Can a New York Bureaucrat Put the Whole Country on a Low-Salt Diet?

Having taken on smoking, trans fats, and calories, New York City Health Commissioner Thomas Frieden is poised for an assault on salt. He wants packaged food producers and restaurant chains to cut the salt content of their products by 25 percent during the next five years and another 25 percent in the five years after that. "If there's not progress in a few years," he warns, "we'll have to consider other options, like legislation."

Since salt is linked to dangerously high blood pressure in only a small subset of the population, Frieden's proposal is the very model of a modern "public health" intervention. It disregards individual preferences and goes over the heads of consumers, treating the population as a collective. To its credit, The New York Times, toward the end of its story about what Frieden ambitiously calls his "national salt-reduction initiative," notes that not everyone thinks it's a good idea:

Beyond the technical hurdles, Dr. Frieden might encounter resistance on scientific grounds. Some medical researchers question whether a mass reduction in sodium is the best way to spend public-health resources when losing weight and quitting cigarettes would do more for the country's heart health.

Genetics dictate that different people have different reactions to sodium. Some people are more sensitive to high levels of salt. For others, low levels of sodium can be unhealthy.

But public health officials say there is a strong consensus that salt leads to higher rates of heart attacks and strokes.

That consensus alarms Dr. Michael Alderman, editor in chief of the American Journal of Hypertension, who thinks more clinical studies need to be done.

In a 2002 review of the research, Alderman, a past president of the American Society of Hypertension, concluded that "existing evidence provides no support for the highly unlikely proposition that a single dietary sodium intake is an appropriate or desirable goal for the entire population." Despite the weakness of the evidence, Alderman noted, the dogma of less salt is still "preached with a fervour usually associated with religious zealotry."

I noted the controversy over low-salt prescriptions in my 2003 Reason story about the Center for Science in the Public Interest, which has been railing against the "deadly white powder," a.k.a. "The Forgotten Killer," since the 1970s. In 2005 CSPI filed a lawsuit aimed at forcing the FDA to stop considering salt an ingredient "generally recognized as safe."

[Thanks to Tricky Vic for the tip.]

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  • Naga Sadow||

    Damn. The bad news is just piling up today.

  • Public Health||

    Salt imparts a pleasant taste to food which leads to overeating.

  • ||

    New York is now the pussiest city in America. I'm so glad I got out when I did.

  • Ardith||

    Jerks. I need extra salt in my diet to keep my blood volume up and keep my heart rate from slipping into tachycardia. Salt's not unhealthy for everybody. I mean, peanuts kill some people, does this mean I should be unable to eat curries with peanuts at the local Thai place anymore?

  • SpongePaul||

    Salt is mostly harmless, for most peole i would venture to say. maybe some etchnic backgrounds take it better. I mean my grandparents put salt on thier salt before they tasted anything. The lived well into thier 80's. my mother and father and family (itialian/french/spanish ancestors, use salt on a daily basis, adding it to things as we cook and go along, added always to taste. i use about a box of salt a month cooking and otherwise. its overall health and moderation, not legeslation that needs to be going on. make your choice, and live with it, it is your life, the gov cant tell you what to eat!

  • ||

    In 2005 CSPI filed a lawsuit aimed at forcing the FDA to stop considering salt an ingredient "generally recognized as safe."

    Well you have to admit that salt hasn't been consumed by humans for long enough to prove its safety.

  • Public Health||

    Most humans who have consumed salt are now dead.
    Coincidence? I say correlation.

  • she-troll||

    Weren't CSPI the guys that lobbied to get everyone to switch to using trans-fats a few years back?
    Yanno on account of yummy butter being sooooo bad for you.

  • Elemenope||

    They can have my salt when they pry it from my cold, dead...it dissolves in water, you say? That makes it so much easier to hide!

  • ||

    Nevermind that salt is used in most foods to maintain freshness. Reducing the salt could reduce the shelf life of lots of foods. So, if the food has to be eaten quicker or get thrown away, guess which one Fat America will do? Bad policy even if no one cared about being told what to do.

    Once, when working in a pizza place in HS, a man came in and asked my boss if he could get a pizza with no salt in it. He was furious when my boss said no. The dough, cheese, and sauce all contained salt as well as all of the meat toppings. Apparently a paper plate covered in green peppers, onions, and mushrooms was not to his satisfaction. He stormed out. People are fucking stupid.

  • she-troll||

    And that note, leave my salt, and my sugar, and my bacon, and my cigarettes, and my coffee alone Mofo's 'cause statistically speaking, I'm going to die in a car crash any day now.

  • ||

    Trials using slugs have shown that even skin contact with moderate amounts of salt is fatal within minutes.

  • Elemenope||

    People are fucking stupid.

    I think it's more along these lines: people have cultivated unreasonable expectations about the world and the choices they possess within it.

    "What do you mean, I can't get it with no salt? I can get anything I want." That's the unspoken driving force behind this sort of tantrum.

  • Reinmoose||

    she-troll

    Butter doesn't have trans fat

  • Reinmoose||

    Nick -
    I think that guy, today, would have brought a lawsuit against your pizza parlor for discrimination or some bullshit.

