Diabetes Self-Management Blog

It has long been conventional wisdom that Americans eat too much salt. Consuming too much sodium in the diet has been linked to hypertension (high blood pressure), which is of particular consequence to people with diabetes because they are already at higher risk for the condition. Hypertension is often called “the silent killer” because of the damage it can cause long before symptoms are present. According to the American Heart Association, possible consequences of hypertension include heart and artery damage (leaving people more susceptible to a stroke or heart attack), kidney damage, and vision loss — outcomes that are also recognized as diabetic complications and linked to sustained elevated blood glucose levels.

But a recent column in The New York Times suggests that the salt situation is less clear-cut than one might think. Some medical experts estimate that reducing salt in processed and restaurant foods could save as many as 150,000 lives each year, while others warn that these estimates are based on questionable data and that such a salt-reduction effort could have unintended negative consequences. One researcher profiled in the article conducted a study that found salt consumption to be remarkably consistent across 33 different countries, leading him to theorize that people automatically and unconsciously adjust their intake of salt based on how much of it their body needs. Given that people can and do add salt to their food (including, according to reports, New York City mayor Michael Bloomberg, a prominent advocate of salt restrictions) — and that people could conceivably eat more food to maintain a consistent salt intake if their food were less salty — the effect of regulating salt in food could be neutral or even negative, if this theory is valid. Critics have pointed out that this researcher, David A. McCarron of the University of California, Davis, is a paid consultant for a group that advocates on behalf of the salt industry.

On the other side of the salt argument is the Center for Science in the Public Interest (CSPI), a nonprofit nutrition advocacy group. Its director has testified before Congress that the government could save $9 billion a year in medical costs if salt were reduced by 25% in packaged items and restaurant food. The group issued a lengthy report on the dangers of salt in 2005. In it, CSPI concedes that the best method of measuring dietary salt intake — urine analysis — has not been used in most studies connecting salt consumption to medical outcomes. Instead, many studies have relied on self-reporting of dietary habits, which tends to be less accurate. Nevertheless, CSPI has called on the US Food and Drug Administration (FDA) to regulate salt as a food additive, which would end food manufacturers’ near-complete control over the salt content of their products.

Have you tried reducing the amount of salt or sodium in your diet? Did you succeed, and if so, did you experience lower blood pressure or any other positive or negative effects? Do you think the FDA should have the power to regulate salt as a food additive? Should lawmakers and regulators wait until a randomized clinical trial of a low-salt diet has been conducted (which would be lengthy and expensive) before mandating salt reductions in food, as some skeptical scientists are urging? Or should salt be reduced as a precaution, in the wake of substantial but not definitive evidence? Who should decide? Leave a comment below!

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Flashpoints
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