by Marion Nestle

Currently browsing posts about: Salt

Nov 25 2009

The latest on too much salt

The British Medical Journal has a new meta-analysis of 13 studies of the health effects of high salt intake.  Its conclusion:

High salt intake is associated with significantly increased risk of stroke and total cardiovascular disease. Because of imprecision in measurement of salt intake, these effect sizes are likely to be underestimated. These results support the role of a substantial population reduction in salt intake for the prevention of cardiovascular disease.

In commentary, the authors insist that regulation is needed.  The effects of salt are large:

a 5 g reduction in salt intake at the population is associated with a 23 per cent difference in stroke rates, and a 17 per cent difference in total cardiovascular disease….eating less salt could avert 1.25 million deaths from stroke and almost 3m deaths from cardiovascular disease – and these projections are…conservative because of imprecision in assessing salt intake.

Why regulation?  Because nearly 80% of salt enters the diet through processed and pre-prepared foods.  The rest is about equally divided between naturally occurring salt in foods and salt added at the table.   To reduce salt, food manufacturers and restaurants need to cut down, and all of them have to do it.

This is because the taste for salt depends on how much is eaten.  On a low salt diet, even lightly salted foods taste salty.  But if you are used to eating a lot of salt, it takes even more to taste salty.  So the object needs to be to reduce salt in the diet across the board.

I’m hearing a lot these days about how federal agencies are getting interested in the salt issue.  Stay tuned on this one.

And have a safe, healthy, delicious, and lightly salted thanksgiving!

Oct 22 2009

Much to-do and to do about salt

It is one of the great oddities of nutrition that public health guidelines invariably recommend salt reduction but the science is so hard to do that the value of doing so can’t be proven unequivocally.  Hypertension specialists insist that salt reduction is essential for controlling high blood pressure, and many people with high blood pressure can demonstrate that this is true.

So why can’t the science show it?  I’d say because even the lowest salt intakes are higher than recommended.  Because everyone consumes higher-than-recommended amounts, it’s impossible to divide people into meaningful groups of salt eaters and see whether low-salt diets work.

With that said, here are the latest events in the salt wars:

1.  An article by a group of investigators in California and Washington state, “Can dietary sodium be modified by public policy,” argues that it makes no difference who you are, everybody consumes salt in the same range.  Therefore, there is no point in trying to lower it.

2.  Not so, say critics, who point out that the authors of that study consult with the food and salt industries (and, therefore, have conscious or unconscious biases) and that plenty of evidence demonstrates the value of salt reduction.

3.  ConAgra says it will cut the salt in its products by 20% in the next few years, according to an article in Bloomberg News (in which I am quoted).  Why is ConAgra doing this? To lower the salt before the company is forced to.  Regulators are well aware that nearly 80% of the salt in American diets comes from processed and pre-prepared foods, not salt shakers.

Expect to hear lots more about the need to reduce salt intake this year.

Sep 28 2009

The cost of obesity (and fixing it)

I don’t usually take estimates of the cost of bad diets and obesity too seriously because they are necessarily based on multiple assumptions, none of them verifiable.  But I do like to collect them.  Here are two papers from the American Journal of Health Promotion estimating such costs.  One estimates the health benefits and savings in medical costs from diets reduced in saturated fat, sodium, and calories (a savings of $60-120 billion), and the other estimates cost savings and productivity increases for reduction in calories and sodium ($109-256 billion).  Whatever the real savings are, they are likely to be enormous.  And that’s just money.  It’s harder to put a value on quality of life.  Maybe that’s all we need to know at this point.

Yale’s Rudd Center for Food Policy has invented a Revenue Calculator for Soft Drink Taxes for estimating the amounts of money states and cities could raise from taxes on soft drinks.  You type in the state or city, estimate the size of the tax, decide what kinds of drinks it’s for, and push the  button.  Bingo.  California could raise about $1.8 billion a year from a 1 cent tax.

