NaCl

So this whole brouhaha is being orchestrated by CSPI. I might have guessed as much.

Funny thing is, for once I agree with them in principle. I'd like to see less salt in food. I speak with my pocketbook. I tend to buy low or reduced salt prepared products (and there are quite a lot of them on the market these days).

Where I part company with CSPI is on this issue is their tactics. Sorry, CSPI, but NaCl *IS* genuinely, demonstrably, and indisputably Generally Recognized As Safe if ever there was a substance deserving that classification. It does NOT warrant classification by FDA as an additive.

I wonder if anyone's looked into how many extra deaths have been caused by consumers who were goaded into excessive worry, stress, and paranoia due to CSPI's many food scare campaigns?

Low-salt, low-salt uber alles? Bah! Down with the food Nazis.

-Paul W.

CSPI brought some heavies along on this attack, though, Paul.

Even the FDA has indicated in their newsletters that increasing sodium levels and increasing heart related problems are probably directly related. The issue is certainly worth debating solely on public health grounds -- heart disease is a leading cause of death in this country, year after year.

We spend billions on curing or alleviating the disease -- a more effective preventative approach would certainly be desirable.

CSPI brought some heavies along on this attack, though, Paul.

Even the FDA has indicated in their newsletters that increasing sodium levels and increasing heart related problems are probably directly related. The issue is certainly worth debating solely on public health grounds -- heart disease is a leading cause of death in this country, year after year.

We spend billions on curing or alleviating the disease -- a more effective preventative approach would certainly be desirable.

I agree, regarding prevention vs. curing/alleviating.

But tactics for combating the problem is the issue.

We allegedly have a free society here, where each person makes their own choices on how they live their lives.

If a majority of Americans choose to live a high-sodium lifestyle that CSPI doesn't like, well, that's CSPI's problem, and they'll just have to live with it.

Ends do not justify the means. The additive laws are there to keep truly toxic substances out of food. Twisting and perverting these laws to promote healthy lifestyle choices (emphasis on CHOICE here) is not justified nor socially welcome.

If CSPI is a much right as they are righteous, let them use the bully pulpit to shame the food industry into offering healthier choices. There is plenty of precedent for this tactic working.

-Paul W.

Seems like they are making the FDA hearings their bully pulpit, Paul. One of the experts proposed at the hearing a food rating system to make it easier for people to understand the pros and cons of foods.

The NYTimes has an interesting article on this part of their attack, as well as a couple of competing standards.

http://www.nytimes.com/2007/12/01/busin ... od.html?hp

Thanks for concrete info and links, Bob. (Knowing it's CSPI, I'm fairly sure it was not a smoke-filled room, and very sure it was not a tobacco-smoke-filled room.) Absence of the individuality factor I mentioned is conspicuous -- I suppose it clouds the issue from an advocate's standpoint but still if it's true (I know little about this subject) it is important. From those postings, it looks as if sub-Saharan African genes may be an example of an individual predisposing factor for sodium sensitivity.

Striking to contrast this case with trans-fatty acids. There, the new mandate to list them in US nutritional labeling is what drove them recently out of mass-market foods. Yet sodium (and recommendations of limits on it) have been on these labels for years, to obviously less effect.

Even gastronomically, the sodium in US products is a problem. Lately I found a brand of economical Italian-import canned tomatoes (La Primavera from Fratelli Andolfo s.r.l. and imported here in the SF area by the A. G. Ferrari grocery chain) with -- mirabile dictu Dei gratia! -- very little sodium (70mg per US cup of 225ml) vs. 500+ mg, even 900+ mg, for some US brands of this indispensable cooking ingredient that I use constantly. (The others even taste oversalted, health issues or no!)

Even gastronomically, the sodium in US products is a problem. Lately I found a brand of economical Italian-import canned tomatoes (La Primavera from Fratelli Andolfo s.r.l. and imported here in the SF area by the A. G. Ferrari grocery chain) with -- mirabile dictu Dei gratia! -- very little sodium (70mg per US cup of 225ml) vs. 500+ mg, even 900+ mg, for some US brands of this indispensable cooking ingredient that I use constantly. (The others even taste oversalted, health issues or no!)

This is my point.

