Diet Debate Obscures Truths About Salt Intake

At many large, national health meetings you will see an almost comical presence of representatives from the salt industry. They are there to promote the virtues of salt, and they have their little pamphlets and booths set up next to the milk people, the American Heart Association, and the myriad veterans of the scientific conference scene.

But the salt industry is nervous these days. The FDA announced in April a plan to reduce the amount of sodium in restaurant and processed foods gradually over the next decade.

The reason is that the FDA, along with most public health experts and the Institute of Medicine — comprising the most lauded biomedical researchers and doctors in the United States — are alarmed that most Americans consume two to five times the amount of sodium they need each day. They argue that reducing dietary sodium can save 150,000 lives per year, largely by preempting high blood pressure, or hypertension.

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A counter argument is shared, not surprisingly, by the salt industry, most food manufacturers, and a sprinkling of admittedly earnest biomedical researchers and epidemiologists.

This counter argument, which many of the mainstream media outlets have bought into, is that reducing sodium at a population level to stave off hypertension is a risky experiment lacking scientific merit. A parallel and even more popular counter argument is that government experts are food Nazis out to control our lives.

Sure, we need salt, which contains sodium, an essential mineral. But we don't need more than 1,500 milligrams a day. Most of us consume 3,000 to 8,000 milligrams daily. It's a sad joke that the food industry is fighting efforts to curb salt.

When it rains it pours

Most consumers have little idea how much sodium they consume and how this is irrefutably linked to high blood pressure, stroke and cardiovascular disease — and likely linked to ulcers and heartburn.

The daily recommended allowance for sodium often is stated at 2,300 milligrams. But that level is for about a dozen or so Americans. The real level for the rest of us — all children, all African Americans, all adults over age 40, and anyone with high blood pressure — is 1,500 milligrams.

Food labels go by the higher level, of course, and you can easily be deceived. Consider how Campbell's Condensed Chicken Noodle Soup has 890 milligrams per serving, which the company calculates to be 37 percent of the daily allowance for sodium. This seems marginally acceptable, one of three meals providing a third of the sodium limit. But the math is fuzzy.

First, recalculate for the real level of 1,500 milligrams. That's 60 percent of your daily sodium — per serving, which is 8 ounces (half of which is water). The 10.75-ounce can plus water makes about 2.5 servings with about 2,300 milligrams of sodium, or 150 percent of your daily limit.

If you add Saltines, well, forget it. That's another 40 milligrams of sodium per cracker.

Dining out is usually far worse, where meals — and particularly fast-food meals — often contain 5,000 or more milligrams of sodium.

Changes to come

The salt is there because the food would otherwise taste bad. Processed food is a science project made in a laboratory, not real food made in a kitchen. The salt compensates for the blandness of cheap food that's not ripe.

Also, various chemicals added to preserve shelf life, crispiness, texture integrity when frozen and defrosted, or the many other problems inherent in creating food in a factory that won't reach consumers for weeks or months.

So what's a company to do? You can see how this board meeting will unfold: Some gruff and embattled CEO will stand before the board, slam his fist on the table, and demand answers for how they can reduce the amount of salt in their processed foods and still have them taste good. Some young visionary will stand up and say, "I know, why don't we use only the freshest ingredients and get up early every day to cook and deliver our food to local supermarkets."

The visionary promptly will be fired, and the discussion will turn to finding a chemical that can replace salt.

What you can do, whenever possible, is cook for yourself with whole foods so that you can control the level of sodium. There are various tricks, too, like using sea salt or sea products such as seaweeds that contain more of a salty taste with less sodium.

A dash of truth

While less nefarious than the corn and sugar industries, with their sunny ad campaigns promoting the natural goodness of these sweeteners, the salt industry is nonetheless trying to redirect the argument.

When experts say there is no proof that reducing sodium levels would reduce hypertension nationwide and subsequently reduce strokes and heart attacks, they are correct. There's no proof, because such a suicidal study to confirm this — placing a large group of healthy adults on a high-salt diet and comparing them with a group on a low-salt diet — would never be approved by an institutional review board, or IRB, a committee that assures human studies aren't exceedingly dangerous.

Instead we have studies such as that published in February 2010 in the New England Journal of Medicine, which found that reducing dietary sodium by 1,200 milligrams per day would reduce the annual number of new cases of heart disease by 60,000 to 120,000, stroke by 32,000 to 66,000, and heart attacks by 54,000 to 99,000. This analysis is based on studies showing the benefits of placing those with high blood pressure on a low-salt diet.

Billions would be saved in health care costs, too. If food industry magnates are worried about the rising cost of food manufacturing by lowering sodium, surely they would be pleased that hundreds of thousands of people will still be alive to buy their healthier products.

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Christopher Wanjek is the author of the books "Bad Medicine" and "Food At Work." His column, Bad Medicine, appears each Tuesday on LiveScience.