Is a Salty Slope Slippery?

The New York Sun reported that New York City's health commissioner, "who has already waged war against tobacco, trans fats, and calories, appears to have chosen his next public enemy: salt." The city's Department of Health and Mental Hygiene, "voicing cautionary tales about high blood pressure that can be caused by eating too much salt...in recent months have used editorials, public testimony, and educational campaigns to mount a push for regulation of sodium levels in food.”

Last year I wrote about salt regulation, and considering the further encroachment of the health police and all the buzz we have heard recently about “Regulation,” I’ve decided to repost this and see what people think:

12/26/07

"While voluntary reductions might be preferable to government requirements, the industry, with some exceptions, has demonstrated over the past several decades that it simply has not been willing to reduce sodium levels on its own. Regulations, in the form of limits or warning labels, would ensure that reductions occur and would be permanent."

I need to lower my sodium intake. It's kind of ridiculous at this point. However, the government wants me to lower it too, and that has me concerned. Below the fold is a petition letter to the FDA that crossed my desk last week, which (due to my job) I have asked a group of scientists/thought-leaders to sponsor (Most agree with the letter whole-heartedly). While I'm supportive of the noble goal of the organization that wrote this letter (decreasing the nation's sodium intake by 50% in 10 years), I'm concerned that the government, prodded by the medical community, might agree to an outright ban on my consumption of foods that exceed their regulations.

I don't like the idea of the government policing all of my bad behavior. I realize that as a member of the human race I must bear civic responsibility and weigh my actions in relation to their effect on others, so I recycle everything, don't drive a car, and I'm eating less meat because of the cruelty and pollution issues, but personally, I like many things that are bad for me, and I really like the idea of making a personal choice to enjoy them, even if it kills me.

I know this idea is a roadblock to the utopian vision of many, but at what point does utopia become tyranny? I've met many utopians both super-liberal and super-conservative, and their ideas often seem so reasonable, particularly after the guilt trip they level in an attempt to help me understand why I must become a pod person or protect myself from myself or other people, but I can't shake the feeling that with a little prodding, even the nicest among them would probably make decent SS officers. I just wish they were reasonable enough to let me destroy myself in peace.

I didn't support the ban on smoking (although I enjoy the ban) because (1) it was an attack on personal freedom, (2) the argument against the effects of secondary smoke in light of modern ventilation systems and the general pollution index in an urban area didn't add up, and (3) made the slippery slope for government interference in our personal lives even steeper, but I glumly accepted it due to the (relatively small) public health issue as it relates to bars and the fact that more and more Americans are becoming ignorant of the concept of freedom: if you don't like certain venues then you can stop going to them or start patronizing/opening venues that you do like. Regardless, 20 years ago I don't think anyone would have believed that in DC, the bars, places where generations of people have gone to smoke, drink, and brazenly destroy themselves, would be smoke-free now.

No, I'm not a libertarian, and I'm not voting for Ron Paul. I want the government to ensure that my food and drugs are safe and that businesses are not allowed to practice a vicious and unethical version of capitalism, but where is the line drawn? I'm curious about how we balance government regulation, because I'm conflicted. If we're telling people that they can't decide what products they want to eat, how long until we have national movements for other regulations on our behavior? Banning all meat products? Regulating our bedtime? What about Political Correctness laws? National fitness standards? Banning the sale of music that is deemed "destructive" or "unhealthy"?

Where do YOU draw the line? What regulation is acceptable? Giving the government this kind of power may benefit you on some things, but what about the issues you don't agree with where your opinion is the minority one?

Here is the letter.

Dear Sir or Madam:

The undersigned scientists, health professionals and organizations are deeply concerned about the harm being caused by excessive amounts of sodium in the American diet and commend the FDA for holding a hearing on this important topic. We support the actions proposed in the Center for Science in the Public Interest’s petition, which include revoking the Generally Recognized As Safe (GRAS) status of salt and making salt a food additive, limiting sodium levels in key categories of packaged foods, and other measures.

The extraordinary importance of lowering salt consumption was highlighted in 2004 by the director of the National Heart, Lung, and Blood Institute (NHLBI), Dr. Claude Lenfant, and his colleagues. They estimated in the American Journal of Public Health (2004;94:19-21) that reducing sodium levels in packaged and restaurant foods by 50 percent would save about 150,000 Americans per year from fatal heart attacks and strokes. The goal of reducing sodium consumption by 50 percent over 10 years was endorsed by NHLBI’s Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC 7) of which several of the cosigners of this letter are members.

A recent government-sponsored landmark study found that among people aged 30 to 54, who were pre-hypertensive, and cut back on sodium, (the average reduction was 800 to 1,000 milligrams a day – for 1 ½ to 3 years) reduced their chances of developing cardiovascular disease by 25 percent and their risk of dying from it by 20 percent.

The 2005 Dietary Guidelines for Americans advises young adults to limit their daily sodium intake to 2,300 milligrams (mg) and middle-aged and older adults, African Americans, and people with hypertension to limit their intake to 1,500 mg. Despite experts’ admonitions over the years, per capita sodium consumption has actually increased (according to NHANES surveys) from 2,800 mg in 1976-80 to 3,400 mg in 2003-04. According to the 2003-04 NHANES survey, 70 percent of adult males and 50 percent of adult females exceed the 2,300 mg sodium intake.

The FDA has the responsibility to ensure the safety of the food supply, but has done little with regard to salt. Despite the scientific consensus that current levels of salt consumption are harmful (and despite a 1979 FDA advisory committee’s conclusion that the evidence didn’t support the GRAS designeation), the FDA still considers salt to be GRAS. The FDA has implemented the Nutrition Labeling and Education Act, which has required sodium to be listed on food labels since 1994, but even that has not reduced sodium consumption. Clearly, stronger measures are needed to prevent the widespread disease and death that is quietly being caused by salt.

In contrast to the U.S. government, the United Kingdom’s Food Standards Agency (FSA) has made salt reduction a top priority. The FSA is making consumers more aware of the health threat posed by excessive salt consumption. The FSA is also exerting strong pressure on the food and restaurant industries to gradually lower sodium levels by about one-third over five years.

Salt reduction should be a top health priority of our government also. Holding the salt reduction hearing is a first step. We urge the FDA to take further steps by implementing the proposals outlined in the CSPI petition and improve the diet and health of the American public. Judging from differences in the sodium contents of different brands of the same food, major reductions should be feasible in the near future. Subsequent reductions would be facilitated if industry-wide reductions gradually accustomed consumers to less salty foods. While voluntary reductions might be preferable to government requirements, the industry, with some exceptions, has demonstrated over the past several decades that it simply has not been willing to reduce sodium levels on its own. Regulations, in the form of limits or warning labels, would ensure that reductions occur and would be permanent.