    Elemenope's right. People's expectations about how other people should make good choices for them are hyperinflated right now. And this one-size-fits-all approach to health policy is ridiculously naive.

  • BakedPenguin||

    Not just naive, but counter productive. Unless they're going to outlaw salt in general, people are just going to start adding it after cooking.

    And they'll probably put on 50% more than was originally in the package.

  • she-troll||

    Reinmoose,

    of course butter doesn't have trans-fat. CSPI wanted to ban butter and lard at the time and replace them with margarine (trans-fat) and other hydrogenated vegetable oils (trans-fat).
    Roll some years on, and then it comes to light that the supposed "healthy" replacement for the "Evil" butter was actually way WORSE. Basically I'm saying CSPI sucks and doesn't know shit from shinola.

  • MattXIV||

    The adult prevalance rate for hypertension ("blood pressure >140/90 mm Hg or taking antihypertensive medications") is probably around 29.3% (the study is from 2004 data) and concentrated heavily in the 40+ population (the prevalance below 40 is around 7%); it's largely a disease of age. It makes more sense to treat it like osteoporosis, where dietary changes are encouraged to address increased risk factors as you get older.

  • ed||

    Frieden's proposal is the very model of a modern "public health" intervention

    Is that what we're calling "extortion" nowadays? Just curious, but what would prevent customers from adding salt after-the-fact? Ban salt shakers too?

  • Reinmoose||

    I'm sorry she-troll. I misread your post before that.

  • Reinmoose the emphatic statist||

    So MattXIV, what you're saying is that we should make people over 40 order from special menus when they go out to eat, and it should be illegal for restaurants to serve them over a certain amount of salt.
    I like the way you think!

  • Kolohe||

    They can have my salt when they pry it from my cold, dead...it dissolves in water, you say? That makes it so much easier to hide!

    Woe, imagine the street value of the Pacific Ocean!

  • ||

    Yeah, salt is harmless for most people. You only need to worry about it if you've got a blood pressure problem.

    Also, some of us need and want packaged high-salt foods. If you're sweating and lot and drinking water, you need salty stuff to replace the salts you're losing through sweat.

    And anyway, there are certain foods where saltiness is pretty much the point. See Crackers, potatos chips, tortillas, and pretzels.

  • ||

    "So MattXIV, what you're saying is that we should make people over 40 order from special menus when they go out to eat, and it should be illegal for restaurants to serve them over a certain amount of salt."
    Actually, its for people over 65, and its time dependent - "early bird special" order before 6 pm or you pay another 15%!!!
    Haven't met a geezer yet who will eat after 6 pm. Old people eating too much salt??? Just take another 10% off the early bird special for salt free.

  • Elemenope||

    Woe, imagine the street value of the Pacific Ocean!

    And suddenly, North Africa is filthy rich. I always know the Mediterranean was good for something.

  • ||

    Woe, imagine the street value of the Pacific Ocean!

    "This is pure snow! Do you have any idea what the street value of this mountain is?"

  • ||

    I think it's more along these lines: people have cultivated unreasonable expectations about the world and the choices they possess within it.

    "What do you mean, I can't get it with no salt? I can get anything I want." That's the unspoken driving force behind this sort of tantrum.


    Nah, Elemenope. I would almost buy that if there were some sort of massive petition circulating, with thousands of people demanding the other six billion ban salty foods. But this is just one asshole with a god complex. Sadly, that's all it takes.

  • creech||

    Give them what they want. All food processors can make special "New York certified" foods and charge accordingly. That should wake New Yorkers up to what dipshits they have put into office.

  • ||

    I admit that banning salt is a bad idea, I prefer that we mandate that sodium flouride be put in all salt in the US.

  • Elemenope||

    Nah, Elemenope. I would almost buy that if there were some sort of massive petition circulating, with thousands of people demanding the other six billion ban salty foods. But this is just one asshole with a god complex. Sadly, that's all it takes.

    I never said they were organized. After all, the hardest people in the world to organize are arrogant people... :)

    I work in a service industry, and so I can say from experience that the attitude being described is not at all isolated to one guy with a god complex. Everyone wants to be their own king of their own private little pile of shit, and they expect their kingdom to be portable with them.

    "...every one of them, waiting to fist-fuck God's ex-planet, lick their fingers clean, and reach out to their pristine cybernetic keyboards to tote up their own fucking billable hours. But then it hits home! You gotta pay your own way, Eddie. It's a little late in the game to buy out now..."

  • ||

    The adult prevalance rate for hypertension ("blood pressure >140/90 mm Hg or taking antihypertensive medications") is probably around 29.3% (the study is from 2004 data) and concentrated heavily in the 40+ population (the prevalance below 40 is around 7%); it's largely a disease of age. It makes more sense to treat it like osteoporosis, where dietary changes are encouraged to address increased risk factors as you get older.

