sodium

FDA Salt Statement Leaves a “Mistaken Impression”

by Daniel Compton on April 28, 2010 · 2 comments

in Health and Illness, Nanny State, Personal Liberty, Precaution & Risk, Regulation, Zeitgeist

Some 80 years ago this month, Mahatma Gandhi led tens of thousands on a 240-mile march in protest against a British salt tax, inciting millions to engage in widespread acts of civil disobedience.  In a seemingly unintentional display of historic irony, the Food and Drug Administration made national headlines on April 20th for its efforts to forcibly restrict the amount of salt that can be added to processed foods.  The Washington Post was among the first to pick up the story, and was subsequently chastised for its efforts in a statement from the FDA, released later that day.  The FDA accused the Washington Post story of “[leaving] a mistaken impression” in the minds of readers.  But examination of the facts shows that The Washington Post got it right, and that it is the FDA statement itself which leaves the mistaken impression.

The event that triggered media interest was the release of a report by the Institute of Medicine urging the FDA to revoke salt’s GRAS (Generally Recognized As Safe) classification, thereby granting regulators the legal framework needed to mandate acceptable levels of salt for processed foods.

The Washington Post responded to the release by reporting that the FDA’s plans to clamp down on salt were already underway and that the initiative would be launched later this year, citing FDA insiders who spoke only on the condition of anonymity.  Within hours, the FDA responded with a statement that the Washington Post article leads readers to believe that the FDA “has begun the process of regulating the amount of sodium in foods.”  The statement went on to assert that “[t]he FDA is not currently working on regulations… to regulate sodium content in foods at this time.”

While it is true that the FDA has made no official announcements regarding their stance on salt regulation, the claims that they have not begun the process and are not currently working on it are demonstrably false.

For 30 years, the FDA had largely ignored calls to reclassify salt, voiced by groups such as the Center for Science in the Public Interest.  That all changed in October of 2007 when, in an abrupt about-face, the FDA announced in the Federal Register that they would hold a public hearing to consider a change in the regulatory status of salt.  The hearing was conducted that November, and the public comment period was closed in August of 2008.  Just a few weeks later, the IOM kicked off a 21 month project titled “Strategies to Reduce Sodium Intake”—a project sponsored by the FDA.  This project would ultimately lead to the creation of the recent IOM report, also FDA sponsored.

Over the course of 2009, 14 meetings and phone conferences were held discussing the project.  All but the first two of these meetings were entirely closed to the public.

At the first meeting, a representative of the FDA itself made a presentation explicitly discussing the regulatory status of salt, as well as its history as a GRAS substance.  The second meeting included a presentation addressing the legality of a reclassification of salt—concluding that the FDA has “ample legal authority” to do so—and one discussing how low salt reduction levels could be set.

But what of the science underwriting this new FDA push?  Also included in the first meeting was a presentation by the Department of Health and Human Services stating that “100% of adults exceed the [adequate intake] of 1,500 mg sodium/day”.  Presented with such a statistic, certain questions spring to mind.  For instance, if 100% of adults eat more than 1,500mg of salt, what research could possibly have been conducted that would lead them to conclude that 1,500mg is adequate?  One might assume that such research was conducted on residents of other countries, but the reality is that the average American consumes about 9% less salt than the worldwide average.

The only places in the world where you might find a significant population who eat so little salt are in countries so poor that people don’t have reliable access to food at all. In such a place, one might indeed find low rates of hypertension-related illness, but only because those who live under such tragic circumstances don’t enjoy the luxury of living to the age where high blood pressure starts to become a concern.

Decades of research, encompassing multiple lines of evidence, have shown that our bodies naturally self-regulate salt intake.  Not unlike the feeling of thirst we experience when we need more water, our bodies send us queues—though more subtle than thirst—that lead us to unconsciously adjust our diets to meet our salt requirements.  One recent study by nutritionists at the University of California at Davis examined data collected from over 19,000 individuals across 33 countries to find that the normal range of salt consumption is 2,700-4,900mg per day.  The study went on to conclude that, because of our natural ability to regulate salt intake, it is “unlikely to be malleable by public policy initiatives, no matter how well intended.”

