Pass the salt, please……NOT!

Dr. Weeks’ Comment: My favorite sipping single malt is Laphroaig, the unique strong peaty distillate from Scotland which is the only single malt I have every sampled which really DOES taste like it was filtered through an old Scot’s dirty socks…  fabulous flavor and bouquet!  (Admittedly, the preceding sentence, as nonsensical as it reads, males no sense until you your self take a sip of Laphroiag – you’ll never go back…. )

The fact is, while there may be beneficial trace elements in single malt whiskey in general   (whiskey is made from barley which is rich in calcium, potassium, magnesium and phosphorous  and let’s not forget that the water is spring water so it also has trace minerals)  and perhaps some additional minerals in Laphroaig  deriving from organic peat…   let’s not stretch things to the point where doctors are recommending daily doses of Laphroaig as a mineral supplement.

Another example of illogic and unhealthy extrapolation delighted me from the Letters to the Editor page of Newsweek magazine some twenty years ago when the benefits of resveratrol, the grape seed extract was just being popularized and some clever fellow wrote the following to the Editor which I now paraphrase:

“Hey! Great news! My buddy just told me there is something really healthy for my heart called resveratrol – a grape product – which is in red wine made from grapes and since I love wine I was really excited.  Then he told me that the problem is,  in order to get enough resveratrol from wine I would have to drink  6 bottles a day and I thought…  “This news just keeps getting better and better!”

So now let’s think about salt, the common table condiment which many people crave and simply can’t taste food without. Salt. Revered through the ages:  the Romans soldiers were paid in salt (the word salary derives from the Latin word for salt “sal”) Gandhi brought down the British rule in India by organizing his civil disobedience Salt March freeing Indians from needing to buy salt from the colonists.  Is salt “good” for your health.   Let me share with you the example from chemistry class in high school. We were instructed to determine which of two apparently identical piles of white powder was sodium and which was potassium. No tasting permitted.  There are various chemistry tests on can use to determine the answer but the simple strategy was to put each powders on two different plants:  sodium killed the plant, potassium nourished the plant. Simple.  (Ask yourself, does any farmer you know fertilize their crops with salt?)

So, while the debate rages (see article below) , let me quietly slip you the answer:  “No”  (In fact, salt in the doses most Americans take it is a toxin and anti-thetical to health and longevity. Here are the crib notes as gleaned from a 40 year study of Anthroposophical medicine:  salt destroys the etheric body (vitality) but fuels the astral body (soul).  Take home message: We enjoy salt, but it saps our life forces   (similar situation with sipping Laphroaig  “A peaty slap in the face. Perfect!

 

And here is a note from my brilliant understated colleague  Dr. Saul Pilar, M.D. – Vancouver Canada.

Hello Brad 

There are indeed many trace elements in salt and a specially unrefined sea salt; in fact in the sea water there are all elements.  Trace or otherwise. However,  sea salt composition is not suitable for supporting life because of the predominance of NaCl.  In the sea water there is not even enough K, Mg, Fe, Zn etc. to be useful before being concentrated and separated by living organisms. (for example Zn by oysters)  
In any rate sea salt is a drug that is harmful and toxic to humans in any but small amounts: less than 1000 mg of sodium daily.  Our current intake is insanely hi.  
Long live trace elements,
Down with (excess) of sodium. 

Saul

 


REPORT FROM MEETING:

Joint Meeting of the European Society of Hypertension (ESH) and International Society of Hypertension (ISH): HYPERTENSION 2014

June 13 – 16, 2014; Athens, Greece    reported by Shelley Wood  June 18th 2014

 

“…Any “controversy” over whether dietary salt is a cause of heart disease and stroke is the result of weak research methodology or commercial interference…”




ATHENS, GREECE ”” There is no real “debate” over the dangers of dietary salt as a cause of cardiovascular disease, and physicians need to take a more active role educating the public, supporting high-quality science, and participating in initiatives to reduce salt intake at the population level. 

Those were the key messages of a no-holds-barred session on dietary sodium and hypertension earlier this week at HYPERTENSION 2014 , the joint conference of the European Society of Hypertension (ESH) and the International Society of Hypertension (ISH). 

Any “controversy” over whether dietary salt is a cause of heart disease and stroke is the result of weak research methodology or commercial interference, Dr Norm Campbell (Libin Cardiovascular Institute of Alberta, Calgary) and Dr Graham MacGregor (Wolfson Institute of Preventive Medicine, London, UK) argued here. 

“One of the challenges,” said Campbell, “is to recognize that most of the effort to reduce dietary salt is not based on 100% conclusive data from multiple randomized trials, with hard outcomes, as we might expect from the pharmaceutical industry. It’s an incomplete database, and that allows fertile ground for controversy. . . . In addition, because there is so much salt in our environment, we don’t have a lot of studies where people are consuming less than 2300 mg of sodium per day.” 

