I'll Give You My Salt Shaker When You Pry It From My Cold, Dead Fingers

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I have seen the future and it's full of bland food

Would someone tell the know-nothing busybodies over at the Center for Science in the Public Interest to please shut up about banning salt? The CSPI's anti-salt scare campaign claims: 

Salt, at the levels present in the diets of most people around the world, is probably the single most harmful substance in the food supply. Salt is used liberally in many processed foods and restaurant meals, with some meals containing far more than a day's worth of sodium.

Reducing sodium consumption by half would save an estimated 150,000 lives per year. That in turn would reduce medical care and other costs by roughly $1.5 trillion over 20 years.

Not really. Yet another study—this time a review in the American Journal of Hypertension of seven randomized controlled trials by the respected Cochrane Collaboration—does not find consuming salt to be all that much of a health problem: 

Relative risks (RRs) for all-cause mortality in normotensives (longest follow-up—RR: 0.90, 95% confidence interval (CI): 0.58–1.40, 79 deaths) and hypertensives (longest follow-up RR 0.96, 0.83–1.11, 565 deaths) showed no strong evidence of any effect of salt reduction CVD [cardiovascular disease] morbidity in people with normal BP (longest follow-up:RR 0.71, 0.42–1.20, 200 events) and raised BP at baseline (end of trial: RR 0.84, 0.57–1.23, 93 events) also showed no strong evidence of benefit. Salt restriction increased the risk of all-cause mortality in those with heart failure (end of trial RR 2.59, 1.04–6.44, 21 deaths). …

Our estimates of benefits from dietary salt restriction are consistent with the predicted small effects on clinical events attributable to the small BP reduction achieved.

Just take a look at the size of those confidence intervals. As MedPage Today described the results: 

The seven studies included in the review consisted of three involving 3,518 normotensive participants; two involving 758 hypertensive participants; one with a mixed population of 1,981 participants; and one involving 232 patients with heart failure.

End-of-trial follow-up ranged from seven to 36 months and the longest period of observational follow-up was 12.7 years.

An analysis of normotensive participants showed that salt restriction was associated with a 33% reduction in the risk of death during the trial, declining to 10% at the end of observation. Both outcomes were associated with overlapping confidence intervals that precluded statistical significance.

The analysis of hypertensive participants showed even smaller effects of salt restriction on mortality: a 3% reduction at the end of the trial and 4% at end of observation.

Salt restriction was associated with a 29% lower risk of cardiovascular events among normotensive individuals and a 16% reduction in hypertensive participants. Neither difference achieved statistical significance.

In the trial involving patients with heart failure, salt restriction significantly increased the mortality risk more than twofold as compared with the control group (RR 2.59, 95% CI 1.04 to 6.44).

In May, my colleague Jacob Sullum, in a blogpost entitled "Could Eating Less Salt Be Deadly," cited new research showing the inconsequential health benefits of restricting salt consumption. Sullum makes the right point:

Whether or not eating less salt is dangerous, there is no reason to expect the entire population to adopt a diet that even its advocates concede they will not like if it benefits only a minority.

Food nanny motto: If some must suffer bland food, then all must suffer bland food! 

Disclosure: At a check up last month, my blood pressure was 108/60. 

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  1. CSPI is about drumming up litigation. That’s it.

    Just like the scam in the UK with vaccines and autism.

    1. And getting grant money. Don’t forget that.

      1. Sure, to fund their promotion of litigation-creating campaigns.

    2. Just like the scam in the UK with vaccines and autism climate data.

      FIFY

    3. You forgot that it’s also about the pure pleasure of pushing people around.

    4. Pro Libertate|7.8.11 @ 12:37PM|#
      CSPI is about drumming up litigation

      I think that is the long and the short of it.

      Last time I talked to those guys, I was interviewing a lawyer who was suing to get Vitamin Water banned in California for false advertising… the more we talked about it, it became clearer the guy was almost amused by the whole thing, and he was perfectly candid in admitting that it was more or less intended to try and create context for some kind of settlement issue…

      All they are I think is a niche lobbying group for class-action lawyers who think theres money to be made scaring up non-existent health risks. I sometimes find it hard to accept they even believe their own bullshit, and in a few cases its obvious they dont.

