This week's (January 5th) National Journal cover story, "Data Bomb ," set off reverberations in my mind. The article recounts the release of grossly-misleading data immediately prior to the 2006 Congressional elections that exaggerated tenfold the number of deaths in Iraq; the study fed popular disillusionment with U.S. engagement in Iraq and contributed to capture of both houses of Congress in the elections several weeks later. The study was produced by the Johns Hopkins School of Public Health. The researchers, it turned out, were anti-war activists, though they claimed their errors didn't reflect their political views.

Bad memories. Six years earlier, researchers from the Johns Hopkins School of Public Health published misleading statistics in the DASH-Sodium trial - and refused to release further statistical calculations that would likely have unmasked their charade. Again, the Johns Hopkins researcher was an activist, a member of the lobby group World Action on Salt and Health (WASH). Again, the incompletely-reported and misleading research was instrumental in an important policy decision - to establish a Daily Recommended Intake level for sodium and a Dietary Guideline supporting reduced salt intake. Even worse, this time, despite the incontrovertible conflict represented both by his WASH lobby group membership and heavy involvement in the research itself, the researcher was installed as chair of the DRI project committee and the Dietary Guidelines subcommittee where he blocked consideration of the full data from the study.

Putting the National Journal aside, I plunged into an editorial in the journal of another advocacy organization, reading an editorial entitled "Eat your fruits and vegetables, but hold the salt ." The editorial writer acknowledged his funding support from the same federal agency that had funded DASH-Sodium for a study he has underway exploring the effects of the "DASH Diet" on individuals with isolated systolic hypertension. I expected little comfort, but hoped that, perhaps, the editorial would confess the over-interpretation of the results (as had an earlier article in 2005 where a DASH-Sodium investigator revealed that in six of the eight subgroups - subgroups that represented a large majority of the public - the reported findings were statistically insignificant even though the authors described them as valid.

All these discussions of DASH-Sodium have attempted to portray the DASH Diet as salt-reduced and demonstrating benefit from lower sodium intakes. This has been frustrating to those of us - including the salt industry - who have strongly endorsed the DASH Diet because it does not reduce salt and the blood pressure effect is produced by the fruits, vegetables and dairy products - not the salt. But the federally-funded PR juggernaut rolls on.

In the editorial, Dr. Paul Conlin of Harvard University's Brigham and Women's Hospital, indeed, endorsed salt reduction and noted a study of blood pressure in chimpanzees supported increased intakes of fruits and vegetables, two of the triumvirate of "good" foods in the DASH Diet. But note the caveats Conlin incorporates into his conclusions:

Elliott et all have provided new information, albeit in chimpanzees, showing that long-term salt restriction in the setting of a diet rich in fruits and vegetables produces sustained reductions in blood pressure. These data are relevant to humans but should be approached with caution and respect for the sample size, the lesser effects when adjusted for key factors, and the inability to add knowledge on the health and/or cardiovascular benefits of salt restriction beyond blood pressure lowering. Major next steps include …confirming that eating such a dietary pattern provides unquestioned health benefits. (emphasis added)

Last year, other WASH advocates took an important step forward in conceding the validity of health outcomes measures instead of controversial statistical extrapolations based solely on blood pressure (ignoring other metabolic changes that occur in salt reduction). As one observer sagely observed, their embrace of health outcomes in a Finnish study "backfired" when the data showed that improvements in Finns' cardiovascular health lagged their European and North American peers. Still, anti-salt advocates have claimed it would be "immoral" to ask study subjects to consume "normal" levels of salt since they "know" it is unhealthy. The Conlin editorial cedes the point, admitting that such a study is not only feasible and moral, but needed to "add knowledge on the health and/or cardiovascular benefits of salt restriction beyond blood pressure lowering" and confirm "that eating such a dietary pattern provides unquestioned health benefits." Those benefits - projected to be improved cardiovascular outcomes like less heart attacks and cardiovascular disease - have not been confirmed in the several studies that have examined them.

The Salt Institute has called for a controlled trial of whether there is any health benefit from reducing dietary sodium. Now, even those who support salt reduction for blood pressure lowering are beginning to see that this isn't the right question and are embracing our view of the need for a new study.

Perhaps those bad memories of incomplete data reporting by Johns Hopkins' researchers can, indeed, be relegated to history and not the basis of public policy.