ATLANTA, GA — A recent report commissioned by the Center for Disease Control (CDC) reviewed the health benefits of reducing salt intake and the take-home message is that salt, in the quantities consumed by most Americans, is no longer considered a substantial health hazard. What the CDC study reported explicitly is that there is no benefit, and may be a danger, from reducing our salt intake below 1 tsp per day. What was absent about the report was is the difference between healthy mineral salts and iodized table salt.
It may be that we’re better off with more salt than less, up to 2 or even 3 tsp per day. How did it happen that such standard medical advice drifted astray, then went un-corrected for so long?
This review by the National Academies Institute of Medicine (IOM), commissioned by CDC, considered dozens of studies, from cross-cultural (less reliable) to prospective, randomized with control (most reliable). Most studies showed no relationship between salt intake and any health outcome. Some seemed to indicate that more salt had a beneficial effect.
As with so many bad public health ideas, the idea of cutting salt found its national footing thanks to Mayor Michael Bloomberg, whose primary public service as head of the largest city in America has been to ban and discourage as many delicious foods as possible. In 2009, Bloomberg started the National Salt Reduction Initiative, led by the New York City health department in an effort to push major food companies into “voluntary” lower-sodium standards. The goal was to reduce sodium intake by 25 percent.
There was push-back on the initiative from the scientific community here and there, but that didn’t stop Bloomberg’s strong-arming quest.
Lucan told The Post the city’s salt war is “misguided” – and potentially dangerous.
“We can’t just swallow this as fact – there’s actually debate about this.
“My concern is that they’re focusing on a single ingredient that the food industry is going to have to replace with something – and what they replace it with might be more damaging,” he added.
Higher sodium intake has been shown in some studies to increase blood pressure, which is a major risk factor for heart attacks and strokes.
But that’s only part of the story, Lucan said.
“There is a relationship between sodium and blood pressure, but it’s not consistent. And even when it’s present, it isn’t clinically very substantial,” he said.
For some high-risk heart patients, some studies show, a low-salt diet “actually leads to worse cardiovascular disease and early death,” Lucan said.
Lowering salt, Lucan notes in his article, “may also decrease insulin sensitivity, alter lipids, and stimulate a variety of neurohormonal pathways detrimental to the cardiovascular system.”
But many of your favorite foods have probably already been ruined. Bloomberg, in concert with the American Heart Association and other alarmists, got more than 20 food companies to cut their sodium in February:
Au Bon Pain
Bertucci’s Italian Restaurant
Black Bear European Style Deli
Boar’s Head Provisions Co.
Campbell Soup Company
Dietz & Watson
LiDestri Foods / Francesco Rinaldi
Mars Food US
Red Gold, Inc.
Starbucks Coffee Company
Uno Chicago Grill
Maybe they haven’t gone through with it. Mercifully, the cheese industry was not as quick to bend to Bloomberg’s will, mostly because chemistry won’t let it.
Several years ago, Dr. Miller and others analyzed the sodium content of more than 1,650 samples of Cheddar, mozzarella and processed cheeses from manufacturers around the country.
”What we learned was that there’s a lot of variability within brands and across brands,” Dr. Miller said. By improving manufacturing processes, he added, companies should be able to make cheeses with consistent, and lower, sodium content and meet some of the targets established by efforts like the National Salt Reduction Initiative, a partnership led by the New York City health department. The initiative has a goal of a 5 percent sodium reduction in most cheeses by the end of this year and a 15 percent reduction by 2014. Targets for processed cheeses are stiffer.
Dr. Johnson said that the industry might meet some sodium-reduction goals by slowly lowering the salt content so consumers became accustomed to the change in taste.
It is relatively easy to produce a cheese with 10 percent less sodium by just cutting the salt, Dr. Johnson said. ”If I gave you that cheese, and gave you a full-sodium one, you’d know the difference,” he said. ”But if I didn’t ever give you the higher one, and gave you the lower one, you’d go, ‘Mmmmm, that’s not bad.’ ”
Maybe this news is enough to prevent this nefarious trick cheese from ever entering the market, though I don’t imagine Bloomberg and Co. will stop pushing for more tasteless and oddly textured options for the American people through a combination of public bullying and government force.
Staff time initially was provided by NYC Department of Health and Mental Hygiene employees. In addition, three grant-funded positions now support the NSRI. TheNSRI databases include data purchased in 2009, totaling approximately $150,000, which was provided by grant funding; the Health Department plans to repeat the purchase in 2012 and 2014. Health Department staff members also were assigned to the development of the 24-hour urine study. Grant funding of approximately $1 million for the study complemented city staff time.
The Health Department has received extensive support from philanthropists and donors, including the Centers for Disease Control and Prevention, the National Association of City and County Health Officials, the WK Kellogg Foundation, the Robert Wood Johnson Foundation, and the New York State Health Foundation.
Update: Alison Rosen and I talked, in part, about this issue on her podcast this week. It’s a lot of fun, and we cover a bunch of family stories, my OCD, pregnancy, and silliness. A quote from me: “IT’S NOT SALT! IT’S FREEEEEEDOM!!!!”