      1. It’s fairly obvious, and it sickens me that the media generally treats the outfit as some sort of legitimate science/consumer advocacy organization. Ha!

    5. They are completely full of shit. Pretty much everything they’ve said in the past (eat less fat, use trans fats to fry food instead of saturated fat [they said that in the 90s and then refudiated it], eat more carbs, eat less sat) has been wrong. You would do well to listen to their advice, and then do the opposite.

      1. eat less sat = eat less salt

  2. The people at CSPI remind me of the medical professionals I’ve run into in my pre-medical career. A lot are very politically-minded and want to use government to enforce healthy lifestyles, and what’s worse, they expect pre-meds to develop the same beliefs as them.

    Hey, I’m all for having a strong social conscience, but that need not have to equate to busy-body, do-gooder, pro-government regulator.

    Oh, the joys of being a libertarian pre-med. Fuck my life, sometimes.

    1. Could be worse. You could be a libertarian at a school of public health.

      1. Oh, Scruffy, you poor thing. How do you cope?…liquor?

        1. Soon, Scruffy, you will have a license, and the ability to write yourself a scrip for Coperin.

      2. Hi There…That’s Me. Healthcare Policy is my specialty with a focus on economics, financing, and law. Yep, people in the other departments just plain kill me.

        As far as I am concerned, we figured out most of the legitimate sphere of “public health” problem after mass vaccinations, sanitary standards, food safety, worker safety, etc. a long time ago. The problem is we don’t even do these things well…the stark bone basics.

        However, the new age of pretentious, self-righteous, social justice worshipping, know nothing, paternalistic, future social engineers has arrived everyplace else it seems.

      3. I am a doctor and PhD in Epi. One of my Epi grad student friends asked me why I went into the field when I did not generally buy the excessive government role in health. I told her I believed diversity was very important. Her head exploded.

  3. That in turn would reduce medical care and other costs by roughly $1.5 trillion over 20 years

    This is where it’s headed. Now that the gment has an interest in health care, all behavior is going to be judged as affecting government costs. It is the patriotic thing to do to quit [smoking][drinking][surfing] as doing so will increase the deficit.

    Fuck heads. You think government controls us now. Wait 20 until we have single payer, all healthcare controlled by the government. We’ll have required skype connections in our homes while we do our calistenics.

    1. This is just great. Can we get another screen for the living room? If you say no, i’ll take some sleeping pills.

    2. If it really goes that far, I’m going Galt. Or just starting/joining a rebellion.

      1. I’m going Galt.

        Shouldn’t that be “going salt”?

        1. Yikes! You sound like my Mom. She thinks her puns are funny too.

    3. The instructress had called them to attention again. “And now let’s see which of us can touch our toes!” she said enthusiastically. “Right over from the hips, please, comrades. One-two! One-two!…”

      Winston loathed this exercise, which sent shooting pains all the way from his heels to his buttocks and often ended by bringing on another coughing fit….

      “Smith!” screamed the shrewish voice from the telescreen. 6079 Smith W! Yes, you! Bend lower, please! You can do better than that. You’re not trying. Lower, please! That’s better, comrade. Now stand at ease, the whole squad, and watch me.”

      This is now at least the fourth time that quote has been apropos.

    4. Do you have any evidence of such controls being in effect in countries that have had single payer for some time?

    5. Single-payer legal care.

      There’s not a single lawyer in this country who does anything that’s worth more than minimum wage.

  4. Gosh Ron, who are you going to believe, a public interest group with the best of intentions or those silly researchers with their “statistics” and “science” mumbo jumbo.

  5. At a check up last month, my blood pressure was 108/60.

    Typical Ron, shilling for Big NaCl…

  6. A nitpick here:

    From the review Ron cites-

    Conclusions

    Despite collating more event data than previous systematic reviews of RCTs (665 deaths in some 6,250 participants) there is still insufficient power to exclude clinically important effects of reduced dietary salt on mortality or CVD morbidity.

    Ron included the sentence right after this one. An interesting editing choice.

    From the article:

    Implications for practice

    Our findings are consistent with the belief that salt reduction is beneficial in normotensive and hypertensive people. However, the methods of achieving salt reduction in the trials included in our review, and other systematic reviews, were relatively modest in their impact on sodium excretion and on BP levels, generally required considerable efforts to implement and would not be expected to have major impacts on the burden of CVD. The challenge for clinical and public health practice is to find more effective interventions for reducing salt intake that are both practicable and inexpensive.

