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Holding the salt could save lives, money

We’ve all been warned of the dangers of too much salt, but it’s hard to regulate salt intake when we’re at the mercy of food manufacturers, who use salt as an easy way to seduce consumers. “The amount of salt in processed foods is just unbelievable,” health policy researcher Douglas Owens, MD, recently told me. “Last night my wife made pizza for our son, and when I looked at the crust alone, it had 4 grams, twice the amount an adult should have in a day. I think the point is that you can’t really cut your salt unless you never eat anything that you didn’t prepare yourself.”

That is why Owens and his colleagues at Stanford’s Center for Health Policy are helping lay the statistical groundwork for a national salt reduction campaign, similar to the one now underway in the United Kingdom. In a new study in the Annals of Internal Medicine, they looked at the numbers behind a voluntary food industry campaign that would limit the amount of salt in processed foods. The results: Nearly a million Americans would be spared from potentially fatal heart attacks and strokes while we would collectively save more than $32 billion in medical care costs. The improved health outlook would come from just a modest reduction in blood pressure, a major risk factor in cardiovascular disease.

“We found these small decreases in blood pressure would be effective in reducing deaths due to cardiovascular disease,” said Crystal Smith-Spangler, MD, the lead author of the study. “The numbers of affected people are huge, so even that small decrease is significant if you have large numbers of people involved.”

As a population, we tend to abuse salt: more than 75 percent of Americans consume more than the recommended amount of 2.3 grams a day, according to the Institute of Medicine (IOM). And we bear the brunt of that through high blood pressure, which is related to salt intake; as many as 73 million Americans suffer from this condition, which can be very hard to manage, the IOM says. And many Americans aren’t even aware that they have this potentially dangerous condition.

A national salt campaign, however, is not without its critics. In a recent column in the New York Times, John Tierney argues that Americans are unlikely to change their ways, and would likely compensate for lower salt foods by adding more of their own or eating more fat to make up for the change in taste. He also cites longtime critic David McCarron, MD, of UC Davis, who believes we are naturally programmed to consume a specific amount of salt, a kind of salt set point for each individual.

Still, the salt-hypertension connection remains incontrovertible, and it seems to me that as a nation, we should do what we can to bring down salt levels in our food.

Previously: Hold the salt, and help the heart

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