"Wild winter weather across China crippled energy and transport, and caused roughly 3 billion US dollars of economic loss," according to China Daily. For the past two weeks, snowstorms have pounded central, eastern and southern China "causing deaths, structural collapses, power blackouts, highway closures and crop destruction." Hunan Province and western Guizhou Province have been hardest hit, but the storm's impact was broad and severe; 220,000 were evacuated in Jiangxi province where 13 have died in snow-related accidents.

Toronto was embarrassed several years ago when it needed to call on Canadian army troops to help overwhelmed local snowfighters. China has mobilized 158,000 Peoples Liberation Army troops and supplemented those with more than 992,000 police and 303,000 "paramilitary" personnel. In Nanjing, capital of eastern Jiangsu Province, where the accumulated snow reached about 13 inches, the provincial government reports mobilizing a quarter million volunteers to shovel snow.

Yet roadways were reported uncleared well after the storms. Seven of the eight highways connecting Guangdong and Hunan provinces were cut off. At least 25 bus passengers were killed when a bus ran off a road "covered with a thick layer of ice and the temperature about minus two degrees Celsius." About 11,000 vehicles were piled up on the highways in eastern Anhui Province, where half of the state and provincial highways were crippled by the snow. China Daily reports that "more than 8,000 traffic police were dispatched to keep order on the 40- kilometer congested section in Anhui - nearly one policeman for every stranded car! Vegetable prices in cities have more than doubled.

Perhaps the storm clouds will have a silver lining and stimulate improved winter maintenance on Chinese roadways.
 

 

Higher standards of evidence urged for Dietary Guidelines. A recent article in the American Journal of Preventive Medicine, "A Call for Higher Standards of Evidence for Dietary Guidelines," asserts that past reliance on lower-quality evidence in devising the U.S. Dietary Guidelines has actually done consumers more harm than good. Authors Marantz, Bird and Alderman make the case that relying on poor science has led the Guidelines to focus on individual nutrients; their primary example was fat. Thinking that urging a reduction in fat intake couldn't harm anyone, the Guidelines made that recommendation in the 1970s only to reverse course with the 2000 Dietary Guidelines which targeted carbohydrate consumption, not fat consumption, as the culprit for the burst of obesity. Consumers adjusted their diets and reduced fat, but added calories from carbs. Marantz et al also point to the advice given on salt intake as another example of the unintended consequences of a seemingly innocuous recommendation, noting that any blood pressure benefits may be trumped by the stream of harmful effects on plasma renin, insulin resistance, sympathetic nerve activity, and aldosterone levels. They further point to a recent finding of no difference in total mortality between randomized sodium-intake groups.

"The Great Diet Delusion." A January edition of New Scientist revisited the topic with renowned science writer, Gary Taubes arguing in "The great diet delusion" that nutrition scientists and policy-makers need to understand physiological mechanisms of fat deposition and over-consumption. Citing examples from adolescent growth spurts, Taubes credibly describes the impact of hormones on growth and fat deposition. Carbohydrates, such as starches and sugars, stimulate the secretion of the hormone insulin which, in turn, accelerates deposition of fat.

The devil's in the details. The media was an eager consumer of the reported results of a massive (20,244 persons) 14-year mortality study reported in January which showed that four simple interventions -- increasing fruits and vegetables, becoming physically active, not smoking and consuming no more than moderate amounts of alcohol -- increased lifespan by 14 years. Investigators led by Kay-Tee Khaw reported that "the trends were strongest for cardiovascular causes." Within hours this week, television newscasters, as well as some 500 published articles - for scientists, medical professionals, nursing professionals, business professionals and consumers - were all reporting the authors' conclusions. But the media missed the fact that the study failed "to find a tenable correlation between any of the health behaviors and mortality: all-cause, cardiovascular disease, cancer or any other cause of death." (emphasis in original) and that the risk of dying differed by only 0.2% between those doing no interventions and those doing all four. Even when the results fit a comfortable mindset, we're reminded of the importance of looking hard at the evidence.

Dogma CAN be changed. Perhaps there is hope for evidence-based diet recommendations. The American Academy of Pediatrics, which had been advising mothers of infants with a family history of allergies to avoid cow's milk, eggs, fish, peanuts and tree nuts while breast-feeding, having taken a fresh look at the science, in January updated its advisory. The new advisory concedes that there's no good evidence for avoiding certain foods during pregnancy, using soy formula or delaying introduction of solid foods beyond six months. An Associated Press story quoted Dr. Scott Sicherer of Mount Sinai School of Medicine's Jaffe Food Allergy Institute in New York City, one of the authors of the revised AAP policy statement: "They say, 'I shouldn't have had milk in my coffee. I've been saying, 'We don't really have evidence that it causes a problem. Don't be on a guilt trip about it.'"
 