CSPI is in the right on this issue (for a change ). They don't need to resort to their usual last-refuge-of-the-scoundrel tactics. No need to try to get sodium legally branded as a toxic additive (which it's demonstrably not, from a scientific viewpoint). The approach they SHOULD be taking is the approach based on the truth:

High-sodium foods are a cheap cop-out. Unnecessary added salt is something you put in to disguise the faults in an otherwise inferior product. AND to top it off it might be bad for you.

For once in their career, CSPI doesn't have to resort to lies, half-truths, and subterfuge. Shock horror! They don't know how to deal with it.

-Paul W.

No need for a chip on your shoulder. It's called dialogue. So we disagree, that's what makes discussions interesting. I'm supposed to agree with everything you say?

I would hope that no one agrees with everything I say. Last thing I want is a planet of people that all thing the same way. Sorry if it came off wrong but I just felt you were asking for dialog and then discounting that dialog for which you did not agree.

No worries.

I'm cool. I throw out (sometimes controversial) topics to generate interesting back and forth discussions.

[Jenise]

Seems to me there are some folks who pretend to understand the inner city multi-cultural marketplace without ever experiencing it firsthand.
Pfew!
Bp

Pretend? That's a pretty insulting assessment. If you're pointing the finger at me, there was actually an article on the subject (why fast food thrives in poorer communities) in one of the three or four national magazines I read, most likely either TIME or The Atlantic, though it could have been something I picked up in a doctor's office, too.

Jenise, I saw a recent article on the subject, Atlantic I'm sure, but there is no doubt this is a real problem in inner cities. Here's an article from Boston a couple of years ago:

The problem is relatively new and rapidly worsening. Thirty-three years ago, when I began treating the children of the South End and Lower Roxbury, I was not confronted with 300-pound 14-year-olds. We worried about chicken pox and measles in children, but not Type II diabetes in teens.

Now, a shocking 40 percent of our 8,000 pediatric patients at the South End Community Health Center are clinically obese. On a recent Friday, 75 percent of the children I saw were obese. Why is this?

* Diets have changed. Inner-city children of immigrants who once ate home-cooked meals of rice and beans now consume fast food once a day or more. Cheap, tasty, on every corner, and buttressed by a barrage of advertising, fast food has become an almost inescapable option for overworked, often single parents with few economic resources. Adding to the problem is the fact that low income neighborhoods have 30 percent fewer supermarkets than more affluent areas.

* Television confines children and teens to the couch, burns no calories, and bombards children with a constant stream of ads for soda, hamburgers, and snack food.

* Exercise has virtually vanished from public schools. In safer suburbs children and teens have opportunities to play outside and to use yards, public parks, and playgrounds. Where and when can inner-city children burn off calories and build their bodies?

The causes are simple. The solutions, unfortunately, are not. What is required is a change in lifestyle. At the community health center level we are ideally situated to recommend the needed changes and monitor and reinforce those changes over the months and years needed to see that lifestyle and health improve.

Finally, let's stand up to the purveyors of fast food. As a society we took on tobacco and alcohol when their health ravages became too high a price to pay. Junk food is addictive, its advertising pervasive, and its health effects pernicious. Our politicians need to find the courage to stand up to corporations that are selling our children shortened lives.

It is fashionable in some circles to laugh at such talk, to say that "personal responsibility" should drive better health behavior and the market remain unregulated. That is a hard argument to make in the face of a depressed, obese child whose health is failing, who has no safe place to exercise, and is under siege by adults selling him salt, fat, sugar, and a shorter, sadder life. As adults, we have an obligation to do better.

<------------------->

Dr. Gerald Hass is physician-in-chief at the South End Community Health Center, assistant clinical professor of pediatrics at Harvard Medical School, and a senior associate in medicine at Children's Hospital.

http://www.commercialalert.org/obesityhass.htm

It would be very easy to put together a bibliography of similar reports, but I'm impressed with Hass and his work.

Consumer Union has been a leading voice in the area; I was impressed with this letter outlining the problem two years ago:

Link.

