House speaker Nancy Pelosi (D-CA) unveiled her version of healthcare reform at a highly-orchestrated news conference yesterday. Featured in coverage in the Washington Post was the fact that the event featured 50-pound bags of salt -- used to anchor the background staging for the outdoor event against gusty winds,

six 50-pound bags of salt -- ice-melting salt, to be specific -- placed on the bases of the six U.S. flags on the stage to keep them from toppling over in the wind and marring the event with unwanted visuals and ruinous metaphors.

The Post headlined the speaker's rollout: "Rally has a lot of salt, but little pep."

Who knew salt would get dragged into the healthcare debate?

Matthew Continetti's editorial, "The inevitability myth," in the November 2nd Weekly Standard asks: "Did the Democrats become Calvinists when we weren't looking?" Continetti discusses the Obama/Reid/Pelosi strategy to pass healthcare reform. They argue, he says, that passage is "inevitable" given the overwhelming partisan majorities on both sides of Capitol Hill. He notes "lately they've been talking a lot about predestination" and claim enactment is "foreordained."

Healthcare reform is a discussion for another forum. Some might find the same pattern for other issues like global warming or the electronic bombardment of those living under high-voltage transmission lines. As usual, I see a salt connection.

I was struck by the synergy of the Standard's construct with an observation noted here in the past: how salt reduction activists have been prying into citizen's lives and larders. We had in mind more the "fire and brimstone" Puritans seeking to affix the "Scarlet S" on the nutritionally/politically incorrect than the Puritans' Calvinist forebearers . But it's much the same.

Now that we think of it, the second strand of strategic embrace of predestination/foreordaination as a rhetorical tool would also characterize these salt nannies. While reasonable scientists find evidence of elevated risk for significant portions of the population with a one-size-fits-all salt reduction strategy and others find evidence that human's salt intake is a physiologic appetite not a choice that can be educated or regulated, these New Calvinists gloss over the scientific controversy and want to skip ahead to "implementation," churning up group endorsements to add momentum to their version of "the inevitability myth."

Science, like time, would seem to answer this myth. Over time, population salt intakes are unchanged. Moreover, it may not be due to sinful choices of salty foods nor the perfidy of food manufacturers who (take your choice) either stuff their products with hidden salt or make wild health claims that low-salt products have proven health benefits. Salt intake, the science now suggests, is the direct result of neural signals from the brain controlling an unconscious salt appetite. Some may see intelligent design. We think it's heavenly.

Pointing to recently published evidence that salt intakes are unchanged over decades and in a range above that recommended in the Dietary Guidelines for Americans and may, therefore, reflect physiological signals of need and not consumer behavior, the Salt Institute has renewed its call to abandon numeric targets for Americans' salt consumption.

In formal comments today to the Dietary Guidelines Advisory Committee (pdf 36.38 kB) , Richard L. Hanneman, president of the Salt Institute pointed out that the body's consistent physiological salt appetite has the perverse result of increasing caloric intake instead of curtailing dietary sodium.

The Institute called for further study and for replacing the numeric target in the 2005 Guidelines with a call for "moderation" as contained in Guidelines beginning in 1980 until 2000.

Sometimes when telling the truth isn't "politically correct," messages in the mainstream media receive short shrift. Elitism trumps the views of the "man on the street." We've seen it blatantly in coverage of the salt and health issue. But as Bobby Dylan famously sang "the times they are a-changin.'" Today's Times (London, UK) carried a story dismissing efforts to demonize salt intake ("Is salt really the devil's ingredient? "). No, concludes journalist Peta Bee, quoting the chief dietitian at London's St. Georges Hospital, Dr. Michael Alderman from the Albert Einstein College of Medicine and Dr. Paul Whelton of Loyola University.