 

Diet-disease relationships need "more- illuminating" biomarkers: IFT. There are many biomarkers pertinent to diet and disease, Roger Clemens and Peter Pressman explain in the January issue of Food Technology. All biomarkers should "indicate the biological plausibility of a diet-disease relationship, improve the assessment of relative risk, and serve as surrogate endpoints," the authors explain. Biomarkers include blood pressure, serum glucose, serum triglycerides. Some are better indicators than others. There is a "critical need for markers that distinguish the clinically meaningful stages of pathology," they state, decrying the "simplistic model" that fails to predict outcomes accurately. They warn: "The food industry, in its effort to provide more-healthful choices in the functional foods arena, must consider more-illuminating biomarkers. When specifying a biomarker, it is important to understand how it fits with nutritional exposure or intake, time frame, sampling, specimen collection, storage, the model system under study, biologic variation, and the analytic quality control." Unfortunately, unmentioned by Clemens and Pressman is the growing awareness of the inadequacy of blood pressure as a reliable biomarker for cardiovascular risk. Increasingly, we understand that not only are multiple processes and interactions taking place with regard to dietary sodium intake and that individuals vary widely in their response, but that how we attempt to change surrogate biomarkers can be a clear indicator of the result. We need to focus on the hard disease outcomes and then look back to see which surrogate biomarkers offer value predicting adverse outcomes. Until then, take two doses of humility and see me in the morning.

Washington Post discovers distinction between "risk factor" and "risk." The current dust- up about the ENHANCE drug study where inappropriate research procedures were used to justify the drugs Vytorin and Zetia has raised consciousness of the difference between actual risk and "risk factors" that may or may not actually lead to disease. In a recent story on "Heart Choices," the Washington Post asserts that "lower LDL cholesterol itself is not the final goal; the goal is to lower the risk of heart disease and stroke. Only with the new study has it become known that Vytorin and Zetia are probably not superior to statins in improving health. Although another study looking directly as their effects on heart disease and stroke is underway, it looks as if consumers may have been throwing away their money." This distinction between "risk factors" such as LDL cholesterol and "risk" of heart attack and strokes (not an extrapolation from the risk factor findings, but an examination of the actual health outcomes), is one too often ignored and central to understanding the current controversy over whether or not to encourage general reduction of dietary salt. Salt reduction may affect the "risk factor" of blood pressure in many individuals; it also affects other disease "risk factors" such as insulin resistance, plasma renin activity and sympathetic nervous system activity. What it seems NOT to affect is the "risk" or rate of cardiovascular disease, CV events like heart attacks and strokes or, ultimately, mortality.

AMA starts 2008 with a misdirected campaign against CV "risk factors." The American Medical Association January 11 urged Congress to pass legislation to help Americans control their risk factors for cardiovascular diseases. With obesity, hypertension, diabetes and other risk factors on the rise, the association is calling on elected officials to support measures that focus on research and prevention. "Risk factors, such as unhealthy weight, poor diet, smoking and diabetes could undercut many of the gains we've made to reduce cardiovascular disease deaths," said AMA president Dan Jones. The "risk factors" of age, ethnicity, etc. were unmentioned. As SI technical director Mort Satin observed: "How do you prevent age, for example, the surest predictor of cardiovascular events and deaths? How about being an African-American, another powerful 'risk factor'?" The proper focus of public health policy is to prevent disease, extend life and improve the quality of that life. A focus on "risk factors" presupposes that they can be modified as part of our public health efforts. Some "risk factors" cannot be modified. Others, like "salt sensitivity," as recently as a decade or two ago were thought to be immutable and unchangeable and are now properly understood to be the product of deficiency intake levels of other nutrients, in this case, calcium, magnesium and potassium; correct those deficiencies (as with the DASH Diet) and the "salt sensitivity" disappears. So, the proper policy focus should not be on "risk factors" but on the effectiveness of HOW we try to modify those risk factors. Again, salt is illustrative. Blood pressure is a risk factor for CV events and mortality. Few would deny that. But HOW blood pressure is modified is what's important, not the raw number itself. Blood pressure is not the disease. It is the symptom, the "risk factor" for CV disease, myocardial infarcts and strokes. Treating the symptom is not prevention. It may even make the underlying condition worse and increase the risk of an event rather than prevent it. That's what we discovered when scientists started examining the question of whether cutting salt (a "risk factor") would yield in actuality the "prevention" benefits predicted by mathematical models such as those used by the AMA. It turns out, they don't. In a long string of "health outcomes" studies, no pattern of a health benefit is correlated to diets lower in salt. It turned out that other "risk factors" such as insulin resistance, plasma renin activity and sympathetic nervous system activation were also affected by reducing dietary salt. These "risk factors" increase the risk of cardiovascular events, proving, once again, that HOW we seek to modify "risk factors" is more important than announcing a campaign focused only on change.
 

