Food nannies’ killer salt recommendation

A new study in the Journal of the American Medical Association has a graph showing how potentially harmful the government dietary sodium recommendation is.

The graph below (click to enlarge) is from a new study of 28,880 subjects comparing the rate of cardiovascular incidents with urinary sodium excretion.

Keeping in mind that the food nanny sodium recommendation is 1,500 mg/day and that there is a near one-to-one correspondence between sodium intake and urinary sodium excretion, it’s clear that the level of “no risk” is on the order of 4,000 to 5,000 mg of sodium ingested/excreted per day.

The food nanny preferred level, ironically, appears to be about as “risky” as consuming/excreting about 8,000 mg/day.

That irony, however, is entirely lost on poor food nanny Paul Whelton of the Tulane University School of Public Health who insisted in a commentary accompanying the study that sodium intake should be limited to 1,500 mg/day to 2,300 mg/day.

So what is the purpose of data anyway, Dr. Whelton?

Read the JAMA study.

Read Whelton’s JAMA commentary.

Related Reading:

4 thoughts on “Food nannies’ killer salt recommendation”

  1. MisterG, you actually illustrate why the study to in JAMA to which this post refers actually isn’t very useful for guiding health policy. The study was not performed in healthy people to predict risk of future disease, but in people with existing CVD and predicted how likely they were to have an “incident” like a heart attack or stroke. But many people with CVD can have misleadingly low sodium levels which don’t reflect their actual sodium intake, often because of the effects of blood pressure and other medications (like you). It might have been possible to get a handle on how much sodium these people were really getting in their diets despite this by collecting *24 hour* sodium excretion, because all of that sodium has to go somewhere — but they didn’t do that, because these trials were never actually designed to assess the relationship between sodium and CVD or even cardiovascular incidents. Instead, it estimated it from a morning fasting spot test which was not originally intended for assessing sodium. By the time you spend all day taking a water pill or other drug that lowers your sodium levels in the day, a morning spot test can be misleadingly low. So the people with low morning sodium may simply have been at higher risk because they were sicker and taking more drugs — or were not using those drugs properly. Studies actually involving reducing sodium *intake* from the diet (like the Trials of Hypertension Followup I and II, Morgan, and Trial of Nonpharmacologic Interventions in the Elderly (TONE)) studies, as well as the DASH diet studies, show the benefits of lowering sodium intake.

    In any case, the “Food Nannies” are first and foremost working to get the huge excesses of salt out of processed food and restaurant meals: I think it’s pretty clear that people managed just fine adding their own salt at the table before these prepackaged salt bombs became a staple of the American in the middle of the 20th century.

  2. I am a type2 diabetic (MODY to be precise.) I tend to have low salt levels, partially due to the medicaion I take to manage my genetic condition) Incorporating salt into my diet mitigates this. “Arm twisting”/forcing food suppliers to lower salt content impares my ability to manage.
    Sugary drinks – great for addressing hypogycemic events.
    Fatty foods – moderates blood gluclose rise post eating and helps prevent lows.
    In short, the food nannies are hostile to my health.
    I think a better name for them is eugenicists

  3. The human body is remarkably robust. This chart tells me the following: (1) the ‘hazard ratio’ is essentially flat for sodium throughputs from 3 to 7 grams per day (7.5 to 17.5 grams of salt per day), (2) the 95% confidence intervals (CIs) are so broad that significant increases hazard ratios (in excess of 20% above baseline) cannot be confidently claimed for sodium throughputs of less than 9 grams /day (22.5 grams of salt per day), and (3) we have before us a perfect example of a dose/response curve with a non-zero intercept to counter the claims of chemophobes about nearly every substance they try to “warn” us about.

  4. It’s all relative anyway. For me, perhaps 6000 a day is fine. For another 1000 might cause health issues due to their constitution. duh. All these studies are merely guidelines and informatives for doctors. Instead bureaucrats take them and club us over the head with them. Then some ten years later it’s all, “Whoops, NEW studies show that the old study was wrong.” Alar. Butter. Eggs. Etc. QED.

Leave a Reply

Your email address will not be published.