Dietary Guidelines: With a Grain of Big Salt

Hi Mike,

A few things. Can you furnish your readers with any reference to the actual clinical evidence used to substantiate the recommendation of 1,500 mg sodium per day? Even one will do.

You mention that 92,000 lives a year would be saved if we consumed sodium at the Dietary Guidelines recommended levels – is that from clinical evidence or from a speculative model based on debatable assumptions such as the defunct Rose population strategy?

You sound like you have had considerable hands-on experience in the food industry – did you?

Speaking about transfats, New York instituted an absolute ban on transfats in December 2006. Can you tell me with your untrammeled view of nutrition what has been the positive health outcomes for new Yorkers – better cholesterol profiles, reduced cardiovascular disease, reduced mortality – what? (And please, don’t get into “it’s multifactorial, so we can’t really tell” argument.) For years the NYC Health Dept promised to run the numbers since the ban – but five years on and I’ve heard nothing other than myth-informers continuing to make assumptions without data. Have you seen any results?

And finally, since I am with the Salt Institute, you and your followers may believe that you have dedicated your career and accomplished more for consumers than I have – you know, highly nutritious food products, publications on nutrition, food safety and food poisoning, etc., etc. Would you be willing to make a public comparison of such accomplishment? I feel obliged to do this because you give the impression that our motives are driven uniquely by the wish to sell more salt. I would like to convey the dedication we have to informing the consumers of all the credible peer-reviewed science cautioning against the current salt recommendations. And don’t use the names of our great institutions as a substitute for actual evidence. It’s easy to go along with the establishment – but unchallenged recommendations such as those for hormone replacement therapy are the sort of disaster that can happen. People can eat as much or as little salt as they want, but they should do so from a point of fact and knowledge, not of myth and ignorance.

Morton Satin
Salt Institute

The Intersalt study demonstrated that average sodium (not salt, DrDons) consumption around the world ranges from 120 – 210 mmols or 2,760 – 4,830 mg per day. This is nowhere near the recommended 1,500 mg Na/day. In fact, when life expectancy is charted against sodium consumption around the world, it is clear that the more salt consumed, the longer the life expectancy. While no cause and effect relationship between sodium intake and lifespan is implied, the data does demonstrate the compatibility between life expectancy and the associated high levels of sodium intake. On the other hand, the four low-salt outliers in the Intersalt study (who consumed 500- 1,400 mg Na/day) all have life expectancies of less than 50 years.

With reference to special interests, we cannot ignore two very important conflicts of interest – intellectual passion and institutional arrogance. I am certain that there are many individuals in this debate that believe that their ‘mission’ is so altruistic and important that minor exaggerations or omissions are allowable – the ends justify the means. Sorry, that is just not on – opinions don’t count, only evidence will do and when it is not available, then we are obliged to everything to get it.

Some well known institutions and agencies believe that their word cannot be challenged – well, even the might and reputation of the Holy Roman Empire was unable to make the sun revolve around the earth for Gallileo. And so it will be for the IOM and the FDA. It is evidence, not institutional fiat that will describe the effect of salt on heath.

Get over blood pressure and start considering total health outcomes – if not, we risk repeating the tragedy of the establishment recommendations for hormone replacement therapy.