To the right is the famed $55 million gold, ebony and enamel salt cellar created by the noted Renaissance master Benvenuto Cellini. In May 2003, a thief broke into the Kunsthistorisches Museum in Vienna, Austria and made off with this masterpiece of salt art. Last Tuesday, the FBI named the stolen Cellini salt cellar 5th among the top 10 art crimes in history.

For more on salt history see the Salt Institute website .

Last month, the Journal of the American Medical Association published an issue that featured the revelation that gastric bypass (bariatric or stomach stapling) surgery raises the risk of early death "considerably higher than previously suggested." Those who had their stomachs stapled were promised lower risk of health problems and longer lives because their obesity equated to more adverse health outcomes. Public health campaigns have bombarded us all with the strong message that excess weight is unhealthy.

Excess weight is unhealthy. So why didn't this dramatic surgery that consistently reduces obesity work out as planned?

The research addresses the broader question: does everyone who loses weight lower their risks of the adverse outcomes associated with obesity? Or, put another way: does it matter how someone reduces weight or just that they reduce excess weight?

But that's not the question I want to answer. You'll have to read JAMA for that answer.

What I wanted to point out is the strong parallel here with another recommended intervention which, its advocates promise, will reduce health risks, improve health and extend lives. That intervention isn't bariatric surgery; it's salt reduction.

Consumers are bombarded with public heath messages telling them that cutting back salt will save their lives.

Is that true or is it more like stomach stapling? Consider the parallels.

A gastric bypass will result in the patient eating less and losing weight. Salt reduction, for a significant minority of the population, will reduce blood pressure. Obesity is strongly correlated with adverse health problems and increased mortality. Elevated blood pressure, likewise, is correlated with increased risk of heart attacks and strokes.

The simplistic answers of bariatric surgery or salt reduction rest on the assumption that it makes no difference how a person loses weight or lowers high blood pressure - Just do it! The JAMA papers suggest that this isn't true for obesity. A dozen papers examining salt intakes and comparing them to health outcomes reach the same conclusion: it matters a great deal how blood pressure is lowered. Salt restricted diets do not reduce adverse health outcomes; in fact, some of the studies show elevated risks, just as the JAMA papers find for stomach stapling. Read more about salt and health on the Salt Institute website .

"If a car slips on ice, intelligent (roadway) systems could not only inform other drivers but send a notice through the receivers alongside the highways to road crews that salt or sand is needed. Such systems could even be programmed to stop cars before an accident occurs - without driver involvement." So says GreatestJournal! in a blog post today.

That's true and there's other good news as well.

There are tremendous highway safety benefits inherent in new Intelligent Transportation Systems. Road Weather Information Systems today send road maintenance professionals data on roadway surface conditions from embedded sensors so that salt trucks can deliver their lifesaving service when snow and ice threaten safe driving conditions. More information can be found on the Salt Institute's website .

Today's Tech Central Station has a great article by author John Luik entitled "A Grain of Salt " that summarizes the ongoing salt and health controversy admirably. Luik points out: "That's why across the board salt reductions such as the MRC and CSPI call for make no scientific sense. Instead, the science, taken in its entirety, suggests that population-wide dietary salt reductions do not improve health outcomes, such as the number of strokes, heart attacks or the risk of premature mortality. In fact for some groups they actually increase certain risks. For example, analysis of the MRFIT (Multiple Risk Factor Intervention Trial), which followed the lives and deaths of 12,866 American males for an average of 12 years, found there were no health benefits from low-sodium diets." It's worth a read.

