Health group urges less salt in foods

May 21, 1996

Study questions need for low-salt diets
CHICAGO - Challenging the conventional wisdom among doctors and government experts, a study found that healthy people and even some patients with high blood pressure gain little from lowering the salt in their diet.

From bacon to peanut butter, low-salt products abound at the supermarket, aimed at health-conscious shoppers trying to avoid high blood pressure.

But the report by Canadian researchers concludes that while a salt-restricted diet can lower blood pressure in hypertension patients over age 45, it has little or no benefit among younger hypertension patients and those with normal blood pressure.

The analysis of 56 previous studies was paid for in part by the Campbell Soup Co., which has been criticized by the U.S. government and interest groups for touting the health benefits of its salt-laden soups.

The report appears in Wednesday's Journal of the American Medical Association. This week's issue focuses solely on high blood pressure, which afflicts some 50 million Americans. It includes a study underscoring the link between high blood pressure and heart disease, and one emphasizing the effectiveness of diet, exercise and drugs in treating hypertension.

In an accompanying editorial, Dr. Claude Lenfant, director of the National Heart, Lung and Blood Institute, challenged the Canadian report because it includes several studies of less than two weeks' duration - not enough time, he said, for a salt-hypertension relationship to show up.

"The preponderance of evidence continues to indicate that modest reduction of sodium, as recommended in the 1995 U.S. Dietary Guidelines for Americans, would improve public health," Lenfant wrote.

Prompted by research linking high-sodium diets with high blood pressure, the U.S. government has been warning all Americans since the early 1980s to go easy on salt. The recommended daily allowance is 2,400 milligrams, though the average daily consumption is about 3,900.

The Canadian report is "truly important ... because many bureaucratic organizations have been advising the whole population of America not to eat salt," said Dr. John Laragh, director of the cardiovascular and hypertension center at New York Hospital-Cornell Medical Center.

"They make low-salt everything. ... They charge more for it ... The implication is that this is good for your health," Laragh said. The new analysis shows "that is an exaggeration, to put it mildly," he said.

Dr. Alexander Logan, an epidemiologist and co-author of the report by University of Toronto researchers, acknowledged that most hypertension sufferers may benefit from a low-salt diet since most are older than 45.

But he and his colleagues argued that advising everyone to lower their salt intake is unnecessary and even risky. One recent study found that some hypertensive men on such diets run a higher risk of a heart attack; another suggested that blood pressure could rise in people without hypertension who severely restrict their salt intake.

Though the last major review on the subject - a 1991 analysis by epidemiologist Jeffrey Cutler of the National Heart, Lung and Blood Institute - supported the salt-hypertension link, there's been an explosion of conflicting information since then, Logan said.

Logan said Campbell's funding did not influence the report's conclusions, though he acknowledged that he sought the company's support, knowing it would find him "an attractive candidate" given his previous research exonerating salt.

By The Associated Press

PHILADELPHIA (AP) — The nation's largest public health group is recommending a 50% decrease in salt in processed food and restaurant meals over the next 10 years.

[We’re a bunch of well meaning, interfering, busybodies who are about to tell you how to live your life and run your businesses. Of course we’ll be backing it all up with some lovely statistics. Here there come!]

The American Public Health Association said the reduction could save 150,000 lives a year from strokes, heart attacks and other illnesses linked to high blood pressure.

[See, it’s for your own good. What could be wrong with that?]

Government guidelines already recommend limiting intake of sodium — which increases blood pressure — to no more than 2.4 grams daily, or the equivalent of about a teaspoon of table salt. But the average American adult consumes nearly 4 grams a day, according to the association.

[Our advice is already backed up by a bunch of official, interfering, busybodies so you know we’re doing this for your own good. What could be wrong with that?]

A resolution passed Tuesday at the health association's annual meeting in Philadelphia urges a collaboration with food manufacturers to meet the goal.

[People who make the food should have to make it the way we say. That’s only fair and it’s for the benefit of everyone. What could be wrong with that?]

"Americans are consuming an ever-increasing amount of processed foods high in sodium at home, at work, at school and in restaurants," said Dr. Stephen Havas, the lead author of the new policy. "The excess sodium in these foods is unnecessary and leads to a large, preventable toll of hypertension, premature death and disability."

[Your children are being poisoned at school as well. We want to do what’s best for the children. What could be wrong with that?]

About 50 million U.S. adults have high blood pressure, or hypertension. About 710,000 die annually from heart disease and more than 166,000 die of stroke, according to government statistics.

[Still not convinced? Have some more statistics. These are from the Government so there’s no need to question them. It’s for the common good. What could be wrong with that?]

"Appealing to individuals as well as to industry to take simple but effective steps to limit sodium in our diets will yield measurable results in lowering Americans' risk for cardiovascular diseases and related conditions," said Dr. Claude Lenfant, director of the National Heart, Lung and Blood Institute.

[Now if you’d just listen to us we’d all be a lot better off. What could be wrong with that?]

Alison Kretser, director of scientific and nutrition policy for the Grocery Manufacturers of America, said the policy should have had a broader focus. A diet rich in fruits, vegetables and dairy products could also help lower blood pressure, she said.

[Of course sodium would be just the start of this since we’d eventually have to control all parts of your diet so we could make sure you stayed healthy. What could be wrong with that?]

"My concern is that just reducing the sodium levels in diets becomes very unpalatable," she said. "People may potentially feel discouraged and deprived."

[OK so everyone needs sodium in their diet in order to live and the food you’d be forced to eat might not taste too good and the food you would like to buy is no longer available, but you would be healthy and what could be wrong with that?]

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