Weekend Reading: Salt Wars!

Michael F.  Jacobson.  Salt Wars: The Battle Over the Biggest Killer in the American Diet.  MIT Press, 2020.

Michael Jacobson was one of the founders of the Center for Science in the Public Interest, which he directed for more than 40 years.

His book comes with an introduction by Tom Frieden, former head of New York City’s Health Department and Director of the CDC.

I wrote a blurb for it:

Public health authorities advise eating less salt as a way to prevent high blood pressure, but a few scientists disagree. For anyone confused by these arguments, Salt Wars is a must read.  Michael Jacobson has been fighting these wars for decades, and his assessment of the research on both sides—and the policy implications–is exceptionally fair, balanced, and fascinating.

Here are a few excerpts:

• One reason that the debate has been so vigorous is that most journalists treat new reports supporting the conventional view on salt with a yawn.  Dog bites man?  Big deal.  What does capture the attention of journalists and headline writers are the man-bites-dog reports—those suggesting that eating less salt would be harmful—especially when they are conducted by credentialed researchers at prominent universities and published in respected journals…The poor consumer, lacking an advanced degree in epidemiology or nutrition, can get dizzy trying to follow the arcane biomedical and statistical jousting (p. xvi).
• I was sorely disappointed that the FDA was not setting mandatory maximum sodium levels.  Such limits for all foods in a category…have at least three advantages over a voluntary approach.  First, they would have teeth and ensure that all companies actually trimmed sodium in their saltiest products.  Second, the FDA could easily enforce them.  And third, they would provide a level playing field…I have since been persuaded that the voluntary approach was inevitable (p. 139).
• The process to propose sodium reductions was frustratingly slow, but there was no villain or cabal that sought to undermine the FDA’s effort to lower sodium consumption.  Rather, it was a case of how the Washington policy-making apparatus works when it comes to anything that is complicated, controversial, and consequential…It took the administration so long to propose the guidelines that there was no time to finalize them and the matter has languished for four years  (p. 143).