The salt debate continues

By Amanda Johnson 02/08/2011

A new comment just published in The Lancet resurrects the salt debate yet again, following the publication of the controversial Cochrane report on salt last month (6 July).

The plain language summary of the Cochrane report stated,

’Cutting down on the amount of salt has no clear benefits in terms of likelihood of dying or experiencing cardiovascular disease.’

In their Lancet commentary, Feng He and Graham MacGregor say that,

’In our view, Taylor and colleagues’ Cochrane review, and the accompanying press release reflect poorly on the reputation of The Cochrane Library and the authors. The press release and the paper have seriously misled the press and thereby the public.’

They go on to say,

’The totality of the evidence, including epidemiological studies, animal studies, randomised trials, and now outcome studies all show the substantial benefits in reducing the average intake of salt.’

The Cochrane review, published last month, was followed by media headlines around the world such as that in the UK paper The Daily Mail, which said, Cutting back on salt ‘does not make you healthier’ (despite nanny state warnings) and The Daily Express which said, ’Now salt is safe to eat’

Significant debate was prompted among the scientific community around the world and the New Zealand Science Media Centre collated response from leading experts in the field.

Professor Robert Walker, Head of Department, School of Medicine, University of Otago, said that,

’In the context of general good health, it is not appropriate to go out and reload the salt shaker. Dietary reduction in salt for those at risk of cardiovascular disease should still be encouraged and placed in the same context as exercise, healthy diet and smoking cessation.’

And Simon Capewell, Professor of Clinical Epidemiology at the University of Liverpool, commented

’This is a disappointing and inconclusive meta-analysis, with mixed data and small numbers of events. It is fronted by a potentially misleading press release from the American Journal of Hypertension.’

The salt debate is likely to continue, both within the scientific literature and within the media (an article in The Press just last week looked at how much salt was too much).

In the meantime, the best advice is to just follow a few basic practical tips for a healthy diet: focus on fresh foods; use alternative flavourings in foods; and if you are buying processed foods then check out the food labels and go for the lower sodium options. Take a look at the Dietitians New Zealand recent fact sheet on salt for more information and advice.