We have heard a lot in the media lately about salt and health. In fact, there has been an unceasing parade of talking heads and cranks that have emerged from the woodwork to repeat the urban legends on blood pressure and cardiovascular deaths that will result from our continued consumption of salt. The fact that cardiovascular disease death rates have plummeted in the last 30 years seems to be lost on these soothsayers. Another fact they conveniently ignore is that the Mediterranean countries that have such excellent cardiovascular figures eat far more salt than we do here in America and at that countries, which consume the highest levels of salt, such as Japan and Switzerland, also have the longest life expectancies. Oh well, how can actual evidence ever compete with a good scare story?

We're beginning to hear about the importance of reducing salt in the diets of young children. Unfortunately, much of what we hear does not coincide with what is being demonstrated in the medical literature.

In particular I refer to a review paper very recently published in Pediatrics, the Journal of the American Academy of Pediatrics, in November 2009. The article is titled Hyponatremia in Preterm Neonates - Not a Benign Condition . In this paper, authors Michael Moritz and Juan Carlos Ayus state that hyponatremia, or low sodium levels in the neonates pose a significant risk for future childhood development. These risks include reduced neuromotor abilities from infancy through later years as well as impaired growth and mental development. Hyponatremia has also been found to be a significant factor for hearing loss, cerebral palsy, intracranial hemorrhage and increased mortality - all because of low sodium levels in the blood resulting from decreased salt intakes.

Furthermore, the authors quoted research carried out in Israel demonstrating that low sodium levels lead to hyponatremic neonates weighing 30% more than their peers maintained at normal sodium levels and that hyponatremia in infants was predictive of increased salt appetite in adolescence and later years. So, once again, contrary to the urban legend of salt consumption leading to obesity, the evidence is exactly the opposite – it is low salt levels in neonates that lead to obesity.

The authors then went on to stress that the emerging literature also suggests that hyponatremia in adults can have very deleterious effects and may be an independent predictor of mortality in hospital patients, those with community acquired pneumonia, with congestive heart failure and liver disease. Chronic low salt levels produces neurologic impairment that affects both balance and attention deficit conditions in the elderly - effect similar to alcohol ingestion. These data were able to explain why low-salt levels are such an important cause of falls and bone fractures in the elderly. This is clinical evidence, not urban legend.

Nutrition and nutrition-related policy initiatives are not things to be trifled with and it's certainly not anything to be left to in competent activists and minimally-trained physicians parading around as nutritionist-wannabes. Neither should they be matters of gratuitous opinion. Nutrition is a key to health and any policies regarding nutrition have to be based upon strong, clinical evidence.

The USDA's Supplemental Program for Women, Infants and Children or WIC program provides food and nutritional information to low-income people who are at nutritional risk - yet, to qualify for the program, WIC foods must contain little or no added salt . Just look at the regulatory requirements for WIC-eligible foods. In particular, there is great concern over products such as vegetables and instant preparations containing vegetables that are required to be made without salt. Not only does this increase the chances for hyponatremia, but because children are so sensitive to the natural bitterness in vegetables, it is unlikely that they will eat them without the addition of salt, thereby robbing of the natural goodness these products contain.

Here again, falling victim to anti-salt propaganda, government bureaucrats in charge of this program have backed away from their responsibilities and blindly gone along with the urban legends and myth-information regarding salt, rather than heeding the published evidence in the medical literature.

As a result, the low income women, infants and children, who are most at nutritional risk have had these risks compounded by the additional risks related to low salt intakes and hyponatremia - risks leading to poor neuromotor development, impaired growth and mental development, hearing loss, cerebral palsy, brain hemorrhage and increased mortality – now how's that for government assistance?

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