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War Declared on "War on Salt"

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Last week, writes Melinda Wenner Moyer of Scientific American, "a meta-analysis of seven studies involving a total of 6,250 subjects in the American Journal of Hypertension found no strong evidence that cutting salt intake reduces the risk for heart attacks, strokes or death in people with normal or high blood pressure."

Wenner Moyer asserts that "the correlation between salt intake and poor health has remained tenuous" over the years, pointing out that "for every study that suggests that salt is unhealthy, another does not."

We've been told to reduce our sodium consumption in no uncertain terms:

And companies that make the things that go in, around, or near our mouths -- Heinz, Starbucks, Kraft, Unilever, and many others -- agreed to reduce sodium levels in their foods by 25% over five years. And, perhaps most visibly, Walmart has begun an initiative in concert with the White House to cut the sodium in its packaged foods by 25%.

At the time, Reuters reported that "US researchers found recently that cutting salt intake by nearly 10 percent could prevent hundreds of thousands of heart attacks and strokes over several decades and save the United States $32 billion in healthcare costs."

"It's tough to nail these associations," Lawrence Appel, an epidemiologist at Johns Hopkins University and the chair of the salt committee for the 2010 Dietary Guidelines for Americans, tells Wenner Moyer.

She notes:

One oft-cited 1987 study published in the Journal of Chronic Diseases reported that the number of people who experience drops in blood pressure after eating high-salt diets almost equals the number who experience blood pressure spikes; many stay exactly the same. That is because "the human kidney is made, by design, to vary the accretion of salt based on the amount you take in," explains Michael Alderman, an epidemiologist at the Albert Einstein College of Medicine and former president of the International Society of Hypertension.

Recently, we spoke with Morton Satin, Vice President of Science and Research at the Salt Institute, the North American trade association for, as the name suggests, the salt industry.

“As an industry, we’re really pretty sanguine about [the anti-salt movement],” Satin said.

Satin maintained that “human physiology answers to a much higher authority than dietary guidelines put out by the government,” and that the body has an “innate salt appetite,” which ensures consumption will never drop below a certain level.

“We have biological functions to handle salt. Salt is an essential nutrient, and will always be used in a certain amount,” Satin said. “The data shows that the entire world -- and that’s every single country -- consumes salt within a very narrow range, somewhere between eight and twelve grams per day. What the new dietary guidelines are recommending is for 50% of the US population to go down to four grams and for the other 50% to go down six grams. That’s lower than anywhere else in the world and lower than any other time in recorded history, and we’re going to be the guinea pigs in a 300 million-person clinical trial.”

Table salt is also an effective delivery system for iodine, the absence of which can be catastrophic.

“Everybody talks about eradicating polio and the space program, while most people don’t know that iodized salt was one of the greatest triumphs of the 20th century,” Satin said. “Iodized salt has been key in reducing mental retardation in children. The fact is, if we hadn’t added iodine to salt back in 1924, we may never have had the intellect to get to the moon.”

Satin also pointed out that, “as salt levels in food go down, the usage of table salt goes up.”

“When you want to fatten an animal, you cut down the salt. They keep eating and eating; they’re never satisfied. With human beings, if you cut the salt too much, you’ll end up exacerbating the obesity problem,” he said.

In a post on the Salt Institute’s website, Satin offered this example:

When we cut the nicotine out of cigarettes, people smoked far more; when we cut the sugar out of soft drinks, people swilled tons more low-cal beverages; when we cut the fat out of foods, people gorged themselves on low-fat, no-fat foods to such an extent, they ushered in the current obesity epidemic.

Satin also said salt intake cannot be reduced purely by market forces, as happened in the 1950s.

“The big reduction came after the end of World War II, when we almost halved our salt consumption,” he explained. “That came about because of refrigeration. Nobody was forced to drop salt, but salt was no longer the only method of food preservation.”

Subway corporate dietician Lanette Kovachi told restaurant-business publication that part of the challenge in reducing sodium has to do with the natural processes that occur during preparation -- bread requires salt to limit yeast development, and the proteins in cured meats would quickly go rancid without salt. And a Starbucks spokesperson said the primary source of sodium in its beverages comes from that which occurs naturally in dairy products.

“People say, ‘Well, you’re from the Salt Institute, why should we believe you? You’re just an industry stooge,’” Satin concluded. “But Walter Willett out of Harvard University, arguably the most famous nutritionist in the country, came out with a study that showed salt consumption has remained flat for the past four, four-and-a-half decades, while hypertension and heart disease have gone up. Why?”
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