    1. there is still insufficient power to exclude clinically important effects of reduced dietary salt

      Um, what the fuck is this shit?

      We shouldn’t even be talking about forcing people to reduce their salt intake unless it’s abso-fucking-lutely certain that reducing salt is unambiguously clinically important.

      Saying, “Well, gee, we can’t exclude the possibility that maybe it’s clinically important” just doesn’t fucking cut it. We can’t exclude the possibility that aliens will magically cure cancer for us tomorrow, either.

      1. NM has once again ferreted out my nefariousness. Curses!

        1. Foiled agin, Ron. Will you never learn?

        2. Come on Ron. If you are going to cite a study as evidence of something, it is probably important to include the fact that there is not sufficient power in the study to come to a conclusion one way or the other. There is a meaningful difference between “haven’t proven it helps” and “it doesn’t help.” Neither supports a policy for banning salt, but you could at least report the most basic conclusions of the review you cite.

          1. There is a meaningful difference between “haven’t proven it helps” and “it doesn’t help.”

            Actually…no there isn’t.

            The default position is that it doesn’t help. That position can only be overcome by the presentation of evidence that it does help. At least, if we’re going to be scientific about it. That’s the way the helpfulness of any new drug would be analyzed.

            1. The default position is that it doesn’t help. That position can only be overcome by the presentation of evidence that it does help.

              And there is evidence that it does (based on the review Ron cites – “findings consistent with the belief” and such). That evidence, however, is not strong enough to overcome the null hypothesis due to the lack of power. This is a much different situation than one where there is no evidence. So I will disagree. There is a meaningful difference between “hasn’t been proven” and “it doesn’t help.”

          2. The default position of the medical nanny establishment is that reducing salt = health benefits.

            Ron says the study “…does not find consuming salt to be all that much of a health problem.”

            He did not say anywhere that I can find that the study found salt to be safe.

            NOT Finding bad != finding good

            It sounds to me like you’re fighting on behalf of all the idiots who would read Ron’s post and assume that it means scientists say salt is safe. As far as I can tell, the only idiot who assumed that was you.

            1. scientists say salt is safe
              versus
              does not find consuming salt to be all that much of a health problem.

              I am trying to figure out how “not much of a health problem” and “safe” are different claims.

              But that is beside the point. Ron’s message is, it seems, that the scientists who claim reducing salt would provide a public health good are wrong (his words “not really”). He then cites a study to support his claim that reducing salt would not “not really” provide a public health benefit. The scientists who conducted that report think that their results are consistent with a belief that reductions in salt provide a public health benefit, but recognize that their study is underpowered and, therefore, can not be used to decide the matter one way or the other.

              So my nitpick is between Ron’s “not really” (i.e., “CSPI is wrong”)and the position the science would support “maybe, maybe not, we can’t tell yet” (i.e., CSPI’s claim is not on firm ground yet”).

              Like I said, a nitpick. Neither state of affairs would provide support for a policy banning salt.

    2. Yawn. Another bullshit, hairsplitting post from NM.

      1. Nitpicking, not hairsplitting. Get it right (~_^).

  7. After almost a year of bringing my own lunch to work my blood pressure went from 130/80 to 110/60.

    And I live with Jennifer…

    1. If you reduce Jennifer intake by only 50%, you can add 23% more years to your life, saving an estimated $22,817 over 100 years.

      1. not just that, but the decimal point will move to the left on everyday purchases saving lots of money over the avg 7 yr marrage till divorce.

      2. “Jennifer intake?” Dude, that’s not how it works.

        1. Depends on Jennifer’s intake, if you get my meaning.

          1. Hey now!

    2. I wonder if I ever got a blood pressure reading while I was dating a redhead. It was probably something lie 210/130.

      1. Since Jennifer is a redhead, are you suggesting that Jeff P.’s blood will simply stop flowing if he weren’t around her regularly?

