Three weeks ago, at the GMA/FPA and CSPI Salt Conference, Michael Jacobson of CSPI categorically stated in his opening remarks, "The debate on sodium is over. There is no longer a debate whether salt is good or bad." He was followed by Steve Havas of the AMA who stated that he did not believe any additional research was necessary to prove the beneficial impacts of a dramatic sodium reduction in the diet. This attempt to stifle discussion and pronounce, as if by imperial fiat, that there was no longer any debate concerning the benefits of salt reduction in the diet backfired.
When the audience, which was composed of professional food scientists, nutritionists, dieticians, epidemiologists and policy makers split into working sessions to consider all that was said, they concluded that the benefits of salt reduction to health outcomes had yet to be proven scientifically and that that a singular focus on salt reduction was not a viable solution. Indeed, the delegates unanimously stated that a more holistic approach was needed to improve overall dietary quality.
Almost as it on cue, within two weeks of the Salt Conference, two peer-reviewed medical journal articles appeared, both demolishing Michael Jacobson's assertion that "the debate on sodium is over." In a paper published in the October issue of the European Journal of Epidemiology , prominent Dutch scientist D.E. Grobbee and colleagues in the Rotterdam Study concluded that urinary sodium is not significantly associated with myocardial infarction, stroke, or overall mortality, adding: "The absence of a relationship between salt intake and mortality in our study corroborates the findings from the large Scottish Heart Health Study among almost 12,000 middle-aged subjects with 24-h urine samples."
Shortly thereafter, in the Journal of Interactive Cardiovascular and Thoracic Surgery , Drs. Jay Walker, Alastair MacKenzie and Joel Dunning of the Department of Cardiothoracic Surgery at James Cook University Hospital, in Middlesbrough, UK reported their in-depth review of all available evidence to determine if restricting dietary salt intake would provide protection from adverse cardiovascular events or mortality. They found it impossible to find a link between salt and heart disease due to a "lack of adequately powered randomized trials or observational studies conducted with sufficient rigor." Dr Dunning went further - he dismissed the theory that salt can cause strokes and heart attacks as,
...an argument of hope over reason....
These two publications reinforce the conclusions of the recent evaluation of the health outcomes study from Finland's three decade long salt reduction program.
Today saw a scathing denunciation of the poor science that has gone into the UK's public health policies . Dr. Phil Peverley, a GP from Sunderland in Northern England is this year's Magazine Journalists and Designers Association Columnist of the Year. Last year, he won the Press and Periodical Association's columnist of the year award. In his article, "A Very Large Pinch of Salt," Dr. Peverly criticizes
those doctors and politicians who have for years promoted the nannying theory that we should be forced to eat less salt in our diets. The obvious lack of a correlation between elevated blood pressure and salt intake should have been good enough for them.
He goes on to describe Public health minister Dawn Primarolo, who was recently quoted as saying that a low salt intake was an essential part of a healthy diet.
Ms Primarolo's only qualification to spout off on this subject is a six-year pre-MP career as a 'mature student', so I would always have regarded her pontifications as profoundly suspect…
Delving deeper, he states:
However, my remit is a wider one. This is further evidence that it is us, the medical profession, who don't know what we are talking about. I never fell for the bollocks about salt, but I have been as guilty as the rest of spreading disinformation and inaccurate advice about a whole manner of other medical subjects. It is becoming embarrassing.
Bravo Phil Peverly! There are not many like you, but hopefully there will be enough to drive away the fog, so we can get back to the science.
