Here's What's Shakin' With Salt
WebMD News Archive
"The issue about salt has become unnecessarily polarized, and I am not
sure why," Theodore Kotchen, MD, tells WebMD. "I think the more
balanced overview is that salt is one component of a diet that affects blood
pressure -- but it is an important component." Kotchen, a professor and
chairman of the department of medicine at the Medical College of Wisconsin in
Milwaukee, is also a member of the Nutrition Committee of the AHA, which makes
up the recommendations.
"Kaplan's position reflects the thinking of a relatively large number of
professional organizations including the AHA, the National Heart, Lung, and
Blood Institute [part of the National Institutes of Health], and others,"
says Kotchen. "I think it is a balanced and accurate assessment of the salt
"I think McCarron does make some important points, and I think it's true
that we don't have the definitive evidence that perhaps some people would like
before making population-based recommendations, but I do think his conclusions
are somewhat distorted," he says.
But McCarron stands firm. "We have made too much of the issue of low
sodium diets helping reduce blood pressure, and in that process we have not
been talking to people about the issues that really matter," McCarron tells
WebMD. Those issues are weight, too much alcohol, and getting a balanced diet.
"We're not promoting the DASH diet, which has shown an effect that is
probably 10 times as powerful as reducing salt." The DASH diet includes
eating a lot of fruits and vegetables and low-fat dairy products.
"The problem is we started setting policy before we did the
science," says McCarron. "What happens is that you get policy and
education, and basically the bias is built-in. And then you get the data, and
then what do you do?"
"Sometimes science get brushed aside in the interest of politics,"
he says, noting that it is hard to turn the tide of public policy.
Despite their differences, both men can agree on one thing: the need for
Americans to adopt a healthier diet.
"I think the positive message, in terms of both blood pressure and
overall [heart] health, is people should pay attention to their overall
diet," says Kotchen, adding that it is "probably a mistake" to
focus exclusively on salt. He says we should avoid obesity, avoid eating too
much salt, and make sure we eat plenty of fruits and vegetables.