The Institute of Medicine released its report on Front-of-Package Nutrition Labeling today . In what is becoming the norm for the IOM, they totally missed the opportunity to produce something actually useful for the American public and once again demonstrated how gratuitous status and intellectual inertia can be coupled with a good dose of taxpayer's money to produce a 175 page report that is pathetic rubbish.

Not only were the authors of the report steeped in the dogma of outdated labeling practices, they could not tear themselves away from a nutrition doctrinaire that is patently false.

We have known for 4 decades that the front of the package was a totally useless place to communicate information to consumers. Under pressure from consumer groups such as the Center for Science in the Public Interest, (who thought they could 'control' the food industry) the government quickly agreed to a series of front-of-package, side-of-package, and back-of-package labeling schemes. The fact is there is not enough real estate on a label for useful nutritional information, nor do consumers have enough time to read and digest it.

Of course, the understanding was that if the public was made fearful of certain nutrients, the limited information on the label would compliment this fear and the consumers' choices could be influenced. Never once was there the thought of actually educating the consumer, thereby allowing for an 'informed choice.'

From the very beginning of the labeling debate, there was the option to develop the Universal Product Code or UPS or Barcode into a consumer information system. For those consumers who had a genuine interest in nutrition, one swipe of the UPC across a scanner would bring up a complete database of nutritional information, recipes, allergies, etc., etc. No longer would there be a limitation on label real estate. Unfortunately, consumer advocacy organizations were far too interested in fighting it out with industry to employ some imagination in the interests of the constituency they supposedly worked for. Now, with near-universal access to the Internet and UPC-reading smartphones, this technology is easier to put into place than ever.

So conventional labeling systems, with all their insurmountable problems endured. Over the years, like a growing Tower of Babel, labeling systems became more complex and even less understandable. To deal with that problem, the food 'authoritarians' decided to simplify the label and go another step further in eliminating intelligent consumer's choice. Simplified systems intended to drive the consumer directly to a specific choice - traffic lights, check marks, scores, medical society endorsements - began to appear - designed to eliminate thought and dispense with informed decision making. Again, not the slightest thought given to educating the consumer.

Into the fray steps the Institute of Medicine whose 175 page report now says that the problem is that there is too much information on the front-of-package label. They recommend cutting it back to just four items. All consumers really need to know about is calories, saturated fat, trans fat and sodium.

This latest IOM report comes on the heels of two related publications: 1) the Harvard study by Bernstein and Willet , which revealed that sodium consumption has not changed in 40 years, while the rate of hypertension has gone up considerably, and 2) the report at the Obesity Society annual meeting in San Diego showing that calorie labeling on the menu did not reduce calorie consumption in fast-food restaurants.

The first publication revealed that sodium is not related to the rise in hypertension, which was always the main reason that the IOM wants salt consumption reduced, while the second report revealed that calorie labeling had little effect on consumer choice.

Talk about being a day late and a dollar short!

Supertasters are people who experience taste with far greater intensity over the average. It is estimated that about 25% of the population are supertasters and women are more likely to be supertasters than men as are Asians and Africans. The cause of this heightened response is thought to be due to an increased number of fungiform papillae or taste buds. Although one would think that the taste sensation would be an advantage if it is more sensitive, this is not always the case. An increased response to bitterness may severely limit the range of foods that are palatable. Vegetables have important phytochemicals that are protective of heart disease and cancer risk but their natural bitterness may turn supertasters off.

A potential unintended consequence of population-wide salt reduction has been highlighted in a paper by John Hayes and colleagues from Pennsylvania State University, published in the latest edition of Physiology and Behavior .

Hayes and colleagues examined the response of supertasters to varying amounts of salt in a wide range of foods. As indicated previously, these supertasters make up about 25% of the population and are genetically hypersensitive to bitter tastes, leading them to naturally avoid some vegetables and other foods that taste naturally bitter.

The researchers measured the liking and intake of foods with varying amount of saltiness among 87 healthy adults (45 men).

Supertasters reported greater saltiness in chips and pretzels and soup broth at levels comparable to regular-sodium products. They also found greater sensory enjoyment to growing salt concentration in cheeses (where sodium ions mask bitterness).

