Government still wrong about salt, still doesn't care

For years, some scientists and nutritionists have been pushing back on the government’s salt guidelines. The notion that the average amount of American sodium intake is dangerously high and must be lowered tremendously through recommendations and regulations alike is not exactly supported by science. It is true that if one is hypertensive, cutting salt intake can be helpful. It is not true that, for the population at large, removing sodium from processed foods or from fast-food menus will have a great health benefit. In fact, some evidence suggests government guidelines on salt may actually be small enough to be detrimental to the human body. Each of our bodies reacts differently to the substance, and it has plenty of health benefits, just as other formerly crucified food staples do— eggs, fat, and butter to name a few.


Despite a rising chorus of skepticism about federal salt guidelines, the federal government—big, slow animal that it is, with a bias toward regulation— will likely not be loosening its recommendations anytime soon.

“There is no longer any valid basis for the current salt guidelines,” said Andrew Mente, a professor at McMaster University in Ontario and one of the researchers involved in a major study published last year by the New England Journal of Medicine. “So why are we still scaring people about salt?”

But the debate over dietary salt is among the most contentious in the field of nutrition, and other scientists, including the leadership of the American Heart Association, continue to support the decades-old warning.

The result is that as the federal government prepares its influential Dietary Guidelines for 2015, bureaucrats confront a quandary: They must either retract one of their oldest dietary commandments – or overlook these prominent new doubts.

The federal government’s recommendations, of course, influence far too many things for my taste, as the Washington Post catalogs— school lunches, menus, dietary advice. Unfortunately, that means when they’re wrong, the damage can be serious. For instance, it’s becoming more understood that the confluence of government fat-demonization coupled with nutritionists’ and food producers’ willingness to adopt it, and the media’s longtime bias in favor of over-extrapolating study findings to write many a panic piece may have inadvertently led to all of us getting…fatter. As soon as fat was removed from foods, they began to taste bad, which meant they needed to be stuffed with sugar and carbs to be palatable. The government assured us those carbs should most definitely be the basis of your diet if you’d like to stay slim and healthy. Oops. Writing in 2002 for the NYT, long before this notion had become as mainstream as it has now, Gary Taubes put his finger on it:


The perversity of this alternative hypothesis is that it identifies the cause of obesity as precisely those refined carbohydrates at the base of the famous Food Guide Pyramid — the pasta, rice and bread — that we are told should be the staple of our healthy low-fat diet, and then on the sugar or corn syrup in the soft drinks, fruit juices and sports drinks that we have taken to consuming in quantity if for no other reason than that they are fat free and so appear intrinsically healthy. While the low-fat-is-good-health dogma represents reality as we have come to know it, and the government has spent hundreds of millions of dollars in research trying to prove its worth, the low-carbohydrate message has been relegated to the realm of unscientific fantasy.

Over the past five years, however, there has been a subtle shift in the scientific consensus. It used to be that even considering the possibility of the alternative hypothesis, let alone researching it, was tantamount to quackery by association. Now a small but growing minority of establishment researchers have come to take seriously what the low-carb-diet doctors have been saying all along.

Still, 13 years later, the government’s heavy-handed recommendations and regulations have been slow to catch up to science on these fronts. It takes a long time to turn a giant ship. Perhaps the ship shouldn’t have so much power.


The salt news is similarly not exactly new. It’s just that the government and prevailing notions as hardened as our arteries have a hard time changing. A couple of years ago, the Institute of Medicine of the National Academies did a survey at CDC request of available research on salt and found it wanting evidence to support for our current restrictions. Kevin Glass wrote at the time:

The findings won’t be welcome to food paternalists. Many of the studies linking decreased salt consumption with better health outcomes aren’t up to par. “Overall,” the report reads, “the committee found both the quantity and quality of relevant studies to be less than optimal.”

Many of these studies were conducted on populations around the world that bear little resemblance to Americans. The American diet, for example, is actually relatively low in salt compared with others. It’s entirely possible that the amount of salt in the average American’s diet carries no adverse health outcomes with it. Indeed, on studies that are relevant to Americans, there’s little evidence to support FDA regulations that would limit salt in our food.

“The evidence from studies on direct health outcomes is inconsistent and insufficient to conclude that lowering sodium intakes below 2,300 mg per day either increases or decreases risk of CVD outcomes (including stroke and CVD [cardiovascular disease] mortality) or all-cause mortality in the general U.S. population.”

So no relationship between lowering salt in the American diet and health outcomes. What about at-risk populations? This time, the committee found “no evidence for benefit and some evidence of risk of adverse health outcomes” for “disease-specific population subgroups.”

This is a strong rebuke to the CDC’s current guidelines and the progressive hysteria surrounding salt.


And, the harm done by such widespread adoption of draconian recommendations isn’t just anecdotal. Back to the Washington Post, which also quotes the originators of salt studies used to make dietary guidelines who say they were never meant to be interpreted in that way:

Then, this past August, the New England Journal of Medicine published the results of a massive research effort known as the PURE study. It indicated that people who conform to the U.S. recommended limits actually have more heart trouble.

To explain their findings, these researchers pointed to studies suggesting that low sodium may stimulate the production of renin, a hormone that may have harmful effects on blood vessels.

While food studies are often financed by the industry, the PURE study in the New England Journal of Medicine and the Institute of Medicine study were funded by governmental and other sources.

Oops. So, maybe the government will abandon regulate-first-ask-questions-later approach until this is straightened out. Nah.

Many experts expect that the 2015 Dietary Guidelines will stick to the existing 2,300 milligram limit.

Already, the 15-member advisory panel in February recommended keeping the limit, though it withdrew support for the even stricter 1,500 milligram limit for African Americans and people over 50. It further called for measures to remove salt from American foods.

Cheryl Anderson, a nutrition expert at the University of California at San Diego who led the advisory panel’s sodium working group, said the government should continue to offer salt guidelines despite some of the recent findings that have called them into question.


Front image photo credit: Dubravko Sorić on Flickr

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