Salt

A Whole Lot of Shakin’ Going On 

Salt was at one time so precious and rare a commodity that Roman soldiers were paid with it. In fact the word salary comes from the Latin word for salt.

By: Dr. David L. Katz*

Salzburg, Austria translates to “salt city.” At one time, the city was a center of commerce based on this prized commodity. But the modern food environment has done to salt what it has done to calories, sugar, and saturated fat: Transformed what once was scarce into a daily dietary deluge.

We are all but drowning in salt.
The recommended intake for U.S. adults is up to 2300 milligrams per day, but the average daily intake is 50 to 100 percent higher. From its once exalted status, salt has become the subject of scorn and scrutiny.

Last week – at the prompting of the Center for Science in the Public Interest – the FDA held a daylong hearing to consider regulating salt as a harmful food additive. Salt is currently considered – in FDA-speak – GRAS: generally recognized as safe. That designation means carte blanche for food companies when it comes to salt in their recipes. Regulation would mean the government says when the salt must stop pouring into processed foods.

The American Medical Association weighed in strongly in support of regulation, noting that excess dietary sodium contributes to high blood pressure. High blood pressure is the leading cause of stroke, which kills 150,000 U.S. citizens every year.

My view? There is certainly too much salt in processed foods. What’s worse, it’s not only hiding where you would expect it. Many popular breakfast cereals have more added salt, calorie for calorie, than potato or corn chips -- this is not theoretical; I’ve done the math! Some chocolate drinks have more added salt than salty snacks, too. What chance do you have of meeting recommendations for salt intake for your whole diet when breakfast cereal pulls your average up -- not down?

I don’t object to category-specific caps on sodium content. There is a reasonable upper limit to the amount of salt that should be added to foods that aren’t even supposed to be salty, and if the industry won’t apply that limit voluntarily, it should perhaps be imposed.

There is a fringe benefit of reducing salt in sweet foods: they wind up tasting sweeter. My wife and I have wondered why cookie recipes should call for salt. Since we couldn’t come up with a good answer beyond tradition, we took the salt out. I am pleased to report the cookies did not explode. But they tasted too sweet without the salt, which cuts the taste of sugar. So we reduced the sugar, too, and still the cookies failed to blow up! They tasted great, and their shelf life far outlasted our restraint.

Still, I’m a little dubious about regulating salt levels. If salt is regulated, why not sugar, or saturated fat? And if all of these are regulated, we do seem to be inviting nutritional martial law. Although my detractors have accused me of being a member of the food police, I don’t want cops running the kitchen any more than you.

I also have doubts about trying to fix the food supply one nutrient at a time, because it invites mischief. Some years back when the health benefits of oat bran were hot off the presses, every product boasted in a banner ad that it contained oat bran. The banner ad did not tell you that the amount of oat bran was vanishingly trivial, and that in every other way the product was nutritional junk -- as was often the case.

More recently we’ve seen the same problem with claims about no cholesterol, no trans fat, or the addition of whole grains.
A product that boasts “reduced salt” in compliance with new regulation may compensate by adding sugar, or saturated fat. When I’ve scrutinized products – which I’ve done many times – I’ve often found that one improvement highlighted on the front neglects mention of an array of unfavorable changes with every other nutritional property. So much so that some “better for you” products are not better for you at all! Regulation of salt could lead to “Low Salt” advertising boasts that mask a host of other nutritional ills.

While I think sodium reduction is important, I am not convinced the best way to better nutrition is one regulated nutrient at a time. I support reduced sodium intake, but only as one aspect of better nutrition overall.
I think the right tools can help us get to better overall nutrition, and have been devoting considerable time and energy to that very cause (see: http://abcnews.go.com/Health/Diet/story?id3930233&page1). Transparency about the nutritional qualities of our food may be a better fix than nutrient-by-nutrient regulation.
FDA attention to the hazard of excess salt in our diets is warranted, and therefore welcome. While waiting for the FDA to decide what to do, you can certainly make some headway on your own. The recommended daily intake of salt translates to a bit over a milligram per calorie. So look at the nutrition facts panel to find sodium, and calories. If there is more salt than calories, consider the food salty, no matter what category its in. You will usually be able to find a similar but less salty alternative on the shelf nearby.
If we start to show we prefer less salt in our diets, the food supply will change to accommodate our demand. Job one for the food industry, after all, is to keep the customer satisfied. With or without help from the FDA, we can start to shake up the salty status quo one informed food choice at a time.

* David L. Katz, MD, MPH, FACPM, FACP; Director, Prevention Research Center, Yale University School of Medicine and medical contributor for ABC News. He may be reached at www.davidkatzmd.com.