Despite adding less salt, supertasters consumed more sodium through food, as salt was more important to preference, both for its salty taste and masking of bitterness. This suggested to the researchers that supertasters appreciate increased salt in food formulations to mask naturally bitter foods particularly vegetables and other foods that may be deemed to be healthy.

The Dietary Guidelines Advisory Committee (DGAC) of the U.S. Department of Health and Human Services and the U.S. Department of Agriculture may increase health risks, including obesity, by ignoring sound science as they announce recommendations to reduce sodium consumption to 1,500 mg per day. It is reckless for the government to risk the health of Americans by relying on substandard levels of evidence and refusing to consider new evidence.

The rationale behind the recommendation is purportedly blood pressure reduction. While no one doubts that a small percentage of our population may experience modest blood pressure declines from salt reduction, it has not been scientifically established that a population-wide reduction will benefit overall health. Research indicates health risks for some on low salt diets, including higher risk of heart attacks. And new research shows that not a single modern society consumes such a low level of salt as that recommended (less than 4 grams of salt per day). This recommendation is essentially an unauthorized massive clinical trial using 300 million Americans as guinea pigs.

Recent research (Can Dietary Sodium Intake be Modified by Public Policy? David A. McCarron, Joel C. Geerling, Alexandra G. Kazaks, Judith S. Stern) involving data collected from more than 19,000 individuals in 33 countries has demonstrated that healthy humans, all around the world, consume sodium within a relatively narrow range (2700 mg- 4900 mg sodium) – a range controlled by a number of physiological mechanisms. The DGAC recommended level of 1500 mg is drastically lower and will result in unintended health consequences if Americans strive to reach the recommended target.

Most nutritionists agree that reduced sodium in food preparations will very likely increase the obesity crisis because individuals will consume more calories just to satisfy their innate sodium appetite and their search for eating satisfaction.

Perhaps the greatest failure of the Dietary Guidelines is their priority focus on single nutrients rather than the whole diet. Concerns over blood pressure would be better addressed if Americans would eat more salads, vegetables and fruits. Italians consume more salt than Americans yet they have better cardiovascular health because they eat a well balanced diet. They use salt to make healthy foods more delicious...without adding calories.

The public comment period on the Dietary Guidelines is June 15 to July 15.

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!”

The last week has brought a media frenzy to the debate over population-wide salt reduction thanks to the hypocritical and nonsensical campaign by NYC's Mayor Bloomberg and his administration. The Salt Institute has been in the center of the fray as we seek to get fair media coverage from folks who parrot inaccurate sound bites based on faulty science and a political agenda based on a "villain of the day" mentality. We are happy to report we have made great strides in getting out "the rest of the story" as Paul Harvey would say. SI staff appeared on CBS and Fox News, weighed in on approximately 20 interviews with print media and appeared on one national radio show and another large radio show in Miami (NYC's sixth borough).

In addition, the tide seems to be turning as the national sentiment is rejecting the nanny state mentality and seems keen on personal choice and liberty. There has been a shift in reporting on this issue since Bloomberg and company first publicly entertained the notion of population-wide sodium reduction one year ago. Perhaps our favorite editorial in the last week appeared in the Wall Street Journal. Smack is bad, but the crackdown is on salt by Eric Felten does a fine job of pointing out the lunacy of a city which teaches its residents how to properly shoot up heroin, but strong arms food producers into limiting sodium content. We, like Felten, join in a collective chorus of "huh?" John Stossel also did a fine job of making the case against government food nannies in this Fox News segment.

We are encouraged to see many rising up to fight back against nanny state public policy which ignores sound science. Fox News online ran a story "Restaurant chefs boiling over NYC Mayor's salt crackdown." And a new coalition has popped up to fight back: My Food. My Choice. is made up of businesses, restaurant owners and ethnic groups (they see the policy as an attack on ethnic cuisine) and consumers.

Earlier this year a New Jersey startup "food manufacturer," Bon Vivant International , began marketing "NutraSalt an all-natural, low-sodium sea salt," claiming "66 percent less sodium than other salt products."

Well, I guess this "food manufacturer" makes other things than food. Food grade salt is required to have at least 97% sodium chloride. So NutraSalt cannot be food grade salt.

The founder claims: "The product can be sold as table salt and as an ingredient to food-service companies and food makers."