Unfortunately, today's news also includes the assertion that cutting back salt would cut health care costs in Britain by 6 billion pounds, based on assumed reduced incidence of cardiovascular events. In an online response, I pointed out that "Anyone can build a model and project an outcome (6bn pounds a year), but the model depends on the assumptions of its creators and NHS' model reflects is the triumph of hope over the realities of the scientific data." I further observed:

"Reducing dietary salt is promoted to reduce blood pressure on the assumption that however blood pressure is reduced will lower the risk profile for heart attacks and cardiovascular deaths. That's where the "savings" NHS projects originate. But there are no data confirming this hope. In fact, only a dozen studies have examined the health outcomes of people on lower sodium diets and they show, if anything, that there is a HIGHER RISK of heart attacks. How can that be? When salt is reduced, the body compensates with other metabolic changes: insulin resistance is increased, sympathetic nervous system activity increases and, most of all, the body secretes vastly more renin, a hormone produced in the kidney that has been shown by the president of the International Society of Hypertension to cause four times more heart attacks."

Many artists use salt as their expressive medium. Take, for example, the "Salt Queen," Italian artist (and Long Island dweller) Bettina Werner , Seattle sculptress Pam Gazale , or Jörg Lenzlinger from Switzerland. But this new seasonal artwork is au natural, after a fashion.

Twice in the past two weeks, the Food and Drug Administration has shown why it may have the second toughest and important job in America (after the job of parenting, of course). On November 2, FDA announced its ruling that "there is no credible evidence to support qualified health claims about calcium and breast cancer or calcium and prostate cancer . " Then this week, on November 9, the agency ruled that "there is very limited credible evidence for qualified health claims for tomatoes and/or tomato sauce, and prostate cancer ." In short, FDA is denying qualified health claims, not describing them as its rules seemed to promise.

Pity the FDA! On the one hand, the public expects approval of life-saving medicines double-quick and food labels that inform but don't mislead consumers. On the other, the courts have ruled against FDA's efforts to prevent food manufacturers from making certain claims about the healthfulness of their products -- "commercial free speech."

FDA sought a way to navigate between the Scylla of unrestrained commercial hype and the Charybdis of suffocating hyper-regulation. After the courts invalidated as too restrictive its "health claims" rules for foods with nutrients where "significant scientific agreement" supports a relationship to a "disease or condition," FDA came up with a scheme of "qualified health claims" that manufacturers could make based on FDA's determination about the amount of evidence supporting the claim. So, worst case for a manufacturer, a food would have the right to claim a diet/disease relationship and also be required to carry an FDA warning that there is no evidence to support the claim.

With these two decisions, however, FDA seems to have lost its nerve and reverted to denying claims. Rather than require ketchup manufacturers who want to say their product prevents prostate cancer to affix a warning that the scientific evidence for such a claim is very weak, or make sellers of dairy products warn consumers that medical scholars dispute their claims that their high-calcium product cuts the risk of breast cancer or prostate cancer, FDA is denying the claims entirely (or, in the case of tomato products, largely). Preserving the integrity of health claims is virtually a no-win situation.

This blog is salt-related. How does this tie in?

FDA has yet to consider or approve a health claim that low-salt foods reduce the risk of heart attacks and strokes, though lots of ink is spilled alleging that case. Such a claim about salt and heart attacks, according to my review of the evidence , would have to be judged entirely lacking in scientific support. What is clearly justified in science is the conclusion that "salt is an essential nutrient." Scientific, yes, but politically-incorrect.

What is it they say about great minds? This morning's Washington Post addresses a topic close to my post last evening -- measuring quantities of table salt. In this case, Robert L. Wolke, professor emeritus of chemistry at the University of Pittsburgh, discusses how to adjust recipe amounts of salt when using the two types of kosher salt available (hint: use 1.5 times as much Morton Kosher Salt and twice as much Diamond Crystal Kosher Salt). And, says Wolke, don't bother using sea salt in cooking; if you use it, add it at the table.

You've all seen contests where people are asked to guess how many jelly beans are in a glass jar. Amaze your friends with this alternative: Pour a 26 oz. "round can" of salt into a jar and ask your friends to guess how many salt crystals are in the jar.

Ever wonder how much a single crystal of table salt weighs? The Salt Institute hadn't given that question a thought until this just-received request arrived. Thanks to Lead Research Chemist Lorrie Ann Fisher of Morton Salt, the world now knows (but your friends may not) that the average weight of a single crystal of table salt is 0.16 milligrams. Thus, a typical 26 oz. "round can" of table salt would contain over four and a half million salt crystals (4,606,800 give or take). Now you know!