A study conducted 12 years earlier coincides with these findings, concluding that most people are simply unable to reduce their consumption below about 2,700mg per day, even when receiving regular dietary counseling and instruction.  A third study, conducted the same year, demonstrates that people will unconsciously increase or decrease their dietary salt intake to stay within the normal range, even when they don’t know how much salt is in their food.  Neuroscientists have even successfully identified the specific neurological mechanism by which this unconscious salt-regulation occurs.

Grossly out of step with the current scientific understanding, the FDA clearly has begun the process of regulating the amount of sodium in foods, and has been working on it for several years.  Between the hearing in 2007, their sponsorship of—and participation in—the 21 month project specifically aimed at reclassifying salt, and their sponsorship of the report itself, there is little more that the FDA could have done to expedite the process.

It is true that the FDA has not yet formally proposed a rule, but that is the obvious next step on the new path it’s been taking for the past few years.

It is an outrage that the FDA would deign to censure The Washington Post for publishing an article informing readers about the shape of things to come.  Far from leaving a “mistaken impression”, The Washington Post’s article hit the nail squarely on the head.  If a mistaken impression is to be had, then readers need look no further than the FDA’s own statement.  And why would the FDA go to such lengths to deny that which is both obvious and confirmed by insiders?  It’s a safe bet that they want the unveiling of their plans to be timed just right, as whatever they are about to drop on us is bound to be damned unpalatable.

New York Salt-Slashing Op-Ed in NY Post

by Daniel Compton on January 13, 2010 · 2 comments

in Health and Illness, Healthcare, Nanny State, Personal Liberty, Politics as Usual, Precaution & Risk, Regulation

Here is my op-ed published in the New York Post on January 13th.

As-salt on science

On Monday, city officials rolled out an initiative to curb the salt content in manufactured and packaged foods. But the idea behind it — that salt intake has reached extreme levels in America — is a myth, and this “solution” wouldn’t work, anyway.

City Health Commissioner Dr. Thomas Farley aims to lead a national campaign to reduce the amount of salt in manufactured foods by 25 percent over the next five years. Cutting salt intake is supposed to reduce hypertension-related health problems. But while doctors may advise particular patients to cut down on salt, the science tells us that this is not a public-health problem.

Nutritionists at the University of California/Davis just published the first and only study to address salt intake and public policy. They found that people are naturally inclined to regulate salt intake to physiologically determined levels by unconsciously selecting foods to meet their needs — and even the most extreme interventions don’t do much.

The UC Davis study (published in the October issue of The Clinical Journal of the American Society of Nephrology) looked at data from more than 19,000 individuals from 33 countries worldwide. It determined that daily sodium intake ranges only from 2,700 milligrams to 4,900 mg, with the worldwide average of 3,700 mg.

It also determined that the average American consumes about 3,400 mg a day — disproving the claim spread by advocates such as the Center for Science in the Public Interest that US salt consumption is out of control.

In other words, Farley’s trying to fight a problem that doesn’t exist. Worse, his new guidelines say that daily sodium intake for most people shouldn’t exceed 1,500 mg — which is a ridiculous 45 percent below the bottom of the normal consumption range the UC Davis study identified, and a full 60 percent lower than the worldwide average.

The researchers also cite decades of research describing the specific mechanism by which the central nervous system, acting together with several organ systems, controls our appetite for salt. One of the studies they cite involved hundreds of participants in what was to be a three-year sodium-intake intervention, with the goal of reducing daily intake to 1,850 mg.

But after six months, researchers noted that participants were simply unable to cut sodium intake below about 2,750 mg a day — close to the bottom of the range the UC Davis study identified.

Another study had used intensive dietary counseling to get participants to cut daily sodium intake to an average of 1,775 mg over four weeks. After that, the subjects, while still receiving counseling, were randomly split into two groups — one getting a sodium tablet, the other a placebo.