 

Eating the government-recommended amount of salt (2,300 milligrams sodium) is associated with stiffening of the arteries due to stimulated secretion of aldosterone. Like the hormone renin, aldosterone production jumps when the body detects inadequate amounts of sodium. Research by Y. Shapiro et al in press at Clinical Endocrinology found that 60 healthy young subjects consuming 2,300 mg sodium increased aldosterone and increased arterial stiffness. That stiffness is associated with heightened risk of heart attacks (just like earlier-identified renin increases due to salt reduction). Another straw for the salt-restricted camel to bear; how many will it take?
 

 

Freight shipping challenges on the horizon. Truck shipping will double by the year 2035 and "there is no strategy or clearly defined federal role in transportation generally and in freight transportation specifically, despite a clear federal interest in freight transportation stemming from Congress' constitutional role to regulate interstate commerce and freight transportation's effect on the national economy." That's the conclusion of a report from the U.S. Government Accountability Office (GAO) released January 8th by Sen. James Inhofe (R-OK). The report recommends urgent attention to developing new revenue sources for freight system infrastructure investments. The report has implications for salt companies shipping their products as well as for roadway operations agencies which will have to build and operate systems to accommodate the vast increase in freight movement.

Transportation Financing Commission identifies challenges ahead. The nation's surface transportation system is in a "physical and financial crisis" because current revenue is insufficient to maintain and improve this country's highways, public transportation systems and intermodal connectors, according to an interim report released in mid-January by the National Surface Transportation Infrastructure Financing Commission. The Commission says revenues are lagging required investment resulting in competition between maintenance spending (which would include winter maintenance) and needed new construction; it called for higher user fees for road users.

Bush budget reins in highway spending. The Bush Administration's FY 2009 budget proposal includes $68.2 billion for the federal transportation programs-$2.13 billion less than the total transportation investment in FY 2008. The President's proposal reflects the deteriorating fiscal outlook for the Highway Trust Fund. Last summer, the Administration estimated revenues would be $4.3 billion below the amount necessary to finance the statutorily- guaranteed investment levels which could lead to a potential $16 billion cut in FY 2009 highway investment.

Lots of plants are starting the year off right. Join us in celebrating these achievements:

• Morton Salt, Newark, CA evap plant, 2.2 million hours without a lost-time injury
• Morton Salt, S. Hutchinson, KS evap plant, 1.3 million hours
• Cargill Salt, Akron, OH evap plant, 1 million hours
• Compass Minerals, Lyons, KS evap plant, 600,000 hours
• Cargill Salt, Hutchinson, KS evap plant, 500,000 hours
• Cargill Deicing Technology, Lansing, NY, Cayuga mine, 400,000 hours
• Cargill Salt, Milwaukee, WI packaging facility, 400,000 hours
• Cargill Salt, Newark, CA evap/solar plant, 400,000 hours
• Cargill Salt, Watkins Glen, NY evap plant, 300,000 hours
• Cargill Deicing Technology, Cleveland, OH mine, 200,000 hours
• Cargill Salt, Breaux Bridge, LA evap plant, 200,000 hours
• Cargill Deicing Technology, Avery Island, LA mine, 100,000 hours
• Cargill Salt, Pittsburgh, PA terminal, 30 years
• Cargill Salt, Baltimore, MD processing plant, 16 years
• Cargill Salt, Milwaukee, WI packaging facility, 16 years
• Cargill Salt, Hutchinson, KS evap plant, two years
• Cargill Deicing Technology, Lansing, NY, Cayuga mine, one year
• Cargill Salt, Breaux Bridge, LA evap plant, one year

 

 

Chicago boasts more Polish residents than Warsaw and now it's hijacking a salty secret from Eastern Europe - salt caves or salt rooms. A recent Chicago Tribune article notes a suburban restaurant featuring a relaxing, spa- like respiratory restorative salt cave inspired by one the owners visited on a trip to Poland - as well as "Chicago's first dining room encased in Black Sea salt." The owners also converted one of their salt caves into a small dining room.

Other Chicago-area spas have salt "breathing rooms" to restore mind and body. Patrons claim "30 to 60 minutes in a salt-covered room can help relieve stress, cure a hangover or even improve respiratory health." Don't miss the video.
 

email: tammy@saltinstitute.org

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