It would be interesting to know which "food-service companies and food makers" are using non-food-grade salt. Inquiring minds want to know.

Scientists generally accept that 24-hour urine samples are the most accurate means of measuring sodium intake -- the "gold standard" for dietary sodium just as randomized controlled trials are the "gold standard" in the hierarchy of levels of evidence.

With that as background, how should we understand the claim by the Heart and Stroke Foundation (Canada) which "revealed" today that "500,000 kilograms of salt have been removed from the food supply in the last four years by companies participating in the Health Check program." HSF's health policy director equated the amount to "20 dump trucks of salt."

On its surface, the claim is that the total food sold over the past four years bearing a Health Check logo contains a half million kilos less salt (that figures to 550 tons of salt). Every year, Canadians consume about 130,000 tons of salt. So over four years, Canadians consumed a half billion tons of salt (520,000). In other words, this effort is claimed to reduce Canadians' salt intake by 0.1%.

But is it true? The claim can only be evaluated if we also know the answers to these questions:

1. Compared to the baseline four years ago, what was the composition of the foods bearing the HSF label? If the quantities and/or configuration of the sales differed, what can be said about the 500,000 gram number? If people, for example, are eating less of these foods (because they don't taste good or cost more) the number is invalid. But even more:
2. Compared to baseline, what other foods are Canadians eating and in what quantities? If they are eating less salt in Health Check foods, are they simply eating that salt in other foods?

No, the entire exercise is entirely bogus.

What we need to test the proposition (and we're all for the test!) is to track the total sodium consumption for a representative sample of Canadians randomized to consume a diet including as much as possible all the Heart Check foods and compare that over a year or two, with those randomized into a control group which eats whatever they want. The outcome would be ascertained by frequent collection of 24-hour urine specimens and the analysis done in blinded fashion.

Evidence suggests that physiology determines sodium consumption, not package labels. If an individual consumes "low salt" foods, they may simply eat additional quantities of food (and extra calories) to satisfy this innate "salt craving" automatically determined by the body to reflect that individual's varying need. That's why research shows such a consistent pattern of salt intake between populations and over time .

Most visible among their food industry peers in claiming "credit" for reducing salt in their product lines, ConAgra Foods and Campbell Soup both have declining customer satisfaction scores from baseline, according to the American Customer Satisfaction Index released today. ConAgra, in fact, finished dead last among the 13 named larger companies (and below the "all others" category).

On a 0-100 point scale in the ACSI, food manufacturers averaged 83 points with Campbell Soup lagging in 12th place with 82 and ConAgra dropping 6 points to 78. Leaders were H.J. Heinz with 89 followed, at 87, by Hershey, Quaker (PepsiCo) and Mars.

ACSI produces indexes for 10 economic sectors, 44 industries, and more than 200 companies and federal or local government agencies. Among all industries , manufacturers earned 81.5. Laggards were newspapers, cable/satellite TV companies and airlines (63 and 64). They, together with telephone companies (69), were the only private sector businesses with customer satisfaction as low as the federal government at 69.

ACSI is sponsored by the American Society for Quality, the University of Michigan's Ross School of Business and Cloes Fornell International.

William Grimes book Appetite City: A Culinary History of New York , reviews the City's rich ethnic heritage evolving out of humble beginnings as Nieuw Amsterdam. He cites the increasing popularity of "ethnic" dining as the City's greatest achievement as a "food city."

By ironic coincidence, the book appeared a year ago, when the City launched an initiative that would eviscerate the sale of ethnic foods in Big Apple grocery outlets and decimate ethnic dining in the city. The health department, basing its campaign more on political correctness than sound science, is trying to persuade grocers and restaurateurs to provide shoppers and diners only low-sodium versions of the foods they love. Imagine a low-salt salt bagel. How about a corned beef on rye or hot pastrami? No, can't have that, they're cured in saltwater. Choose your favorite ethnic cuisine and you'll find it impossible to enjoy without salt; it's the quintessential ingredient in ethnic foods.

