When salt, an essential nutrient, is significantly reduced, the population's response is mixed. About 30% experience a minor drop in blood pressure, about 20% experience a slight increase and the rest experience no change at all. So any policy that treats the population as a homogeneous mass is discriminatory because we all react differently.
On top of that, women around the world consume 800-1,500 milligrams less sodium per day than men do. In the U.S., women consume 1,200mg less sodium per day than men do. Because we all eat from the same food supply, if you reduce sodium in all food, will women end up at greater risk of hyponatremia because they naturally consume far less sodium than men?
Hyponatremia is a serious condition that can reduce cognition, increase the risk of diabetes and result in loss of balance in the elderly. Pregnant women on low-salt diets give birth to low weight babies that have a lifelong increased salt appetite. Several peer-reviewed publications indicate that congestive heart failure patients placed on low-salt diets die, or are readmitted to hospitals, far more frequently than those not placed on low-salt diets.
There is far more in the scientific literature on salt and human health than is under consideration by the Institute of Medicine and the Food and Drug Administration, which is why the Salt Institute has repeatedly asked the secretary of Health and Human Services to carry out a large clinical trial to determine the actual impact of salt reduction on population health outcomes. Because there are no historical records of consuming the low salt levels recommended by the IOM, compelling the entire population to consume these levels effectively would place everyone into the largest clinical trial ever carried out, without our knowledge or consent.
The FDA would have done the public a better service if it had focused on promoting a fully balanced diet, rather than on a silver bullet that the scientific evidence does not fully support.
Italians eat much more salt than we do, but they have among the best cardiovascular figures in the world because they eat a balanced diet with far more vegetables and fruits. Here, our consumption of vegetables has dropped because we don't spend enough time promoting their benefits. Consumers deserve better treatment.
Morton Satin is director of technical and regulatory affairs for the Salt Institute.
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