No bitter battle over salt science

Related tags Salt Sodium chloride

Excess salt can cause hypertension, heart disease, death. That’s the scientific consensus behind public health campaigns to reduce consumption of sodium chloride in the diet. But not everyone reads the science as conclusive, and when it comes to minerals that are essential to human life, the voice of caution must not be drowned out.

Concern over the impact of too much salt weighs heavy on governments, pushing them towards costly public health campaigns. Around the world, salt awareness-raising from the top down is being met by bottom-up action from food manufacturers, who are deeply engrossed in reformulation to reduce the salt in their products.

Bit-by-bit, excess salt is being squeezed out by a combination of education and choice-editing.

But not everyone is convinced salt is all that bad.

Whoa, hang on. That’s a bit of a bombshell. Surely we know this by now? Just last week scientists said 3 grams less salt a day would save 92,000 deaths a year – and $24 billion in health care costs.

Indeed they did. But in the other corner is the salt industry – EU Salt, and the US Salt Institute. They don’t see consensus in the science on salt, as some studies have not found cause for alarm. Rather, regular assessment of intervention outcomes is needed, and a close eye on emerging evidence.

Pah. The salt lobby. Those guys make a living out of pushing sodium chloride, right? Their pockets are lined with the stuff. Remember big tobacco used to tell people that smoking was good for their health?

Sure, it’s important to remember who is behind every message, and what their vested interests could be. History tells us messages can be twisted for personal gain.

But it’s also important to remember that, unlike tobacco, the optimal amount of salt for health is not zero. Humans need some salt to survive. The sodium balances our water and pH levels, and ensures transmission of nerve impulses; chloride helps fight infection, helps digestion and the absorption of potassium, and helps carry carbon dioxide to the lungs.

Salt is not a black and white issue, nor is science always squeaky clean and irrefutable; and some people who work for big companies are actually good guys who would rather you didn’t die prematurely.

It’s not just salt producers who are wary of the demonisation of salt, either. Last week FoodNavigator received feedback from a respected journalist colleague who reached the conclusion, after wading through 140 studies on salt (more than I have, I’ll admit), that the evidence for harm caused by excess salt is not irrefutable.

He believes scientists are caught up in the tide of bidding farewell to salt, and losing all objectivity on the subject, he believes.

Ellie Krieger, dietician and best-selling author, suggests in her So Easy​ book that people might want to add salt to low-salt foods to improve the taste – although she says the final level would still be below what the food industry would have added, she reckons.

So where do we go from here?

Humans have always eaten salt; it’s the earliest form of food preservation, and without it many billions would have starved or perished from eating rotten meat.

But we do eat more salt today than ever before.

This week is Salt Awareness week. Raising awareness of the current science is a good thing. It’s devilishly difficult to make processed and packaged foods without adding salt, but efforts to reduce levels on the basis of current science are to be lauded too.

Another goal should be to raise awareness of where there is a lack of consensus. There's no need for the pro- and anti-salt lobbies to be at loggerheads.

Jess Halliday is editor of award-winning website Over the past twelve years she has worked in print, broadcast and online media in both Europe and the United States.

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Salt is not salt

Posted by Hans Ludwig,

What people eat is Sodium Chloride, which IS bad for the body, as is refined sugar.
But real unrefined SALT, like the one from the Himalaya with proven 84 elements, is in fact the stuff the body needs.
There are many reports that it actually LOWERS blood pressure, because the body gets all the 84 elements it needs and not just 2 (and take the others from our organism to puffer Sodium and Chloride).

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Facts and wild opinions

Posted by Morton Satin,

I find Margaret Wilde’s comments rather instructive. She states that facts rather than opinions are necessary and immediately follows with her own biased opinion of the Salt Institute’s material All this without ever providing a single example or ‘fact’ to back up her assertion. Her entire intervention should be re-read so that readers can see the sort of 'facts' driving this issue.

Any population-wide intervention such as salt-reduction is a very serious matter. You cannot trifle with an entire population’s diet unless everyone agrees that no harm can be done. This is not the case here. The population-wide response to salt reduction is heterogeneous with about 30% of the population (salt-sensitive hypertensives) showing a very small decrease in blood pressure of 2-6mm Hg; another 20-25% of the population show a small RISE in blood pressure and the remaining 50% showing no blood pressure response. So, such an intervention will be an exercise in discrimination. Margaret and anyone else can get the peer-reviewed references describing this phenomenon on the Salt Institute’s website.

It has been repeatedly demonstrated that reductions in salt intakes stimulate the renin-angiotensin-aldosterone system. This increased RAAS activity can cause a cascade of morbidity effects which some authors believe may explain the observed higher incidence of mortality in heart failure patients placed in lower salt diets. Again all these peer-reviewed references can be found on the Salt Institute website.

Since Margaret likes facts, here are a few:

1) The CDC data shows that our cardiovascular disease death rates have plummeted in the last 30 years, without any reduction in salt intake.
2) The world’s most productive and longest lived populations are those that consume the most salt (e.g. Japan, Switzerland, etc.).
3) The world’s lowest salt consumers have the lowest life expectancy (Yanomamo, Xingu, etc.).
4) Residents of the Mediterranean have excellent cardiovascular figures, yet consume very high salt levels (anchovies, olives, capers, salt cod, parmesan, feta, etc.)

Few will dispute that eating a balanced diet, replete with salads and vegetables will go much further in improving overall public health than population-wide salt reduction.

Pursuing an unsubstantiated silver bullet approach to public health is facile and irresponsible and it will be the unsuspecting public that will reap the unintended consequences.

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PS to Dr. Kenney (and Bobbie Hennessy)

Posted by David Feder,

As a post script to my comments, I wish to throw down a gauntlet to Dr.
Kenney: Without addressing the fact that no PhD worth his salt (sorry) should have such a closed mind ["The scientific evidence linking added salt to hypertension and more cardiovascular disease is overwhelming. I am sure I have read far more articles than this 'respected journalist'...and can tell you anyone who claims that added salt is not a major killer is the one who is not being objective."], and ignoring your uncalled-for personal slam at Gary Taubes, I'd like to know which and how many studies on sodium and health you've read. I lost count of the ones I've read at more than 140. So far, the results (not the conclusions, which all-too-often conflict 180° with actual results -- again, look at DASH II) fail to show any indisputable connection between salt intake in healthy people and increased risk for disease. The data simply aren't there. I am not paid by any salt lobby; I'm a "lowly" ABD and RD, as well as nutrition journalist who did 4 years bench science in a trace minerals lab. But as such, I look at evidence, not emotion. As my father, a multi-degreed physicist and NASA retiree used to say, any true scientist will refrain from making a definitive statement, that even when asked his/her name, will respond, "According to the data we currently have..."
Perhaps you would like to rephrase your position to be more in line with someone who has respect for the evidence basis of true science.

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