A danger to public health? Uproar as scientist urges us to eat more salt

Public health experts in the UK have spoken out against a new book that claims many of us should be eating more salt, not less – claiming the advice could endanger people’s health.

New York scientist James DiNicolantonio says in his book The Salt Fix that the World Health Organisation and the US and UK advisory bodies on diet have got it wrong with their advice to cut down on salt.

Salt is necessary and good for us, he says. Eating more salt will reduce the amount of sugar in our diet and help us lose weight, he says. Indeed low-salt diets may be causing brittle bones and memory loss and more salt could fix diabetes, he claims. more salt would be better for our health rather than less.

“Meanwhile, the white crystal we’ve demonized all these years has been taking the fall for another, one so sweet that we refused to believe it wasn’t benign. A white crystal that, consumed in excess, can lead to high blood pressure, cardiovascular disease, and chronic kidney disease: not salt, but sugar.”

But Public Health England (PHE), speaking out as promotion of DiNicolantonio’s book gathered pace in the UK, said his advice was not only wrong but dangerous. Prof Louis Levy, head of nutrition science at PHE, said: “Diet is now the leading cause of ill health. By advocating a high-salt diet this book is putting the health of many at risk and it undermines internationally recognised evidence that shows a diet high in salt is linked to high blood pressure, a known risk for heart disease.

“Our work with the food industry to cut the salt in food has already seen consumption in the UK reduce by 11% and is seen as the model to aspire to globally.”

The row follows other diet controversies, such as the renewed debate over saturated fat and cholesterol.

But the evidence on salt is incontrovertible, according to Graham MacGregor, a professor of cardiovascular medicine, who led the campaign for action on salt and health (CASH). That succeeded in persuading the government to take action by putting pressure on fast food companies to reduce the salt levels in their ready-meals, the biggest source of salt in our diets.

“He is entitled to his views but it is all based on a few studies and they are misplaced,” said MacGregor. “It you look at the totality of the evidence on salt, it is much stronger than for sugar or saturated fat or fruit and vegetables – in a positive way.

It’s overwhelming because we’ve got all the epidemiology, migration studies [where people have gone to live in another country and changed their diet], treatment trials, mortality trials and now outcome trials in countries.

“Finland has reduced salt. The UK has and there have been big drops in heart deaths. You can’t really argue against the importance of salt but you always get one or two people who deny it.”

MacGregor, who now also runs Action on Sugar, says DiNicolantonio is “probably quite well-meaning” but is one of those “who think every death on the world is because of sugar.” But DiNicolantonio, who is an associate editor of the journal BMJ Open Heart and a cardiovascular research scientist at Saint Luke’s Mid America Heart Institute, says the evidence does not stack up, whatever bodies such as PHE and the American Heart Association (AHA) say. The AHA recommends no more than a teaspoon of salt a day – equating to 2,300 milligrams of sodium – and says most Americans should cut down to not much more than half of that. “Because the average American’s sodium intake is so excessive, even cutting back to no more than 2,400 milligrams a day will significantly improve blood pressure and heart health,” it says, noting that 75% of intake comes from processed, packaged or restaurant food.-The