Those who got the placebo still raised their intake by nearly 1,000 mg, while those on the sodium tablet actually cut their dietary-sodium consumption to compensate.

These people didn’t know how much sodium they were getting — they unconsciously changed their diets to match what their bodies “knew” they needed.

The UC Davis study also cites surveys showing that sodium intake in the United Kingdom has “varied minimally” over the last 25 years, despite a major government campaign to reduce it.

Overall, the researchers found, salt intake “is unlikely to be malleable by public policy initiatives,” and attempts to change it would “expend valuable national and personal resources against unachievable goals.”

The New York guidelines are voluntary — for now. But the city’s ban on trans fats started that way, too. And the federal Food and Drug Administration has also been looking to get in on the action — it may classify it as a “food additive,” subject to regulation, sometime this year.

But this campaign isn’t about public health — it’s about grandstanding on a pseudo-issue ginned up by activists, when science clearly shows that there’s neither a crisis nor a way for the government to actually alter our salt intake.

All these initiatives do is win headlines for ambitious policymakers (New York’s last health commissioner parlayed his trans-fat activism into a promotion to FDA chief), while making food slightly more costly and leaving a bad taste in the mouths of consumers — literally.

Daniel Compton is a research associate at the Competitive Enterprise Institute and contributor to OpenMarket.org

Regulation Not Worth Its Salt

by Daniel Compton on October 16, 2009 · 3 comments

in Environment, Health and Illness, Nanny State, Personal Liberty, Regulation, Zeitgeist

Recently, the US Food and Drug Administration, working with the Institute of Medicine, has been considering a change in the regulatory status of salt.  The FDA cannot currently restrict the amount of salt that can be added to processed foods, and the proposed change would allow them to do so.

Advocates of the proposed regulation, like former FDA commissioner David Kessler and the Center for Science in the Public Interest, argue that reducing the sodium in foods would improve people’s health and cut public health spending.  Opponents argue that the evidence supporting health benefits of sodium reduction is by no means conclusive, and that attempts to reduce sodium intake could actually be harmful.

But a recent study by University of California, Davis nutritionists concludes that it may not even be possible to reduce salt intake through regulation.  The study shows that people are naturally inclined to regulate salt intake to physiologically determined levels by unconsciously selecting foods to meet their needs.

According to the study, measurements collected from over 19,000 individuals from 33 countries worldwide indicate that daily sodium intake is confined to the relatively narrow range of 2,700 to 4,900 mg, with the worldwide average of 3,700 mg.  This challenges the widely held belief that daily sodium consumption in the United States, which averages about 3,400 mg, has reached extreme levels.

The study also cites decades of research describing the specific mechanism by which the central nervous system, acting together with several organ systems, controls our appetite for salt.

In one cited study, a group of nearly 600 participants took part in what was to be a 3 year sodium intake intervention, with the goal of reducing daily intake to 1,850 mg.  After the first 6 months, researchers noted that participants were unable to reduce sodium intake below about 2,750 mg per day—close to the bottom of the range the UC Davis study identified.

Another study had similar findings.  In this study, subjects, through intensive dietary counseling, reduced their daily sodium intake to an average of 1,775 mg over 4 weeks.  The subjects were then randomized to receive either a 2,300 mg sodium tablet or a placebo, while still receiving counseling.

When taking the placebo, average sodium intake stabilized around 2,750 mg—again very close to the bottom of the identified range.  This means that subjects naturally increased their sodium intake when blinded to their treatment.  When this group was switched over to receive the 2,300 mg sodium supplement, daily intake rose to only 4,050 mg, far less than the predicted 5,050 mg.  This suggests that subjects naturally reduced their dietary sodium intake without consciously intending to do so.

