NEWS
RELEASE
FOR IMMEDIATE RELEASE: March 3, 2003
Statement of Richard L. Hanneman, President of the Salt Institute, in response to publication of the World Health Organization Technical Report Series 916 “Diet, Nutrition and the Prevention of Chronic Diseases.”
Talk is cheap. Science is about data, not personal opinions and
preferences. We’ll stick with the data
and leave WHO with its room full of experts. Policy
should be based on medical science, not political science or fairy tales.
With regard to
dietary salt, the issue we at the Salt Institute know most about, we could find 30 experts
who would take just the opposite opinion from this “Expert Report.” That’s why expert opinion is the lowest level
of evidence in the hierarchy of scientific support for links on issues like diet and
disease. The highest level of evidence is a
double-blinded, randomized controlled trial. That
evidence has been examined by experts at the prestigious Cochrane Collaboration. Earlier this year, they released two Cochrane
Reviews, far more powerful, evidence-based analyses on the subject of dietary salt. These reviews are online and could have been
accessed by WHO/FAO – in fact both have been published in shorter forms in high
quality peer-reviewed journals. The Cochrane
Reviews (“Reduced
dietary salt for prevention of cardiovascular disease” and “Effects of low
sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines,
cholesterols, and triglyceride”) concluded, respectively:
“Intensive interventions, unsuited to
primary care or population prevention programmes, provide only minimal reductions in blood
pressure during long-term trials. Further evaluations to assess effects on morbidity and
mortality outcomes are needed for populations as a whole and for patients with elevated
blood pressure.”
And:
“The magnitude of the effect in
Caucasians with normal blood pressure does not warrant a general recommendation to reduce
sodium intake. Reduced sodium intake in Caucasians with elevated blood pressure has a
useful effect to reduce blood pressure in the short-term. The results suggest that the
effect of low versus high sodium intake on blood pressure was greater in Black and Asian
patients than in Caucasians. However, the number of studies in black (8) and Asian
patients (1) was insufficient for different recommendations. Additional long-term trials
of the effect of reduced dietary sodium intake on blood pressure, metabolic variables,
morbidity and mortality are required to establish whether this is a useful prophylactic or
treatment strategy.”
Jürgens G, Graudal NA. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride (Cochrane Review). In: The Cochrane Library, Issue 1 2003. Oxford: Update Software.
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