people do not embrace technology in the food system. He said he wondered why people wanted to cook the way people did 100 years ago.

The Dietary Guidelines could use input on how food science technology may help meet the Guidelines goals, Dr. Clydesdale said.

We'd prefer an evidence-based approach rather than the DGAC's current expert opinion process. Apparently so do the experts.

Government advisers in the UK are making menu recommendations in order to cut out what they deem to be “high carbon” foods. The Committee on Climate Change has evaluated the methane produced by burping sheep and cows and the carbon footprint of many foods and has pronounced that citizens must change their eating habits.

“Changing our lifestyles, including our diets, is going to be one of the crucial elements in cutting carbon emissions,” said David Kennedy, chief executive of the Committee on Climate Change.

The Carbon Trust, a government-funded firm, is working with food and drink companies to determine the carbon footprints of products.

I am relieved to note that chocolate has a smaller footprint than chicken. But common sense and time spent on farms leads me to question their assertion that lambs burp more than cows. Yes, believe it or not, government bureaucrats are spending money to determine whether sheep burp more than cows.

If about now you are wondering if this is satire or serious, a Saturday Night Live skit or truly a story from the Times, you may wish to read this absurdity for yourself .

It appears there is no end in sight to the quest for government control over what we eat.

Packaged and processed foods sold in the United States started carrying standardized nutrition labels in 1994 when the Nutrition Labeling and Education Act (NLEA) took effect. The major goal was to increase access to nutrition information and improve consumers' ability to make healthful food choices. Since NLEA took effect, technological change has introduced new sources of nutrition information and the consumption of food away from home has continued to increase. But have these measures been effective?

A new report examines how the consumers' use of nutrition labels have changed over the decade by looking at the trend in use of various nutrition label components and demographic groups. The U.S. experience may help policymakers in other countries who are considering mandatory nutrition labeling to achieve public health goals.

The study reveals that in the decade from 1996 to 2006, consumer use of nutrition labels declined. It declined 3% for the Nutrition Facts panel, 11% for the ingredient list, and 10% for the panel's information about calories, fat, cholesterol, and sodium. In fact, only fiber and sugar did not decline over the 10-year period. Sugar held steady while fiber increased by 2% - a telling result.

The decrease in use of the nutrition label was greatest for individuals in the 20-29 year-old bracket.

If you are wondering how the government possibly misunderstood the information desires of consumers, you need look no further that the new UK Food Standards Agency (FSA) report "Consumer Priorities for Sustainable Development "

Not satisfied with spontaneous answers to questions about what is important to consumers when buying food, the FSA researchers prompted them with specific responses. They then combined both the spontaneous and prompted answer for the final result. For example, only 7% of UK consumers were concerned with salt, but after prompting, an additional 27% said they were concerned. This resulted in a grand total of 34%. Talk about fudging!

Is it any wonder we always fail to recognize the consumers' genuine desires?

A new analysis released today by the U.S. Department of Agriculture reported fewer Americans using federally-mandated nutrition information, especially sodium. The 2005-2006 NHANES study of 9,416 representative consumers found about 7 in 10 use the Nutrition Facts label, about the same as a decade ago. For sodium, only 66% consulted the label in 1995-1996 and that number declined 10% to 60% in 2005-2006. Among nutrients, only cholesterol fell more, 11%. Among all the listed nutrients, fiber was the only one where consumers registered increased concern as reflected in label use.

The label was mandated in 1994; sodium labeling had been in effect a decade before that.

Over the past ten years, 5% more reported "never" using the label. For salt/sodium, the increase in "never use" increased by 10 points from 12% to 22%. A decade earlier, 36% "always/often" used the sodium label; that eroded to 34%.

It would take another study to tell us why consumers are shunning nutrition information, but the pattern is consistent. Eleven percent fewer are using label health claims (37% "never") and even the ingredient list (32% "never"). With the multiplicity of advisories and the fact that scientists dispute the health consequences of cholesterol and sodium (and other nutrients), consumers are overwhelmed and doubtful about the advice they're being given. That's why the new Dietary Guidelines should adopt an "evidence-based medicine" approach in lieu of the expert panel approach of past reviews.

The UK Food Standards Agency just commissioned a research contract to study the impact that front-of-pack nutritional labeling has on people's food choices. The goal of this project is to gain an insight into the way in which consumers approach purchasing decisions. Of course, the ultimate goal is to assist consumers in making healthier choices.

The problem is that consumers will be considering labels on individual foods and, as a result, evaluating the merits of products outside the context of the whole diet. The project will look at shoppers' understanding of the main types of front-of-pack nutrition labels used in the UK (traffic lights, Guideline Daily Amounts, and traffic light color-coded GDAs) and how they use them. What the project will not even attempt to determine is how consumers incorporate the front-of-pack nutritional labeling information into the context of their whole diet on a daily basis - which is, of course, the most important change because that is how we derive our nutrition on a daily basis.

The program has the unfortunate potential to focus on the means of communicating information and bits of data while ignoring the greater importance of perspective and context. In other words it has the potential of ignoring the forest by focusing on individual trees.

As an example, a consumer could come across a mayonnaise, or a salad dressing preparation which, by itself, would require a red light on the label. If, however, that dressing encourages the consumer to eat a serving or two of healthy cruciferous vegetables, what decision should the consumer make? Avoid the dressing and the vegetables? Certainly not!

But that is a conclusion one might make if the dressing is taken out of the context of the whole diet. An unintended consequence resulting from a focus on one tree rather than the forest.

It will be interesting to see the results of this research, which will be hopefully available by the end of 2008.