Regards, Bob

Bob,
Thanks for the articles. I found the following part of the second link interesting:
The fast food industry may also exert undue influence on children, regardless of their social, economic, and ethnic backgrounds:
&#9679; According to CBS News, “[t]he highest levels of fast-food consumption were found in youngsters with higher household income levels, boys, older children, blacks and children living in the South.”
&#9679; “Every day, nearly one-third of U.S. children aged 4 to 19 eat fast food, which likely packs on about six extra pounds per child per year and increases the risk of obesity, a study of 6,212 youngsters found.”
&#9679; According to Consumer Reports, “[a]-not-yet published 15-year study from Harvard Medical School of more than 3,700 young adults from across the country found that eating fast food more than twice a week increased the risk of obesity by about 50 percent for whites....”
Recent data suggests that nearly 15 percent of our children are obese.
This strongly suggests that this phenom is not restricted to particular socio-economic groups and just perhaps it isn't just low income people packing away the big macs. This is interesting since higher income people (myself included) have more options, more resources available, but fail to take advantage of these options.
Thanks again for posting this.
BP

There will be tons of ink and pixels spilled on this issue over the next few months, but I really enjoyed this analysis, which outlined some of the junkier aspects of the science relied on in the petition. And, in favor of salt:


The other side of the coin

If there is no support that salt reduction among the general population, versus people with specific medical issues, will save lives and help ensure that everyone will enjoy longer, healthier lives; any evidence that such reductions might harm vast numbers of the population becomes even more critical to consider. Yet, the possible adverse effects of salt reductions aren’t mentioned by CSPI and rarely in the media.

Far from being totally benign, the European Society of Cardiology Guidelines for the Management of Arterial Hypertension, for instance, reported recent research showing low-salt diets can have negative effects: activating the rennin-angiotensin system and the sympathetic nervous system, increasing insulin resistance and hypodehydration (especially with the elderly). This, they concluded, could lead to increased risks for cardiovascular disease.

A cardiologist once explained one of the concerns very simply, when commenting that some of the longest living people in the world also have the highest salt consumptions. When most of us eat a lot of salt, we get thirsty and drink water, and our bodies excrete the excess sodium chloride while maintaining the balance of sodium in our blood and our blood pressures. Our bodies are designed to compensate for excess salt without hurting us. When people eat less salt, though, blood levels of sodium can drop below normal. Should you get sick, go out in the hot sun or exercise, when you drink more water, it dilutes the sodium even more, resulting in greatly increased risks for heat stroke or circulatory collapse. Now, that’s not good for your health.

Salt also improves the flavor of many nourishing foods, helping to prevent nutritional deficiencies especially among vulnerable populations, such as children and elderly. It does more than make many of the foods we love taste good. Salt has served invaluable roles in food preparation and preservation, baking, culturing cheese, and making our food safer to eat since the earliest days of mankind. Salt reductions could jeopardize these benefits, at costs to health, safety and enjoyment of foods.

A recent randomized clinical trial of patients with hypertension, published in the American Journal of Hypertension, confirmed the connection with insulin resistance, as noted by the European Society of Cardiology. It found that increasing sodium in their diet appeared beneficial and concluded: “An abundant sodium intake may improve glucose tolerance and insulin resistance, especially in diabetic, salt-sensitive, and or medicated essential hypertensive subjects.”

The authors of the NHANES II follow-up study of a representative sample of U.S. residents were especially cautious about establishing dietary guidelines based on currently available evidence. This study, led by Dr. Hillel W. Cohen, MPH, DrPH, of the Department of Epidemiology and Population Health at Albert Einstein College of Medicine, Bronx, NY, said that guidelines calling for reductions are based on the modest blood pressure changes associated with low-sodium diets in short term clinical trials. “However, these trials could not assess the long-term cardiovascular morbidity and mortality consequences.”

They said that caution was especially advised with making conclusions based on observational studies, as “no single observational study can confirm a causal inference.” We recently saw that when that World Cancer Research Fund Expert Report said that many of the claims of salt being associated with health problems and higher rates of premature deaths are due to confounding factors not considered in observational studies. For example, they noted that “salt is inversely related to the availability of refrigeration in a population, and so to socioeconomic status.”

Good Salt/Bad Salt Debate

I've enjoyed a number of Sandy Szwarc's articles in the past, and this one shows every sign of very good research -- it's a good place to start unless you've already made up your mind on the issue.

Regards, Bob

PS: Her blog's name really tickles me:


Junkfood Science

Critical examinations of studies and news on food, weight, health and healthcare that mainstream media misses. Debunks popular myths, explains science and exposes fraud that affects your health. Plus some fun food for thought. For readers not afraid to question and think critically to get to the truth.

http://junkfoodscience.blogspot.com/

[David M. Bueker]

This strongly suggests that this phenom is not restricted to particular socio-economic groups and just perhaps it isn't just low income people packing away the big macs. This is interesting since higher income people (myself included) have more options, more resources available, but fail to take advantage of these options.

