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February 25, 2009

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Jenny Patterson

While I am able to understand your point an Institute of Salt putting profit ahead of health, I am unsure of the science behind your arguement. The data on hypertension and sodium, is troubling to me due to the changes most people make in their diet when there is a hypertension problem. This is normally done after some incident that forces several major changes in their diet.
In my personal experience with dialysis, there was my own misery when eating a low sodium diet and the problems I had with being unable to get fluid off without cramping and diving blood pressures.
After years of not adding table salt, nor even having salt around the house, in the last couple of years I have had to find a salt shaker and add Spanish olives to my diet (as advised by my cardiologist). In part this is due to my low adrenal function (Love/Hate relationship of steroids)and low blood pressure and trying to maintain a sembalance of BP in order to run.
There are other cases of this particular problem.
As for NYC, where does it stop? Why not artificial dyes and flavorings? They have been linked to (at least) exsperating ADD/ADHD and is an enormous drain on educational resources. Why not artificial sweetners? Sugar? Sodas?
I hope obiviously, you see that I am using hyperbole in my attempt to make the point of going overboard is not going to solve the problem, it is just going to introduce more policing of the worst kind.

Anna Bennett

"The data on hypertension and sodium, is troubling to me due to the changes most people make in their diet when there is a hypertension problem."

I truly don't understand. What data are you troubled by?

Also, I would suggest that cramping and fluid issues during in-center dialysis while adhering to a strict low salt diet could be attributed to the physics of dialysis covered so eloquently in Dr. Agar's presentation on fluid and solute removal. (It is very difficult to remove fluid in short intense dialysis sessions - due to fluid being stored in the three major compartments of the body - time is needed for the fluid to travel between the cellular, interstitial and blood compartments)

Regarding the concept of a "Nanny State", it will stop when society demands that it stops. As long as seat belts save lives, calories are posted on fast food menus and LA keeps posting those lovely restaurant grades, I'm ok with it. (I've even eaten in and enjoyed a "C" graded restaurant.)

We as a society are gifted with critical thinking. Marketing entities (such as the Salt Institute) can cloud that critical thinking. I feel that public health campaigns such as NYC's War on Salt ameliorates some of the damage done by marketing.

As long as our health care system is bursting, our population is getting sicker at epidemic levels, I will support NYC's "War on Salt" and their "War on Trans Fat". It does not mean that I will not indulge in KFC every once in a while; I'll just think twice before I order.

Don't get me wrong, I was almost a casualty of the Nanny State when my dialysis unit dumped me, and I was denied the right to continue solo home hemo. I fought back, and found professionals who were there to support me. These public health campaigns will cost manufacturers, but the benefits will be paid in a healthier society and a less stressed health care system.

Bill Peckham

In the last comment to the Salt Blog, Dr. Shaldon says:
Dr. M. Alderman is an established critic of any attempts to lower salt intake in the general population. He advises the salt council and is very effective in his dialogues. he is ably assisted by a well known nephrologist, Dr. T. Druecker

I looked at a little of their research and he's saying low salt diets lead to heart problems but he doesn't seem to be controlling for dehydration. For people on daily nocturnal and who control their salt intake, like myself, we have to remember to drink fluid. Salt creates thirst, without the salt people will not have or have different thirst triggers.

People eat way too much salt - 5,000 mg or more a day - bringing that to 2- 3,000 mg would do a lot of good, and for people on dialysis 1,500 - 2,000 will make dialysis less of a burden.

To me the Salt Institute and their funded researchers are like the funded researchers disputing man's impact on climate, or those touting the benefits of clean coal. By funding counter research these industry institutes slow any collective societal action that is not in industry's interest. That's the job of the Salt Institute and all other industry funded Institutes - to sow doubt and slow regulations that would curb the industry's activity.

I'm reading Salt: A World History by Mark Kurlansky and no doubt salt has been integral to city/state economies for millennia, it has always been big business. I say if the interests of big business and public health are at odds, it is time public health came out on top.

Richard L. Hanneman

On behalf of the Salt Institute, let me make just two points:

1 Paterna S ; Gaspare P ; Fasullo S ; Sarullo FM ; Di Pasquale P., “Normal-sodium diet
compared with low-sodium diet in compensated congestive heart failure: is sodium an
old enemy or a new friend?” Clin Sci (Lond)., 2008; 114(3):221-30 (ISSN: 1470-8736).

2 Paterna, S., et al., “Medium Term Effects of Different Dosage of Diuretic, Sodium,
and Fluid Administration on Neurohormonal and Clinical Outcome in Patients With
Recently Compensated Heart Failure,” American J. Cardiol., 2009;103:93–102.

And offer our summary at http://www.saltinstitute.org/content/download/8099/43917.

These reports are from the only prospective randomized controlled trial of health outcomes from a low-salt diet. Look at the data...please.

Dick Hanneman
President
Salt Institute

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