And the Department of Health and Human Service has hooked up with the Advertising Council for a new kids’ activity campaign on the Internet, this one using Maurice Sendak’s Wild Things tied in to a movie coming out in October.  I wasn’t so happy about the last such campaign, which featured Shrek and is still up on the site.  Shrek also advertises junk foods.  Maybe this one will work better?

Sep 10 2009

Cereal makers object to anti-salt ads in U.K.

The British Food Standards Agency is about to take on the high amount of salt in processed foods.  Leading cereal makers are not happy about this.   They don’t the think the campaign is appropriate because cereals account for “only” 5% of the salt in British diets.  Salt reduction is the new frontier of concerns about health.  Expect to hear lots more about how much of it is in processed and restaurant foods this year.

Jul 24 2009

CSPI sues Denny’s over salt

Center for Science in the Public Interest has just sued Denny’s for failing to disclose the amount of salt in its fast foods.  I heard about this from a reporter from Nation’s Restaurant News who thought the suit was absurd.  Everyone knows Denny’s food isn’t healthy, she suggested.  Maybe, but I had no idea how much salt the foods contained, and I’m supposed to know such things.

The figures that follow refer to the sodium content.  Sodium is 40% of salt (the other 60% is chloride) so 4,000 mg sodium is equivalent to 10,000 mg salt (10 grams).  The standard recommendation for healthy people is 2,300 mg sodium per day.  People with hypertension are supposed to restrict sodium to 1,500 mg.  With that said, try these examples and remember, this is sodium:

  • 2,580 mg   Moons Over My Hammy sandwich  (ham, egg, cheese)
  • 4,120 mg  Spicy Buffalo Chicken Melt with regular fries
  • 5,690 mg  Meat Lover’s Scramble (eggs, bacon, sausage, bacon)

I see this as a flat-out issue of consumer choice.  If people want more salt, they can always add it at the table, but those of us want less salt don’t have a choice at all.  We are stuck with what is served to us and if we don’t know how much salt the food contains (and taste isn’t necessarily a reliable indicator of amount), we have no choice about the amount we are eating.

Litigation is not my favorite public health strategy but in this situation it seems like the only current option.  Voluntary salt reduction isn’t happening across the board, the FDA is up to its ears in food safety problems, so there is a huge vacuum waiting to be filled.  I will be interested to see what happens with this suit, and I’m not as convinced as the Nations Restaurant News reporter that it will be so easy to dismiss out of hand.

Later addition: I’ve just seen this from the industry-sponsored American Council on Science and Health, which thinks the CSPI lawsuit frivolous, to say the least:  “Maybe [CSPI’s] Michael Jacobson doesn’t want the public to have the choice of what he considers unhealthy food.”  That says it all!

May 16 2009

Weekend fun: dog food vs. pâté (and the winner is?)

I’ll bet that a study published by the American Association of Wine Economists will be a top candidate for this year’s IgNobel Prize (the prize given for “research that makes you laugh and then think”).  Investigators somehow convinced a bunch of volunteers to undergo a blind taste test of liver pâtés and dog food.  Participants knew that one of the samples was dog food, but not which one.  They gave the dog food the lowest marks on taste, but only 17% identified it as dog food.  Everyone else thought it was just bad pâté.  This must say something about the average American palate, alas.  To address that question, Stephen Colbert  did his own taste trial on camera.  Too salty, he says.  Indeed.

Jan 25 2009

Oops: San Francisco Chronicle columns

I seem to have missed posting a couple of columns from the San Francisco Chronicle:

January 6, 2009:  This one, “ Fussy eaters–they learn by example,” was in response to a question about getting kids to eat real food.

December 17, 2008:  I had so many responses to the November 17 column on salt intake I answered a bunch of follow-up questions in the next one, “The nitty-gritty on sodium intake.”

Dec 17 2008

Bookkeeping: End-of-year columns

I have an op-ed (about the FDA’s handling of melamine in U.S. infant formula) and a Food Matters column (answering questions about salt) in the San Francisco Chronicle this week, and a response to a question from Eating Liberally about Governor Paterson’s proposed tax on soft drinks.  Enjoy!

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