Related to that, he added, is the glut of low-quality studies that have relied on flawed measures of sodium consumption. Both Campbell and MacGregor roundly dismissed the use of spot urine analyses as a hopeless means of estimating sodium consumption, coupled with the difficulties of accurately measuring blood pressure in large population studies. 

When a member of the audience pointed to the PURE analysis showing that most of the world eats much higher levels of sodium than those recommended by most international organizations, MacGregor and Campbell leaped on this as an example of a study that had radically failed to measure salt in an appropriate fashion, even devising a new “formula” to estimate salt intake because even spot urine testing had been inadequate. “Please let [PURE principal investigator Dr] Salim Yusuf [McMaster University, Hamilton, ON] know that he should stop using spot urine analysis,” MacGregor said curtly. 

Poor-Quality Studies Often Reflect Commercial Meddling 

It’s also important that we recognize the extent of commercial interference,” Campbell continued. “This is a growing area of research. There are some academics who have financial interests in the salt and food industries [who have published misleading papers], and we have very prominent journals, I’ll mention JAMA in particular, that publish studies that probably would have [never been printed] if a medical student had tried to publish them” and that appear to be hoping to increase citations and publicity by publishing contradictory papers. 

But in fact, when international and national organizations have done rigorous reviews of the literature, omitting low-quality data, they’ve come up with recommendations that clearly support lowering salt intake to prevent stroke and cardiac diseases, Campbell said. Doctors have a responsibility to acquaint themselves with these recommendations, then educate their peers and patients, he added. 

Physicians: Take a Tougher Stand 

It also falls to physicians and their organizations to take a tougher stand to make sure that science is well-vetted before it is presented, published, and picked up by the media, Campbell urged the audience. 



In fact, the World Hypertension League (WHL) has recently put out a call for the setting of research standards related to dietary salt, to try to prevent low-quality research from being “conducted, published, and getting out into the press,” Campbell said. “This isn’t to suppress science but to encourage high-quality science with reliable results.” Secondary to this, the WHL is putting together a global coalition of national and international organizations to oversee those standards, he said. 

“As scientists and clinicians, we need to be very critical of the science and of the ‘controversy for controversy’s sake.’ I think we are far too generous with individuals and organizations that make money creating controversy that endangers our public, and I don’t see that there’s much difference between these tactics and the tobacco industry, except that the tobacco [fight] is 10 to 20 years ahead of the salt-reduction effort,” Campbell said. 

An important part of that is educating the media that there is no “equipoise” in the science surrounding dietary salt. 

“I do get irritated with the media when they are always trying to balance the stories, when there is no balance in my view,” MacGregor told heartwire . By seeking the “other” perspective, quoting the salt lobby group, the Salt Institute””or quoting physicians who are consultants to the Salt Institute””they create controversy and debate where none should exist. 

Salty Stats 

Both Campbell and MacGregor, in their respective talks, gave the same striking statistic, that a 2-g drop in the amount of salt consumed per day would translate into a 20% reduction in cardiovascular events. 

The problem may be that individual physicians have not accepted the size of the problem. 

Citing a 2010 Institute of Medicine (IOM) report, Campbell said that approximately 32% of hypertension cases are caused by high dietary salt””a number that translates into about 300 million people. 

Moreover, he continued, “The Global Burden of Disease study estimates over three million deaths, 61 million years of disability, and 57 million years of life lost were related to high dietary salt in 2010. This is really a massive and catastrophic public-health problem.” 

Positive Strides 

Countries around the globe have already made strides in implementing mandatory or voluntary reductions in dietary salt, primarily tackling processed foods and launching public-education initiatives. Dr Elizabeth Dunford (George Institute for Global Health, Australia) presented an overview of some of the progress internationally, noting that the number of countries that have launched initiatives has gone from 32 to 60 in the past four years alone. Moreover, the number of countries that have actually demonstrated changes in sodium policies has gone from five to 12. 

“A huge amount of progress has been made in a short period of time,” she said. 

Among the highlights: 

· Finland, which has one of the longest-running public salt-reduction initiatives, lowered salt intake by 15% between 1979 and 2007, from 12.8 g to 9.0 g. 

· The UK reduced intake by 15% between 2001 and 2011, from 9.5 g to 8.1 g, saving an estimated 8500 lives per year. 

· Turkey, where salt intake was a soaring 18.0 g/day, lowered intake by 17%, to 15.0, between 2008 and 2012. 

· Initiatives targeting salt content in bread, one of the main sources, have achieved reductions of 36% in Chile, 26% in Spain, and 29% in the US. 

· In 2013, South Africa became the first country to legislate mandatory salt restrictions for the food industry, aiming to reduce sodium consumption to less than 5 g per person per day by 2020. 

 

 

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Dr. Weeks’ Comment: My favorite sipping single malt is Laphroaig, the unique strong peaty distillate from Scotland which is the only single malt I have every sampled which really DOES taste like it was filtered through an old Scot’s dirty socks…  fabulous flavor and bouquet!  (Admittedly, the preceding sentence, as nonsensical as it reads, males…
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