        1. I’m not a doctor, dammit!

          1. And she’s not a redhead!

            [rim shot]

  8. Forty years ago 120/80 was considered a normal blood pressure and you could add one point to the upper number for every year you were over 40. Now at age 65 my doctor tells me that normal for any age is 110/70. I think they shill for big pharmo to prescribe bp meds

    1. Given that over time we will be dead for far longer than we will be alive, in the end our average will always be just shy of 0/0. So cheer up!

    2. I got a scrip for BP meds after waiting 2 1/2 hours to see my doc for a physical. I tried explaining to him that my BP was high because his staff sucks at scheduling, but he assumed it was my diet/lifestyle.
      I see a different doctor now and still don’t take BP meds.

    3. Forty years ago 120/80 was considered a normal blood pressure…. Now at age 65 my doctor tells me that normal for any age is 110/70. I think they shill for big pharmo to prescribe bp meds

      That’s it! – what else could it be?

      Forty years ago doctors thought that rest was pretty much all that could be done for heart attacks, and now…
      Medical research and advancement – how does it work?

  9. The only part of CSPI’s name that isn’t a misnomer is “Center”

  10. The CSPI likes to err on the side of alarm.

    1. …if by “alarm”, you mean pants-shitting exaggeration of the potential harm of anything…

  11. Reducing sodium consumption by half would save an estimated 150,000 lives per year. That in turn would reduce medical care and other costs by roughly $1.5 trillion over 20 years.

    CUT IT OUT!

    Which is it? Dead people incur no “health care costs” (nor do they pollute). Why wouldn’t we want people to die early, and die often?

    1. As long as they continue to vote.

      1. It’s the Chicago way.

    2. Because dead people produce no tax revenue. Think of extending people’s lives as a kind of ‘urban renewal project’ people.

    3. You can always tell the bullshit health claims that say “Reducing, changing, adding, eliminating… etc the consumption of some such, would save an estimated 150,000 lives per year.” really? 150 000 people who weren’t going to die… My grandpa ate salt pork, salt beef, pickled everything washed down with a moderate amount of beer/whiskey. Had we only stopped him perhaps we could have saved him from an early death at 93

  12. Reducing sodium consumption by half would save an estimated 150,000 lives per year. That in turn would reduce medical care and other costs by roughly $1.5 trillion over 20 years.

    I just did some advanced math on those numbers, and the results are scary. If we don’t Do Something Now, then 1.5 million lives will be lost over the next ten years, costing Us $7.5 trillion over the next century.

  13. Disclosure: At a check up last month, my blood pressure was 108/60

    Ahh, disclosures.

    I honestly dont know if that’s a good thing. Is that a good thing?

    Last I checked, a doctor told me I needed *more* salt. I think it was low blood pressure, but i didn’t pay any attention.

  14. Sorry, Kristen, CSPI is nowhere near the “center”.

    1. Center of the money?

      1. Center of corruption? Or is it really more of a locus?

    2. Could be Center as in they think they’re the center of the universe?

    3. Or their offices are in the center of the stretch of Connecticut Ave between Dupont and Woodley Park.

  15. Reducing sodium consumption by half would save an estimated 150,000 lives per year. That in turn would reduce medical care and other costs by roughly $1.5 trillion over 20 years.

    Yeah, fuck you, no it wouldn’t. Smoking rates have been dropping over the years with the promise from anti-smoking activists that billions BILLIONS would be saved in healthcare costs, and we haven’t saved a fucking red cent.

    I’m done with these arguments. If these idiots mouths are moving, they’re lying.

  16. When they came for the carbon dioxide, I said nothing, because I didn’t use carbon dioxide.

    When they came for the salt, I said nothing, because I didn’t use salt.

    . . .

  17. A friend almost died from hyponatremia during a Grand Canyon hike because he was consuming too little salt. Yes, he’s one of those who buy into the hysteria of people like CSPI.

    We’re going to see more incidents of this as people become conditioned that salt is evil.

    1. No we’re not. This happens all the time and has nothing to do with fear of evil salt. He drank a lot of water because he was hot, thirsty and sweating a lot. So far, so good. His problem was that he was not drinking any/enough electrolyte (call it salt if you wish) solution (Gatorade, Coca Cola, etc) and he diluted out the electroloyte concentration in his “serum”.

      1. Why yes, sodium is indeed an electrolyte, and he got his ass medevac’ed because he was consuming too little of it.

        Did you actually have a point other than pedantism and scare-quoting the word serum?