Literally millions of immigrants entered the US through New York City and, for example, there are 3.3 million Italian-Americans in the New York metro area and extensive number who themselves or whose families emigrated from Greece or other Mediterranean countries -- whose diet is deemed the healthiest in the world (pdf 592.83 kB) . Even though newly-reelected, I doubt Mayor Bloomberg wants to tell them to turn their back on their ethnic culinary heritage -- or encourage them to dine in Hoboken, Hempstead or Yonkers.

Everyone does it. But with this book you can do it right, enjoy yourself and respect yourself in the morning. In short, this isn't just another how-to-do-it manual with "more than 50 recipes." Enjoy Valerie Aikman-Smith'sSalt: Cooking With the World's Favorite Seasoning .

The Scottish-born author is a trained chef, but works in Los Angeles as a "food stylist" for TV and movies (like "Titanic" and "Ocean's Eleven"). Amazon.com's blurb offers:

Salt in all its forms is a hot culinary trend. It enhances any savory dish and makes the taste buds sing. In this beautiful book, top cook and food stylist Valerie Aikman-Smith introduces you to all kinds of salts, from Hawaiian Red Alaea Salt to Jurassic Salt. Her Appetizers include tasty Olive Suppli, Gazpacho with Smoked Salted Croutons, and fun Popcorn with Chili Salt. In Entrees, you'll find the classic salt-crust method with new twists, such as indian-spiced Lamb in a Salt Crust, or how about Spicy Pork Satay with Roast Salted Peanut Sauce, or a refreshing Peach Caprese with Curry Salt? In Sides and Breads you'll discover tempting flatbreads and pretzel bites, and you'll be captivated by Valerie's Drinks and Sweets. How about a Black Olive Martini or Bloody Mary with Celery Salt, or a Chocolate Chip Cookie with Sea Salt? Be amazed as the flavors mingle in your mouth. Finally, a chapter of Rubs, Butters, and Brines offers you dozens of versatile ways to jazz up grilled meat or fish, vegetable crudites or potato chips, or use them with your own recipes. Once you've tried Valerie's stunning recipes you will never look at salt in the same way again.

A new book is out celebrating bacon. Bacon: A Salty Survey of Everybody's Favorite Meat was written by Heather Lauer, whose blog "Bacon Unwrapped " is very popular. In case you didn't know, there are bacon festivals all around the country and celebrations of every form of bacon under the sun. Bacon lollipops. Bacon ties. Chocolate-covered bacon. It seems that there isn't anything that isn't better with bacon. The key to bacon is salt, of course. And that is precisely why it tastes so good!

It is difficult to imagine how many lives have been saved over thousands of years by the process of preserving meat with salt. Heather covers the history of bacon in the book along with many interesting facts.

I must admit, that about a year a half ago I met with Heather for lunch (we have known each other through our public affairs/public policy work) and I was surprised to hear that she had a bacon blog and was in the process of writing a book about bacon. Not being a foodie, I couldn't imagine reading an entire book about food, but I'm a convert. In my opinion, bacon is right up there with chocolate in the perfect food category.

"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."

Over the past six months the public's priorities in food choices has shifted from "freshness, health and the environment" to "taste, price, healthfulness and convenience" according to dualing surveys, one by IPSOS and another by the International Food Information Council.

The IPSOS survey conducted six months ago and released June 11 was summarized by IPSOS Executive Vice President David Pring:

We are seeing a global consumer movement toward heightened consciousness of health, wellness and environmental factors in their food purchasing decisions....We are also seeing that taste, convenience and product difference – aspects that were probably more characteristic of food product drivers towards the end of the last millennium – are taking a back seat in a world now more focused on making a positive impact on freshness and health as well as the sustainability of the planet.

Wait a minute, IFIC would respond. Released slightly earlier, the 2009 IFIC survey concluded that, consistent with all past surveys, taste is the number one factor influencing food purchases, but price has increased steadily as the second most important factor. 87% of consumers consider taste to have some or great impact, price 74% (up from 64% four years ago), while healthfulness trails at 61% and convenience last of the four choices at 52%. Looking just at those who consider each factor of "great impact," taste is #1 with 53%, price next with 43% and healthfulness and convenience at 26%.

For ourselves, we see little evidence supporting the IPSOS headline that "Freshness, Health and the Environment Matter Most in the Kitchens of the World; Global Consumer Priorities Regarding Food Products Shift away from Taste, Convenience." Taste reigns!

What do you think?

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.