The UC Davis study goes on to cite a number of surveys indicating that sodium intake in the United Kingdom has “varied minimally” over the past 25 years, despite a costly Food Standards Agency  campaign to reduce sodium intake in the UK.
The Institute of Medicine says that daily sodium intake should not exceed 2,300 mg, and new guidelines to be released in 2010 may set the recommended maximum even lower. Any regulatory action taken by the FDA would presumably aim to reduce intake at least to this 2,300 mg level, even though it is 17 percent lower than the bottom of the range the UC Davis study identified, and a full 38 percent lower than the worldwide average.

Given the findings of this study, it seems likely that regulation restricting sodium in foods would be ineffective because people would unconsciously adjust their diets to compensate.  As the study puts it, “[sodium intake] is unlikely to be malleable by public policy initiatives”, and attempts to change consumption would “expend valuable national and personal resources against unachievable goals.”

Frivolous Lawsuit Against Denny’s Over Salty Food

by Hans Bader on August 4, 2009

in Legal, Personal Liberty, Precaution & Risk, Sanctimony

Denny’s has never claimed that it serves only health-food, and nutrition facts about its food are available on its web site.

But that hasn’t stopped the notoriously-unreliable Center for Science in the Public Interest from bringing a frivolous lawsuit against Denny’s over its food, claiming that it is defrauding the public by serving food that has more than a day’s supply of sodium. This lawsuit, known as DeBenedetto v. Denny’s, was filed on July 23 in Middlesex County, New Jersey. Hopefully, the judge will impose sanctions on CSPI’s lawyers for bringing this suit.

At the heart of CSPI’s complaint are its unfounded assumptions that (a) all restaurants imply that their food “has no more sodium than a meal at other restaurants,” and (b) that a typical restaurant’s food has no more salt than a person should consume in a day, such that a restaurant’s food doesn’t “contain more sodium than a person should consume in a day.”

Neither assumption makes any sense. Many common food items in grocery stores have more than a day’s supply of salt. One V-8 has nearly half a day’s supply of salt. Many frozen dinners have more than a day’s supply of salt. Why would anyone expect restaurant fare to be healthier? (Many expensive, snobby, high-brow restaurants serve saltier food than what Denny’s serves inexpensively and quickly to America’s working-class and middle-class people.) There is no limit on who can be sued if this suit were to succeed.

Moreover, expecting all restaurants to have less than or exactly equal to the average restaurant’s salt content is as unrealistic as harboring the Lake Wobegon fantasy that all children are above average. Some cuisines are just saltier than others.

If this assumption were accepted, it would be a one-way ratchet that would force all restaurants to steadily reduce their salt content to constantly remain at or below the average of their competitors in salt content. Food would become as bland as cardboard.

And, yet, these are the delusions harbored in CSPI’s court complaint, which contains the following paragraphs:

“48. Plaintiff and New Jersey Consumers have purchased and consumed Denny’s meals without knowing about the presence of excessive amounts of sodium. Plaintiff and New Jersey Consumers reasonably assume that a meal at Denny’s has no more sodium than a meal at other restaurants. As detailed above, this assumption is reasonable, but incorrect, because Denny’s hides the truth about its high sodium levels.
49. The omission of the information that certain meals at Denny’s contain more sodium than a person should consume in an entire day – and that some people should consume in a few days – is misleading. That conduct violates the rights of the Plaintiff and New Jersey Consumers protected by the CFA.”

How could consumers assume anything of the sort? How could they not taste the salt in the food?

My wife likes Denny’s, especially its club sandwiches, and its reasonable prices. When she first immigrated to America, Denny’s was one of the few restaurants she could ever afford to eat at, given her working-class roots. She was well aware that what she ordered was salty. A little extra salt in restaurant food is not a problem for most people, unless, perhaps, they not only have health problems aggravated by sodium, but also are so lazy that, despite those problems, they nevertheless eat out all the time rather than cooking their own meals, even though they could save money by cooking their own meals, as I did when I was younger and had little money to spend.

The Center for Science in the Public Interest (CSPI) is one of the most unreliable sources of nutritional information, having once taught that trans fats were safer than saturated fat.