Bargain? What other crystals can you buy at 10 million for a buck?

Put another way, that means the FDA's "Daily Reference Value" (FDA food labels do NOT provide a "daily recommended value") for sodium is more than 37,000 crystals of table salt.

The nutrition nannies at the gratuitously-self-named Center for Science in the Public Interest are at it again. Denied in court, they today petitioned the FDA to declare that salt should forfeit its "Generally Recognized As Safe" status and that food manufacturers should use less of it in the foods they make.

The petition doesn't pass the sniff test. It badly needed a fact-checker. I opened the petition randomly and didnt' have to read beyond the first paragraph to find an error. There were plenty more.

But worse, CSPI persists in trying to foist off extrapolations and projections in the place of data. They allege salt is killing 150,000 people a year (nearly four times the number that die in traffic crashes and 75 times more than the number of Americans killed in Iraq since Sadaam's fall). The huge number is a statistical construction based on blood pressure only and ignores the fact that lowering dietary salt has other impacts -- No, not just that the food tastes bad. The other impacts of lowering dietary salt are that it triggers the production of the kidney hormone renin, it activates the sympathetic nervous system and it increases insulin resistance, a key risk factor for diabetes.

What we need to look at is the NET EFFECT of lowering dietary sodium. Will it make people healthier or not? If so, then we should address the very real problems of implementing such a change with food manufacturers and try to convince the public to forego their salt. But in the absence of evidence of harm, why expend all these resources? In fact, the evidence shows no benefit and some studies even show people on low-sodium diets suffer more heart attacks and die more often -- not a figure you'll find in the CSPI petition.

See the Salt Institute's compilation of the medical studies . For reference: the CSPI petition.

Today's National Journal Blogroll features a story about how manufacturers are initiating blogs and mentioning this blog.

With extraordinary federal spending requirements for such emergencies as the several devastating hurricanes and the war on terror, Congressional conservatives are trying to constrain discretionary federal spending. This includes rolling back spending authority under the federal highway program alleging "pork" excesses.

Congress brought the "pork barrel" charge on itself by directing funding for a massive number of earmarked projects in key Congressional districts. And the SAFETEA-LU law is massive, more than $286 billion over five years - lots of room for hiding spending. As former Illinois Senator Everett Dirksen used to say, "A billion here, a billion there, and pretty soon you're talking about real money."

So balanced budget advocates are lining up with anti-highway environmentalists who complain that highway builders are trying to "pave over America."

While waste is certain (and certain in virtually all federal spending programs), we should be keeping a few facts in mind. We've added relatively few lane-miles of highways over the past quarter century while we've increased highway usage several orders of magnitude. And, while $286 billion is an enormous amount of money to invest in highways, the Federal Highway Administration says it would take yet another $100 billion -- $374 billion or so over five years - just to maintain the operations of our highways at the same level of safety and congestion. Even spending $286 billion, they calculate, will result in increased congestion because of growing demands of highway users. Most motorists already think congestion is a problem and don't want to see it grow worse.

Add in another fact: getting money to build highways is a political winner. Newspaper photos at groundbreakings and ribbon-cuttings and new roads has been a winner since before the days of George Washington. But that doesn't mean a construction priority is the best way to invest our highway dollars.

The key point in all this is that we are focused on the wrong problem. Sure, we may need more highways, but we need to be spending a lot more time and attention - and probably dollars - on highway operations, not just construction and maintenance.

Credit President Bill Clinton's DOT and particularly Gloria Jeff, now directing the MI DOT, for orienting the FHWA towards operations. The federal momentum has been maintained by President Bush's FHWA Office of Operations (http://ops.fhwa.dot.gov ). This is the right idea. Let's measure how well we are doing in moving people and goods safely and reliably from Point A to Point B and if we've exhausted our technologies in improving traffic flow, then determine what additional capacity we need to be constructing.