    It makes more sense to not do anything about it at all. If someone wants to curb their sodium intake at age 40+... they can do it, but I might not. I also might smoke and drink heavily. Hey, I might gain five hundred pounds and enter a serious relationship with a Heroin-addicted, legally practicing whore. It's none of your goddamn business. Why can't we just leave each other alone?

  • robc||

    Is it a tar shortage or a feather shortage New York is suffering from?

  • ||

    These pretzels are making me thirsty.

  • high blood pressure sufferer||

    My (Yale Med Grad and Harvard Med Faculty) physician thinks that salt is unlikely to be a major factor in my prehypertension. Instead of recommending low salt diet, he recommends a low fat died to aid in losing weight, and to avoid obvious excesses of salt (like adding a ton to McDonald's fries, or example).

    I think he's probably right, not because of his training, but because he is a thoughtful guy. And if he IS wrong, it's not because he is being stupid or ignorant, just a case of interpreting the data available and getting unlucky.

    I also highly doubt this would affect total salt consumption that much for a few reasons.

  • Jeff P||

    He who controls the salt controls the universe.

  • ||

    And to think City Council changed the term limits for city politicians, against the known will of the people, so Bloomy can do a third term. HA

    To clarify, known will of the people, it means we voted on the issue not once, but twice to leave term limits in place.

  • robc||

    He who controls the salt controls the universe.

    The salt must flow.

  • TallDave||

    Next up: a ban on dihydrogen monoxide, the deadliest chemical on Earth.

  • ||

    It's one thing to make the health risk known, assuming it's true. It's a totally different thing to use the rule of law to deny choice of food.

    I say food companies should tell Bloomy to take a hike and if NYC passes a law for them to comply, they should not sell food to NYC. But, won't happen.

  • Ska||

    "This is pure snow! Do you have any idea what the street value of this mountain is?"

    "I think the left side of my brain is frozen"

    *wildly swings right arm in circular motion*

  • economist||

    "Yeah, salt is harmless for most people. You only need to worry about it if you've got a blood pressure problem. "
    Even then, salt's not always the problem. When I was diagnosed with hypertension three years ago, I went on a strict low-sodium diet. No effect. Now I take pills. Apparently, restricting sodium intake only works in 50% of all hypertension cases, anyway.

  • economist||

    high blood pressure sufferer,
    Obviously, you should not adopt my approach to managing blood pressure unless it's absolutely necessary, as it may cause a wide variety of harmful side effects, including the inablility to remember what those side effects are supposed to be.

  • ||

    Won't you people think of Teh Children?? Salt is EVIL!!

  • economist||

    "Ye arte the salt of the earth"
    "Hey, don't insult us! SALT KILLS!"

  • ||

    From my cold dead hands...and will this jerk next mandate cap & trade for salt production? Do these 'regulators' wet their drawers each time they drop new rules on us? Will they wet their drawers when we finally show up outside their offices with tar, feathers, rope and pitchforks?

  • ||

    Salt is necessary to live; how can it not be generally recognized as safe?

  • Naga Sadow||

    TallDave,

    I went through to much chemistry to not call you out on that blatantly wrong nomenclature! And fuck Wikipedia! That shit is just plain wrong!

  • Kant feel Pietzsche||

    Naga, he was referencing a goof "study" done a few years ago, to illustrate how jumpy the herd is. As anyone with an 8th grade education knows....

  • ||

    Chalk me up as another 40+ (many pluses) "sufferer" from high blood pressure. I actually carry the results of my last blood work with me to confront morons who insist that because I have high blood pressure, I must have a salt problem and urgently need to cut down. You see, the difficulty for them is that I am also clinically hyponatremic -- as far below the 'acceptable' blood levels for sodium as my blood pressure is above the 'acceptable' limit for blood pressure.
    Even odder, guess which of the 2 clinical diagnoses my doctor has chosen to treat? sigh.

    no hugs for thugs,
    Shirley Knott
    If you pry the salt out of my hands, they will become cold and dead in short order

  • ||

    So, if I buy potato chips in New york, I'll have to pick up a couple of salt packets to go with them?

    If anyone reading this is in Manhattan, would you be so kind as to bitch-slap that raving bureaucrat if you run into him on the street?

    -jcr

  • ||

    Salt is necessary to live; how can it not be generally recognized as safe?

    Funny, I was just thinking that about carbon dioxide.

    -jcr

  • ||

    He was furious when my boss said no.

    Oh, man.. I wish I'd been there. It would have been so much fun to explain to the idiot that a business has no obligation to offer up for sale whatever some demented would-be customer might ask for.

    -jcr

  • ||

    New York isn't the only city with a weird attitude about salt.

    Seattle, a city that rarely gets snow to speak of, had a policy of not using salt on snowy streets because *it might get into the ocean*.

    http://seattletimes.nwsource.com/html/localnews/2008551284_snowcleanup23m.html

    (This ten-year-old policy was changed recently, after they finished dealing with what was perhaps the city's snowiest December in the past 50 years. Not the most snow falling, but the combination of snow and cold that kept the most snow on the ground for the longest time. The new policy would have allowed the use of salt to deal with that mess - if it had been adopted before the snow finished melting.)

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