Best blog of the year!
Okay, it's still early, but Junk Food Science has raised the bar in its report this week on "Who decides what you can eat? Sating on salt ." Read it all. Twice.
Noting that New York City has announced a campaign to reduce dietary salt in the Big Apple, nurse-blogger Sandy Szwarc laments that the "significance of this initiative may have been lost on media" and capsulizes why people should care:
It deserves to be out in the open, though, because the best science for nearly half a century — including the government’s own findings on examinations reflecting 99 million Americans; more than 17,000 studies published since 1966; and even a recent Cochrane systematic review of the clinical trial evidence — fails to support the hypotheses that salt reductions offer health benefits for the general public. Cochrane’s reviewers specifically concluded that such interventions are inappropriate for population prevention programs.
It’s not just that the salt reductions being proposed will be costly programs that won’t be of much help to people, but that they could hurt people. Even more troubling, the public health messages in this new campaign appear to be most targeting minorities, fat people, the elderly and poor.
Szwarc sums the NYC campaign quoting from the New York Times : “Dr. Frieden says a quiet, mass reduction in sodium levels — stealth health, they like to call it around the department — might be more effective.” She then continues to skillfully excoriate the city health department's scientific summary: "None of these claims can be scientifically supported," she declares.
She then explains how heart disease rates are improving, how population blood pressure has been unchanged over the past 20 years and how salt usage, also, has not increased over the past 20 years. Then she turns to health outcomes, summarizing the findings by a team at the Albert Einstein Medical College who studied the biggest and best federal government database, the National Health and Nutrition Examination Survey (NHANES):
The lowest sodium intakes — the 1500 mg/day that the New York health department says everyone should be eating — were associated with an 80% higher risk of cardiovascular disease compared with those consuming the highest salt diets. The lowest salt intakes were also associated with a 24% higher risk of all-cause mortality. Clearly, low-salt diets are not associated with lower risks for the general population. Conversely, the Albert Einstein researchers were unable to show that even the highest salt intakes were associated with increased risks for developing cardiovascular disease or high blood pressure or for premature death.(emphasis in original)
She explores the "unintended risks" of low-salt diets, the many scientists who question universal salt reduction and queries: "What is it all about?" answering:
As the New York City-led nationwide low-salt initiative is clearly not founded on a true health crisis, on the medical evidence, or on proven health interventions for the primary prevention of high blood pressure or heart disease, what might it really be about?
As the New York Times pointed out today, the target is going after packaged foods and chain restaurant meals. Reducing salt to levels unpalatable to their consumers appears to primarily be about getting people to eat less of foods these public officials don’t think people should eat or others should sell.
Szwarc rarely deals with salt. She's been a consistent and effective proponent of evidence-based health decisions on a broad range of nutrition issues. Her insights earned Junk Food Science "silver medal" runner-up recognition for the best medical/health issues blog for 2008. This could vault her to "gold" in 2009!
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