While these experts weigh-in saying the scientific evidence against dietary salt has been over-interpreted and anti-salt campaigns overblown, the often missed story is found in the "Comments" that regular readers contribute. They may not be "informed" by the science, but they reflect well-earned experiences that offer practical tempering to elite PC opinion. Consider these:

• "I find it very annoying that I was forces to eat tasteless food throughout my childhood due to my bother's belief that salt is bad." -- Genevieve Wilkins
• "I have often wondered why salt licks were provided for animals. We are animals, aren't we?" -- alan burden
• "I have truly believed for many years that if the government says salt is bad fro us, in time the opposite would prove to be true...how much taxpayers' money is wasted on health propaganda campaigns." -- Nicholas Mayes
• "It's funny - my horse's vet tells me that adding salt to feed isn't a problem....Odd how it's so difference in humans - almost like it's just an excuse for the government to interfere and tell us all how to live our lives, isn't it?" - K Charlton
• "Nanny doesn't always know best." - Chris Palmer
• "Be extremely careful about the anti salt message. I cut out salt on this advice, then moved to a sub tropical country and became seriously ill, with low salt at least one of the causes." - Paul Flynn

There seems to be a bubbling up of resentment about dietary diktats that may make holding the line on the anti-salt message akin to the fall of the Berlin Wall -- its demise could be more sudden and complete than "intelligence" estimates.

A study released on-line this week in The Clinical Journal of the American Society of Nephrology indicates that physiology, not public policy, will determine a human’s daily sodium intake. This research likely represents a important step forward in light of past and current efforts by government agencies and government funded organizations to set progressively restrictive guidelines for salt intake among U.S. citizens.

The study, Can Dietary Sodium Intake be Modified by Public Policy? (David A. McCarron, Joel C. Geerling, Alexandra G. Kazaks, Judith S. Stern), analyzed existing research to determine whether sodium or salt intake follows a pattern consistent with a range set by the brain to protect normal function of organs such the heart and kidney. The analysis is based upon 19,151 subjects studied in 62 previously published surveys and reflects the differing ‘food environments’ of 33 countries. The data reported documents that humans have a habitual sodium intake in the range of 2800 to 4600 mg/day with an average of 3600 mg/day. Currently, the U.S. consumes an average of about 3,500 mg/day.

The Dietary Guidelines Advisory Committee of the U.S. Health and Human Services and the U.S. Department of Agriculture considers 2,300 mg/day sodium to be a healthy maximum almost 20% lower than the minimum intake observed in the 19,000-plus subjects reported in this first-time analysis. In spite of that reality, the Committee is in the midst of a review to determine whether that recommendation should be lowered even further. An Institute of Medicine Committee is also considering a strategy to reduce dietary sodium.

The Committees should heed this study as they consider wasting more time and energy on policies which are unlikely to make American citizens any healthier. Time spent on draconian recommendations on a single ingredient would be better spent encouraging a healthful overall diet rich in fruits, vegetables and whole grains. The Mediterranean diet is high in salt, yet the Mediterranean people are known for excellent cardiovascular health. A healthful overall diet, not a fixation on any single ingredient, is one of the secrets to maintaining good health.

See the Salt Institute's news release (pdf 29.80 kB) .

One of the joys of my commute is the opportunity to listen to stimulating recorded lectures as part of The Teaching Company's Great Courses series. I'm in the middle of part 2 of a course by Steven L. Goldman, Ph.D. on "Great Scientific Ideas That Changed the World."

Lecture 13 on "The birth of Modern Science" discusses the contribution of Francis Bacon, an Elizabethan Renaissance man who developed the modern experimental method. Bacon developed his new method to overcome what he considered the intellectual fallacies of his time which he called "idols" of which there were four: idols of the tribe, idols of the cave, idols of the marketplace and idols of the theater. An idol, in Bacon's terms, was a fascination or fixation without basis in fact and which interferes from acceptance of an accurate understanding of some phenomenon.

Consider how relevant these fallacies are to the current debate on salt and health.

Idols of the tribe are deceptive beliefs inherent in society; they are based on error because they interpret observed relationships through the eyes of (current) orthodox opinion.

Idols of the cave are errors rooted in personal experience and limited by that experience.

Idols of the marketplace are errors rooted in semantics; words conjure up conclusions so the use of improper descriptors induces misunderstanding.