These roads are being paid for by highway user fees (the "'"gas tax"), but highway users are more interested in service levels than in pouring concrete.

Yet, in one state DOT after another, it is far easier to get the Legislature to lay out funding to match federal dollars to build new or wider roads and much harder to get authorizations for technologies and programs - like using salt to keep winter roadways safe and passable - that ensure motorists are getting the highest possible service from the roads we've already built.

It's time we reversed these priorities and implemented an "operations priority."

In a play on "give 'em an inch and they'll take a mile," this week's media brought news that the level of the Great Salt Lake in Utah is four and a half feet below its historic average. At 4,195.5 feet elevation, the lake covers 1,000 square miles. At its normal level (4,200') the lake is 70% larger, 1,700 square miles. Doing the math, 54" of elevation increases the lake by 700 square miles, so in this case an inch equals about 13 (square) miles.

Salt crystals are grown at the point saline water reaches saturation, about 26% salt. A smaller lake, of course, contains the same amount of salt, so with lower lake levels, the salt concentration has increased to the advantage of salt production. But it was only a decade ago that rising levels of the Great Salt Lake threatened rail and highway arteries, flooded saltworks and prompted the state to install two massive pumps to protect against the rising lake levels.

Mother Nature has her rhythms.

Today's Washington Post carries a reminder that the DASH Diet, high in fruits, vegetables and dairy products, provides vital potassium to blunt salt-sensitive hypertension. True, as far as it goes.

The DASH Diet, released in 1997, promotes a food consumption pattern, although it does clearly make the most striking changes in overcoming mineral deficiencies. Those under-consumed minerals include not only potassium, but also calcium and magnesium. There is strong medical consensus that these essential nutrients are under-consumed in today's diet.

The focus here is on blood pressure. When the DASH Diet was announced, the Salt Institute endorsed it strongly, since it focuses properly on enhanced mineral intake; it does not reduce dietary sodium/salt. For example, hypertensive subjects in the DASH Study population reduced their systolic blood pressure (SBP, the top number) by an impressive 11.4 mmHg. In a later study that also featured cutting salt by 60% (it was, after all, only a 30-day study), hypertensive patients on the DASH Diet with this drastically-reduced salt intake reduced their SBP by 11.5 mmHg. Salt restriction in 6 of the 8 subgroups reported (important because the sample represented particularly a salt-sensitive universe) no significant differences of blood pressure even when salt was reduced by more than half for those on the DASH Diet.

We should all keep in mind that blood pressure is only one of several relevant health impacts. The key is to understand the net health outcome of any dietary change. As outlined on the Salt Institute website ( http://www.saltinstitute.org/28.html ), the limited studies on health outcomes of salt-reduced diets show no health benefit because other systems in the body are adversely affected by salt reduction (e.g. insulin resistance, plasma renin activity).

So, eat those fruits and veggies -- and dairy products (dairy contributed more than half the blood pressure-lowering effect) -- but don't get too hung up on what our prehistoric ancestors ate. After all, they didn't live long enough to worry about blood pressure.

A new FDA report says consumers are confused about the "health claims" made on food labels. FDA's been trying to balance "free speech" for food manufacturers against the problems of misleading advertising. Health claims used to be based on "significant scientific agreement." The courts have held this unfairly restricts free speech. For salt, the only approved health claim is for "sodium and hypertension." FDA's proposal of "qualified health claims" is designed to meet this judicial mandate, but this new report shows FDA still has work to do.

For salt, the health claim that I think most justified is "eat salt or die" or something along that line but less dramatic. Salt is a necessary nutrient. All but one of the studies of health outcomes of salt intake -- studies that relate health outcomes like heart attacks or deaths to the amount of salt people eat -- have confirmed that low-salt diets either don't deliver any health benefits or are actually more risky. See http://www.saltinstitute.org/28.html.

Unsurprisingly, the public is confused about health claims on food labels. Unfortunately, this will likely lead consumers to devalue nutrition/health advice on food labels much as they currently dismiss the 42 nutrition/health messages in the Dietary Guidelines.