A Salty Dilemma

Just as I realize all these years of watching the sodium content of foods has left me with a distinct dislike for salty foods – you know, the ones with the most flavor – the salt controversy comes to the fore.  I think you’ll need to take this information with a grain of salt (sorry, couldn’t resist) in light of other recent posts about sodium and health despite the fact that this is Campbell Soup, for heaven’s sake!  The article is long, but clearly presents both sides of the controversy.

Campbell Soup Increases Sodium As New Studies Vindicate Salt

Jul. 18, 2011

Cheddar Cheese canvas from Campbell's Soup Can...

Image via Wikipedia

In February 2010, Campbell Soup announced that it would re-formulate over 60% of its condensed soups to reduce the sodium content of 23 of them up to 45%. With high salt diets having been previously linked to cardiovascular disease in medical studies, health advocates were delighted. Last week the company’s
CEO-elect, Denise Morrison, made another announcement, this time a somewhat more alarming one. The company is putting the salt back in. With Campbell’s soup sales sliding in recent times, Morrison believes that lower salt levels have translated to lower taste for their customers, and that the tweaked offerings may have been responsible for the flagging financials. The company hopes to tempt soup-lovers back by increasing sodium levels up to about 650mg per serving (they had been
brought down from 800mg to 480mg) in many of the cans in their Select Harvest line.

Campbell’s new strategy appears all the more startling in light of the fact that the US Department of Agriculture’s 2011 Dietary Guidelines couldn’t be any clearer on the point that, as a nation, we need to step away from the salt shaker. “Virtually all Americans consume more sodium than they need,” it says.

According to research by the U.S. Centers for Disease Control and Prevention, the average American adult currently consumes 3,436 mg of salt a day. With an estimated 75% of our salt intake coming from processed and packaged foods, the USDA guidelines go on to add: “An immediate, deliberate reduction in the sodium content of foods in the marketplace is necessary to allow consumers to reduce sodium intake to less than 2,300 mg or 1,500 mg per day [for those aged 51+, all African Americans, plus anyone with hypertension, diabetes, or chronic kidney disease] now.”

Faced with pressure to ease up on sodium, big players in the food industry, such as Kraft Foods, Heinz and Unilever have responded by recently joining the National Salt Reduction Initiative (NSRI), which aims to slash salt content in retail and foodservice throughout the country by 20% in five years.

Again, next to this, Campbell’s renegade approach seems irresponsible.  Surely the company should continue to encourage a healthier consumer base which, presumably, will stick around longer to enjoy its products? This is especially since research shows that our perceptions of saltiness and taste intensities can
change over a relatively short period of time. In plain speak, this means that if Campbell’s perseveres with the lower salt offerings and convinces its customers to do the same, diners will quickly grow accustomed to the more modestly seasoned soups.

But, maybe we shouldn’t be so quick to condemn Campbell’s new strategy. After all, recently published pro-sodium studies suggest that
food manufacturers across the board should actually be following Campbell’s lead.
Contrary to everything we’ve been previously fed, a high-profile scientific paper by The Cochrane Library, came to the following straight-stalking conclusion: “cutting down on the amount of salt has no clear benefits in terms of likelihood of dying or experiencing cardiovascular disease”.

The paper, published last week in the Journal of Hypertension, reviewed seven studies, which in total included 6489 participants, a number which, the authors say, provides sufficiently reliable results. The study – led by Professor Rod Taylor from Peninsula College of Medicine and Denistry in the UK, found no evidence to
support the theory that a reduction in salt intake decreases cardiovascular disease or all-cause mortality in those with normal or raised blood pressure. Astonishingly, it also concluded that salt reduction could be detrimental to health. In people with congestive heart failure, salt restriction actually increases the risk of death from all causes, the paper claims.

If this all sounds a little sketchy to you, especially since salt has been demonized no end until now, there’s more research to support the idea that we  should give the tasty mineral a break. You might recall a perplexing study published in the May issue of the Journal of the American Medical Association. It surmised that people who eat lower amounts of sodium are more likely to die from cardiovascular disease and that, among those with normal blood pressure, sodium intake didn’t lead to high blood pressure.

Certainly these pro-salt studies have created something of a media frenzy, and they have amassed critics aplenty. The May study was so riddled with problems and flaws it prompted Harvard researchers to deem its conclusions as “most certainly wrong.” The main complaint was that most of the participants in the study were in their early 40s when the research began, and were only tracked for about eight years. This entailed that the population was too young to reliably determine how
sodium intake could impact their long-term health.

