Salt in the wound

A sophisticated analysis, just published in the journal hypertension and based on three separate computer modelling approaches, found that significant reductions in the average intake of sodium in the American diet can save between 280,000 and 500,000 lives in the next decade.

Those are big numbers, impressive. Not all that long ago, this provocative statement would be a clear and direct to goad public action because there was widespread acceptance that excess sodium has been damaging. While that view still persists among the majority of the experts, a vocal minority has voiced dissent over the last few years enough to create at least the impression of dwell. There is the possibility, then, that the opportunities highlighted in the new study may prove to be only new fodder for endless and controversial debate. I'd help you preempt.

The new study has worked its various models based separately on observational epidemiology, epidemiological studies and intervention trials. For A long time we had evidence that excessive dietary sodium is harmful, based on only those sources.

[See 9 surprisingly simple ways to reduce sodium intake]

Decades of observational epidemiology indicate lower rates of hypertension, stroke and cardiovascular disease in populations with lower salt intake. Obviously such studies, such as Intersalt, cannot completely isolate the effects of sodium. Intervention trials, however, as DASH and related studies can and have reached similar conclusions —. Cross-cultural studies that track what happens to health outcomes as move groups with the same genes in different cultural contexts have lent further support.

[See DASH diet]

On the basis of the aggregate evidence, the Center for Science in the public interest has long asserted that sodium excess kills 150,000 Americans prematurely every year. While the new analysis suggests that self-esteem can be a bit overkill, corroborates the fundamental concern.

Of course, the issue has always been that excessive sodium was harmful and even then, only for those who are vulnerable to its effects. Sodium, per se, are not only not harmful, is essential for life. If you don't consume enough sodium, we develop hyponatremia (low blood sodium), and if that continues, we die. Most of us who have gone through the medical education have seen cases of life-threatening hyponatremia, and it isn't pretty.

The mere possibility of an excessive intake of sodium is a modern anomaly. Marine animals — and is long enough, that was the whole animal life — are surrounded from the brine and immune to be pickled from it. In the seas, we had unlimited access to soda and were at no risk of too.

[See the skinny on salt. How Much Is Too Much?]

Our need has become acute sodium only when we ourselves took out that brine and became terrestrial creatures. On Earth, the soda is pretty hard to find a suitable power, let alone in excess. Deer will be licking a salt for that very reason.

But "salty" is one of several basic categories of food and flavor as others on that list — particularly sweet and savory, tend to stimulate the appetite. So while adding dietary salt was born with conservation efforts and prevention of deterioration, more time has been added to make the food more palatable. Copious additions of salt in processed foods are among the reasons why no longer no one can eat just one.

Of course, you really shouldn't be any debate about the harm of excess "sodium", because they give is implicit in the term "in excess". If our sodium intake not harmful, what basis there would be defined as excessive? Compared to what?

That showing the weight of evidence is that the prevailing assumption is excessive compared to what is optimal for health. Taking environment into United States is excessive by the standards of the world — standard associated with much lower rates of sodium-related chronic diseases, such as hypertension, osteoporosis, stroke and heart disease. Prevailing levels are excessive compared to our native intake level in a food world and recognizable Speakable, no Golden Arches. Our stone age ancestors consumed more sodium, potassium and we reversed that ratio dramatically.

The fact that too much harmful does too little innocuous. The deficit, as excess, is a term of quota: deficient, compared to what? We need a certain level of sodium to maintain normal levels in our blood, maintain normal blood pressure and maintain their normal hormonal balance. Neither too much nor too little is good. So the studies showing potential damage from very low sodium intake are not surprising.

Nor do such studies invite you to neglect the prevailing excess. It would be foolish to overlook global warming (more than they already do) for fear that our efforts could overcome corrective and induce an ice age. The fixable problem that we should have priority over the hypothetical problem which we could create, if we pass absurdly. Let's not exceeding — but let's do something.

That something? Experts claim a need for change in processed foods, which provide 80 percent of the sodium we eat all. The saliera adds only minimally. With regard to taking matters into their own hands, you can do this by eating more foods directly from nature. They tend to represent the relative scarcity of sodium and potassium plenty familiar to our ancestors and help move our balance of these nutrients to the normal native.

[See 7 reasons for choosing a vegetarian diet]

Interested parties that we have distorted the harmful effects of any nutrient because they deserve to be heard. But going too far when any given study is used to replace the hard-earned aggregation tests that preceded it. Scientific evidence is more useful in the context. When the scientific opinion is knocked around like a ping-pong ball, public health tends to take a beating.

There is no doubt that eating habits at odds with the fundamentals of what we know about the basic care and feeding of Homo sapiens are major cause of most egregious injury imposed on modern public health. There are many minor and major gaps excesses that contribute to the adversities of our dietary intake, and an excess of sodium is in no way responsible for what ails us. But the weight of evidence implicates much like one of the many shows.

There are, in other words, serious wounds in public health — and there is, along with the rest of a dubious recipe, salt into those wounds.

Hungry for more?Email eatandrun@usnews.com with questions, concerns and feedback.

David l. Katz, MD, MPH, FACPM, [RSDT], is a specialist in internal medicine and preventive medicine, with particular experience in nutrition, weight management and prevention of chronic diseases. He is the founder and Director of the Prevention Research Center at the University of Yale and principal inventor of NuVal nutrition guidance system. Katz was appointed editor-in-Chief of childhood obesity in 2011 and is President-elect of the American College of Lifestyle medicine.

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