        And no, this isn’t about how much salt he consumes during normal (non-hiking) days; this is about people becoming so conditioned that salt is evil that they won’t increase their salt intake when they’re doing strenuous activity and sweating a lot.

        1. Point? The unending battle against misinformation on the internet, I guess. Nothing much more.

          1. The most effective way for you to fight against misinformation on the webs is to STFU.

          2. Since you just said the incident had nothing to do with fear of salt, wouldn’t the point be that you’re a fucking moron?

            1. I’ll chime in since you guys are close to the topic of my comment. I consider “salt” to be any form of salt including electrolytes. If you live an active lifestyle (i.e. you sweat) then you should pass excess salt from your body even if you consume more than the recommended amounts. If that’s too much work (as it is for many) can’t you pass excess salts by consuming water. If it’s medically possible to drink enough water to dilute the body’s salt to the point of death why can’t people simply consume enough water to control salt intake? It doesn’t make sense to me that salt is a problem for anyone if they can simply drink water to pass it from their system. I have no expertise in physiology, but could someone please explain.

  18. The food nannies always seem to ignore the fact that the millions of healthy and hearty 70 and 80 year olds cluttering up the roadways of Florida and Branson, MO, grew up on a diet of fatty pork chops, mashed potatoes with butter, and ham and eggs fried in lard for breakfast 7 days a week.

    Diet is totally overrated as a predictor of health–look to stress, genetics, and the iron will to live just to spite Michael Jacobson’s yogurt-eating ass.

    1. Eggs weren’t fried in lard (‘least not at my house). We used the bacon fat that we stored right by the stove top for all our cooking-oil needs. Yumm!

  19. Just take a look at the size of those confidence intervals.

    Hot. So hot. I’ll be in my bunk.

    1. CIILF’s ?

  20. Potassium and sodium have an inverse relationship in the human body. Consuming more potassium can counter health risks caused by high sodium intake. Most Americans don’t even get the RDA of potassium, but get plenty of sodium. Unfortunately, the govt limits the amounts of potassium supplementation. Maybe CSPI should spend some time arguing for relaxing potassium limits rather than creating sodium limits. But of course these are the same people that long ago argued against building nuclear power plants, resulting in more coal-fired plants that they now hate more.

    1. that doesn’t sound right. Don’t they both increase blood pressure? They’re both salts

  21. What about pepper? How come there’s no war against pepper! 😉

    1. I want a war on the war on stuff.

    2. First they came for the coriander…

  22. Shorter CSPI:

    WE’RE ALL GONNA DIIIEEEEE!!!

    1. I love these “discussion” boards.

  23. My statistical knowledge is a little bit low. Can anybody help me understand how the study can say “33% reduction in the risk of death” and yet it is not statistically significant?

    What would need to change for this number to be significant? Were there just not enough people dying? Were there not enough people in the study to come up with any significant finding?

    1. there is always too many people dying one salt induced death is too many… Dammit won’t anyone think of the children

    2. Were there not enough people in the study to come up with any significant finding?

      This one.

  24. these here scientists don’t know thier ass from thier elbow. My whole town eats bacon, eggs, grits, toasts and coffee everyday and we all healthy. Hell i knwo this one old guy he ate a pound of bacon a day, smoke 2 packs and drank like a fish and he lived to an old age of 68. So i don’t believe any of this nonsense these experts put out like salt is bad for you, global warming is real, and radiation is bad for you. Just live life and be happy

  25. Y’all need to watch Fat Head on Hulu or onNetflix It has hilarious caricatures of CSPI. They are basically crusading, morally-righteous vegan nutbags who actually PUSHED trans-fats before they were uncool, and then in a Stalinist manner, now claim to have been always against trans-fats.

  26. Supposedly, high levels of salt consumption are associated with stomach cancer. But for some reason, that nannies never talk about that. I’m just sayin. Don’t really have a conclusion about it. I eat huge amounts of salt. I love it.

  27. I believe that salt consumption is one of those things that won’t change easily. If you can’t get people to stop smoking, you’re not going to convince them that salt is going to kill them. I totally understand where the people are coming from when they complain about a high sodium diets – but like I mentioned – It will most likely never end. Sodium responsibility should come down to a personal responsibility.

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