Idols of the theater grow from sophistry, a body of opinion sustained and perpetuated by group acceptance and popularity, but based on false assumptions.

How do Bacon's "idols" relate to the ongoing controversy over salt?

Tribe -- the overwhelming popular majority accept fallacious reasoning that because salt and blood pressure are related and blood pressure and health outcomes are related, that lowering salt will improve health. The evidence shows the contrary.

Cave -- Blood pressure researchers can manipulate subjects' BP by varying salt intake; therefore, they reason that changing BP alone, by any means (and an easy "means" is changing salt intake) will produce better health. There is no evidence to support this conceit.

Marketplace -- It's too bad recently-deceased William Safire didn't address this point. Assertions of "excess dietary sodium" and conclusions that "we eat more salt than we need" are among the several sleights-of-hand employed by salt reduction activists. How do they know better than an individual's neural-hormonal system what is "too much" salt?

Theater -- There are several illustrations, but the easiest to see is the continued preoccupation with endorsement by "expert groups" of the policy recommendation to reduce dietary salt, all the while ignoring the lack of evidence of a health benefit.

We salute Francis Bacon for pioneering a modern scientific method. He would be right at home with his passionate advocacy in today's kerfuffel over dietary salt.

European "food companies guilty of misleading people with health claims" trumpets a headline in the October 2 issue of Medical News Today . The story reports the views of the UK-based activist group Which? quoting the group's chief policy advisor saying of an ongoing review of health claims by the European Food Safety Authority (EFSA):

A huge number of food products claim to have health benefits, but finally we are separating the wheat from the chaff. Incredibly, only a third of health claims looked at by EFSA could be backed up.
Clearly many food companies are exploiting people's interest in improving their health, often over-charging them for alleged health benefits which can't be proved.
On a more positive note, there are foods using proven health claims, so it's vital that industry acts responsibly when making claims, and that the Food Standards Agency ensures the removal of misleading products. Only then can people be confident that the health claims on items they buy are genuine.

Medical News Today reports that EFSA has assessed over 500 claims.
Among the claims supported by Which? and found acceptable by EFSA are claims that reduced sodium foods are healthy. Food companies offering these products are pleased to cooperate to say these foods are healthier for consumers.
Talk about misleading people! EFSA (and Which?) ignore two yawning data gaps that fatally undermine the argument for salt reduction:

1. There is no evidence that there is a net health benefit of reducing dietary salt (pdf 434.26 kB) (in fact, the single controlled trial of the health outcomes (pdf 802.65 kB) of salt reduction found a greater risk among those on low salt diets), and
2. There is no evidence that those who choose low-salt foods (with "healthy" labels) consume lower sodium diets -- the evidence suggests salt appetite is an autonomic physiological response (pdf 517.27 kB) to the body's need for salt.

So, Which?, if food manufacturers are misleading consumers for unsubstantiated claims that their low-salt foods are healthier, you're no better for criticizing them while endorsing the very basis on which their misleading claims are based. As Wikipedia explains, the original idiom about "the pot calling the kettle black " has an alternative, subtler interpretation from a century old poem that extends the critique beyond simple hypocrisy. The poem points out that the actual idiom is "The Pot Bottom Calling The Kettle Bottom Black" drawn from the fact that "the pot is sooty (being placed on a fire), while the kettle is clean and shiny (being placed on coals only), and hence when the pot accuses the kettle of being black, it is the pot’s own sooty reflection that it sees: the pot accuses the kettle of a fault that only the pot has, rather than one that they share." The observation that the root of the problem is that food companies are reflecting back the junk science of groups like EFSA and Which? properly assigns responsibility.
The poem found in "Maxwell's Elementary Grammar" school book, reads:
"Oho!' said the pot to the kettle;
"You are dirty and ugly and black!
Sure no one would think you were metal,
Except when you're given a crack."
"Not so! not so! kettle said to the pot;
"'Tis your own dirty image you see;
For I am so clean -without blemish or blot-
That your blackness is mirrored in me"