It has helped to blur the distinction between unhealthy and normal foods over the years, by denigrating normal food items such as baked potatoes, hamburgers, pizza, pork chops, and bacon as unhealthy. Never mind that a baked potato has only 100 calories, gives you 30 percent of your day’s supply of vitamin C (more than a banana), some protein, and many important minerals — and that potatoes are so cheap that even a person of modest means can afford them. The potato saved generations of impoverished Irish, German, and Russian farmers from starvation and diseases related to nutritional deficiencies. (By the way, I lost 10 pounts while working at McDonalds during Summer of 1988, during a 10-week period in which I subsisted largely on the hamburgers I ate for free as an employee).

CSPI’s list last year of eight supposedly awful restaurant foods both blurred the distinction between healthy and unhealthy foods, and shows ignorance of basic math. Along with some disgusting concoctions that were loaded with fat and have few nutrients, its list includes a couple dishes that are fairly healthy, such as the Twice-Baked Lasagna with Meatballs at Romano’s Macaroni Grill.

CSPI faulted the Twice-Baked Lasagna for having twice the fat of most other restaurant lasagnas. But that’s only natural, because it’s a relatively large lasagna — nearly 1360 calories. It also has much more protein than most restaurant lasagnas.

CSPI pointed to no evidence that the Twice-Baked Lasagna has a significantly unhealthier ratio than the typical restaurant lasagna, either in terms of the ratio of fat to protein, or fat to total calories. The Twice-Baked Lasagna has about your daily fat intake, but it also gives you about half your daily calorie needs. It’s a large lasagna, not an unhealthy lasagna. If you were hungry, wouldn’t you rather be served a large lasagna than a small one?

Food Police Attack Denny’s Over Salt

by Greg Conko on July 29, 2009 · 1 comment

in Culture, Healthcare, Legal, Nanny State, Personal Liberty, Precaution & Risk, Regulation, Zeitgeist

It seems that the food police at the unconscionably named Center for Science in the Public Interest are at it again.  These are the same people who’ve attacked movie theater popcorn and who called fettuccini alfredo “heart attack on a plate.”  Their new pet peeve is salt — or to be more specific, sodium.  Last week, CSPI filed a class action lawsuit against the restaurant chain Denny’s, claiming that, because most Denny’s menu items contain a “high” level of sodium, the chain is engaging in consumer fraud and breaching the implied warranty of merchantability.  The complaint itself, filed July 23 in Superior Court in Middlesex County, New Jersey, can be viewed here.

A full analysis of the case’s legal merits will have to wait for another day.  But, suffice it to say that, by alleging on page 3 of the complaint that “Sodium is the deadliest ingredient in the food supply,” these folks aren’t beyond gross exaggeration.  The gist of the argument seems to be that (1) increasing sodium intake is known to increase blood pressure; and (2) very high blood pressure is known to increase the risk of heart attack and stroke; so (3) Denny’s failure to notify customers of the total amount of sodium in its menu items is putting them at risk.

There’s a bit of sleight of hand here, of course.  Although allegations 1 and 2 are true, there is no clear relationship between the slightly higher blood pressure that results from exceding the recommended daily amount of sodium intake and the very high blood pressure levels that raise the risk of heart attack or stroke.  That’s why scientists have never been able to conclude that high sodium intake itself is associated with an increased risk of heart attack and stroke.  It’s like arguing that mouthwash manufacturers are responsible for thousands of automobile accidents every year because we all know that mouthwash contains alcohol and that drunk driving causes auto accidents.

Unfortunately, lawsuits like these are bad news for companies like Denny’s.  Most people won’t bother to see what the facts are, they’ll just hear that Denny’s is being sued for harming customers and it’ll tarnish the chain’s reputation.  It’s one reason why so many unmeritorious lawsuits get settled — it’s much easier to pay the plaintiffs, change your behavior in small ways, and be done with it.  Still, I hope Denny’s decides to fight this one in court.  It’s about time someone started standing up to these bullies.  And, if Denny’s does go to court, I for one will make an effort to eat at a Denny’s restaurant more often.