Which is not something that should be used to put extra regulations in place for the free markets.

But to Jenise's prior point, the main city near me has essentially zero major grocery stores. They all moved out. There's one small, privately owned store with a very high fence (and the one time I was in it, very poor selection of anything that wasn't frozen, canned or made with hops, barley and yeast), but that's it. Not a lot of choice in the inner-city neighborhood.

David,
I agree. None of this justifies additional regulations, although I'm sure the end result will be the opposite of my desire.
I'm not so silly as to thinks there equal opportunities to find quality food products in the inner cities. There are studies that have concluded that demand/consumption for fast food is relatively inelastic vs. income level. This at least suggests on the surface, that inner city people (low income?) are not more prone to consume fast food than higher income groups, despite being at the disadvantage of not having as many options as the general population.
Bill

"This at least suggests on the surface, that inner city people (low income?) are not more prone to consume fast food than higher income groups, despite being at the disadvantage of not having as many options as the general population."

Bill, you've lost me. You seem to be agreeing with Jenise that there are less inner city choices, i.e., relatively more fast food joints in those locations.

Doesn't it follow that inner city people are forced to consume more fast food?

"This at least suggests on the surface, that inner city people (low income?) are not more prone to consume fast food than higher income groups, despite being at the disadvantage of not having as many options as the general population."

Bill, you've lost me. You seem to be agreeing with Jenise that there are less inner city choices, i.e., relatively more fast food joints in those locations.

Doesn't it follow that inner city people are forced to consume more fast food?

Bob,
I don't believe it necessarily follows that inner city people consume more fast food. While it is true that the inner city offers fewer choices in quality food, as well as many other consumer items, at least some studies suggest that lower income people (inner city?) consume fast food at about the same proportion/rate as their higher income (suburban?) counterparts.
Bill

Bob, thanks for the further quotations showing other sides of this.

This probably doesn't need pointing out, but one need not be in favor of salt to oppose mythmaking or demagoguery. (I've run into those often, on public-policy issues with technical content .)

Since the mid-20th-century, flavors of packaged, canned, and "instant" foods have been routinely tarted up with legal but hokey crutches, especially salt, sugar, MSG and its relatives, and hydrogenated fats. Some products like dried soup mixes have contained little else. Critics pointed out -- in one backlash against this practice, for soups in particular, some years ago -- that if you pulled out those four additives, what's left would taste like dishwater. Awareness of this basic situation is a good aid to learning about flavor, IMO.

I like the idea of my Besserwissers forcing me to make the right decisions by legislating away my right to choose for myself. It saves me from thinking or making decisions they don't approve of.

Found the following interesting as it Relates to the discussion of real groceries leaving the inner city. Today was the grand opening of a Giant grocery store in ward 8 of DC which is one of the poorest section of town. Ward 8 is the south-east part of DC across the anacostia river. According to the news article it is the first major grocery to move into the area in 10 years but it also noted that there are other smaller non-chain grocery stores that have been in the area. This move was apparently part of a larger development plan but what was not clear was if the government was subsidizing the development.

Found the following interesting as it Relates to the discussion of real groceries leaving the inner city. Today was the grand opening of a Giant grocery store in ward 8 of DC which is one of the poorest section of town. Ward 8 is the south-east part of DC across the anacostia river. According to the news article it is the first major grocery to move into the area in 10 years but it also noted that there are other smaller non-chain grocery stores that have been in the area. This move was apparently part of a larger development plan but what was not clear was if the government was subsidizing the development.

So I have to ask the question: has ward 8 been so ill-served by the "smaller non-chain grocery stores that have been in the area" that the ward needs or wants the incursion of a "major grocery"?

In my own area, which is decidedly non-urban, I've found that the non-chain grocery stores that still remain are the places I can find items that are out of the mainstream.

I'm also fortunate that one of the regional chains (Market Basket) has excelled at tuning its individual stores to the local needs, especially regarding ethnic foods, of individual neighborhoods.

So I wouldn't necessarily count presence of chain grocery stores in the inner city as a plus.

-Paul W.