About a week ago, I discussed the shortsightedness of a New York City Council proposal that would limit the number of calories in McDonald's Happy Meals (and other similar promotions) to 500. Now Big Apple lawmakers are back at it again, with another food-based nanny law passed Wednesday that would require any meal with a sodium content exceeding 2,300 mg (the recommended daily amount, which is generally consumed in the form of salt), to be flagged with a salt shaker. Not only do we believe that these regulations will not work, but they'll only confuse the science and vilify an essential nutrient.
For several decades, salt reduction has been trumpeted as a necessity for healthy living by NGOs and public health advocates, but this position does not have enough scientific backing to be accepted as fact. In 2010, the Dietary Guidelines for Americans first stated that we should be consuming less than 2,300 mg of sodium a day, but the American Heart Association's position was that one should consume less than 1,500 mg daily. Another analysis put the average American's daily sodium intake at just under 4,000 mg. There's a large disparity between reality and what officials recommend, creating a fair amount of confusion in the process.
From a policy standpoint, as I pointed out with the Happy Meal bill, merely providing more information does not necessarily change consumer choice, and these "warning labels" are not likely to work. Several studies comparing neighboring counties, some with calorie counts and others without, showed no difference in the meals purchased and calories consumed. Ergo, there's no reason to believe behavior will be altered when it comes to salt warnings: people will keep buying their high-salt meals.
From a science standpoint, the story on salt is a bit shaky, which was highlighted in the 2013 Institute of Medicine report on sodium intake, commissioned by the CDC. Its main finding was that the literature does not elucidate a benefit of restricting sodium intake below 2,300 mg, and furthermore, it actually may cause harm. Its authors cited several studies in making this claim, including one from 2008 noting that patients with congestive heart failure on sodium restriction to below 2,000 mg had more hospital readmissions, and a higher risk of death, than those who consumed 2,700 daily. And then there was a 2011 study of 29,000 adults with high blood pressure which found that a sodium intake below 3,000 mg and above 7,000 mg was associated with increased risks of heart attacks, strokes, congestive heart failure and death.
More recently, a study this year of 2,600 septuagenarian found a higher mortality risk for those who consumed more than 2,300 mg of sodium, but the increase was not statistically significant. Another study this year of adults in Japan, where researchers followed them for three years, found that high sodium intake was associated with a 25 percent greater risk for increased blood pressure.
Why all this attention devoted to salt? Sodium is instrumental in water balance in the human body. Sodium is also vital to maintaining electrical potential across cell membranes, which is important for nerve innervation and muscle contraction and relaxation. Sodium balance is also instrumental to cellular health, as it's involved in actively moving chemicals into, and out of, our cells.
As with consumption of any food, moderation is the key because the dose really does make the poison. A report by the Center for Science in the Public Interest listed many meals which can be bought at NYC chains that have almost laughably-high levels of sodium.
For instance, a Buffalo Chicken Cheese Steak (on White Giant bread) from Jersey Mike's, has almost 7,800 mg of sodium. Analysis of this sandwich highlights the notion that consumers should aim not for a specific daily intake figure, but instead for an amount within a healthy range. Researchers working at McMaster University in Canada recently published a paper showing that those who stay between 3,000 to 6,000 mg of sodium per day were less likely to have heart problems, and less likely to die from heart complications.
All this leads us to the conclusion that when it comes to salt intake, moderation is the spice of life.