NEWS
RELEASE
February 11, 2004
Washington, D.C…(February 11,
2004)…When medical experts in two major, similar countries in two successive weeks
come to very different conclusions about whether their entire populations should undertake
a major dietary change, it should provoke a critical examination of the process that those
experts used to review scientific evidence to reach their conclusions. That’s the view of the Salt Institute
expressed today as the Food and Nutrition Board released its expert review of studies of
dietary sodium.
Last week, The Canadian Hypertension Society, The Canadian Coalition for High Blood Pressure Prevention and Control, The College of Family Physicians of Canada, The Heart and Stroke Foundation of Canada, and the Chronic Disease Prevention Division, Centre for Chronic Disease Prevention and Control, Health Canada, published their recommendations that do not include restricting salt intake for a majority of Canadians.
“Since the sponsors are reputable, the reports are contemporaneous and the experts consulted in both cases are distinguished scientists, the public has a right to know how each group examined the evidence since that must be the distinguishing variable,” stated Salt Institute President Richard L. Hanneman. Expert opinion, he noted, is considered “Class D” evidence – the lowest type of evidence used in making general recommendations. “What we really need are recommendations based on Class A evidence,” Hanneman said, “evidence of whether the intervention recommended actually improves human health. There is no evidence that asking everyone to reduce dietary salt improves health outcomes. None.” Impacts of reduced sodium diets on intermediate variables such as blood pressure, insulin resistance, sympathetic nerve response and plasma renin activity show “evidence of both benefit and risk in lowering salt, depending on the variable and the individual. This is far from comforting to those advocating across-the-board interventions,” he noted.
Dr. Lawrence M. Resnick, executive editor of the American Journal of Hypertension, disputed the published conclusions. “The recommendations of the panel to further reduce dietary sodium intake beyond that already recommended in the past is not justified by a fair analysis of the evidence quoted in the report. A fair discussion of the data does not allow us to come to a universal recommendation about dietary sodium for the population as a whole.”
Dr. Alexander G. Logan, co-author of the Canadian recommendations published last week agreed: “Our process in Canada tracks the internationally-accepted approach of the Cochrane Collaboration. Obviously, the U.S. report has not adopted this rigorous scientific and widely accepted method of assessing evidence to make dietary recommendations.”
For the Salt Institute, Hanneman added that he has informed
the federal Dietary Guidelines Advisory Committee that the Food and Nutrition Board report
“fails the standard of the federal Data Quality Act and cannot be considered by the
Advisory Committee as the basis for its current review of federal dietary
guidelines.” He noted that the FNB
report references reports where the data have been the subject of a Data Quality Act
petition.
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