As for the Cochrane Review, medical experts are equally unimpressed. The chief criticism is that one of the studies involved patients with heart failure, meaning the results aren’t relevant to the general population. Participants also only reduced their sodium intake by fairly moderate increments, and were followed for relatively short periods, again, not enough to see a significant difference in their long-term health. To further lessen the credibility of the study, the editor-in-chief of the Journal of Hypertension, Michael Alderman who accepted the paper, once worked as a consultant for the Salt Institute. As you might suspect, this Virginia-based advocacy group touts the benefits of higher sodium consumption while warning efforts to cut salt could be disastrous for the population’s wellbeing.

Indeed the Salt Institute couldn’t be more delighted with the recent research, as well as Campbell’s announcement of its intention to up salt levels. “The scientific evidence is overwhelming,” said Lori Roman, President of the Institute, clearly unconvinced of the criticism lobbed at the pro-sodium studies. “[I]t is time for the government to cease its costly and wasteful efforts to reduce salt consumption until it can conclusively prove a tangible benefit for all consumers.”

But before you throw caution to the wind, and open up that bag of salt and vinegar chips in anticipation of Campbell’s tastier potages, you might want to consider another study that was also published last week, this time in the Archives of Internal Medicine. Researchers from the Centers of Disease Prevention and Control concluded that Americans who consume a diet high in sodium and low in potassium have a 50% increased risk of death from any cause, and have twice the risk of death from heart attacks. The group found that high salt intake was associated with a 20% increased risk of death, while high potassium intake was associated with a 20% decreased risk of dying. Also, don’t forget the link between a salt-heavy diet and high blood pressure is relatively well established, even the Cochrane Review couldn’t undermine this widely accepted relationship.

So where does this leave Campbell’s? In light of the lack of conclusive evidence linking sodium to an increased risk of cardiovascular disease, is the company justified in increasing salt? Perhaps the assertion that customers should have the right to choose whether they consume higher or lower levels of salt is in fact a fair and balanced one? After all, Campbell’s still plans to include a number of low-sodium options among its soup offerings. And let’s face an unfortunate reality; consumers are less concerned about salt in their diet than they are about other nutritional no-no’s such as fat and sugar. The bottom line is that fat and sugar makes us well, fat, and there’s no escaping this truth. We read it in magazines; we see it on TV, and even posters on the subway shout about the blubberizing impact of sugary, fatty foods. Salt, on the other hand, doesn’t effect our appearance in the same way  – although admittedly, it can lead to bloating and water retention, but not everyone is cognizant of this. So while we might compromise on taste to save our figures, we don’t make the same allowances to save our insides. Indeed, Campbell’s
incoming CEO Denise Morrison was explicit in her analysis that sodium reduction is not a priority USP for many consumers.

Campbell’s big mistake might have been boasting about its salt reduction initiatives. Change doesn’t always sell. Remember when Coca-Cola launched New Coke in 1985, and accompanied the re-jigged recipe with a massive marketing campaign? The altered drink was a huge failure and the original formula had to be reinstated. Who knows, had Coca-Cola kept the change quiet maybe we’d all be drinking New Coke now. Similarly, had Campbell’s gone about reducing salt in small increments and not made a lot of noise about it, maybe its consumer base wouldn’t have even noticed. Unilever found in a 2007 study in the Netherlands that when consumers were given two identical samples of Lipton Cup-a-Soup and were told one had 25% less sodium, the majority of respondents said the soup labeled as low-salt tasted inferior.

You can find Nadia Arumugan’s well written and documented  “Chew On This ” blog at:  http://blogs.forbes.com/nadiaarumugam/feed/.  She raises some interesting points. As CKD patients, does it behoove us to keep our sodium levels low?  I say it does, since hypertension plays a part in our disease. You need to remember that we are NOT part of the general population anymore.  As I mention in my book, CKD affects all your other medical issues.

On to another topic, my vote on www.baselineyourhealth.org is yes. Everything you need is right there: background information, calculators, and reading material. It’s well organized and easy to use.

By the way, I was interviewed by The Wellness Show about the book and will let you know when the show will be aired.

Until Friday,

Keep living your life!

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Published in: on August 9, 2011 at 9:56 am  Leave a Comment  

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