Salt Worse than Smoking? Here We Go Again

You saw it on – you know, the folks who pride themselves on “bring[ing] you the most objective, trustworthy, and accurate health information on the web. “ Cutting salt, shouts the headline, is “as good as quitting smoking.”  “Half a teaspoon less salt a day,” they continue, “would prevent 92,000 deaths, 99,000 heart attacks, 66,000 strokes.”

Hmmm, you may be asking yourself, which is easier?  Quit smoking, or eat a little less salt each day?  Well, duh.

Because smoking is widely known as the single biggest preventable cause of morbidity and mortality, it seems to be the health hazard to beat if you want to make a splash in the news.  (I recently blogged about obesity, another condition that has vied with smoking for the role of number one health villain.)

What is wrong with this picture?   (And c’mon, deep down you know you can’t balance out the risks from smoking by blocking half the holes in your salt shaker.)

First of all, according to the article, the “benefits of reduced salt intake are on par with the benefits of population-wide reductions in tobacco use….”  The operative words here are “population-wide reductions.”  Most Americans consume excessive salt (mostly not from the salt shaker or in cooking; nearly 77% of the salt in the American diet comes from processed foods), whereas the risk of smoking is largely confined to the 20% of Americans who smoke.  Population-based estimates average out your risk with that of your nonsmoking next-door neighbor, but in fact, most of the risk of smoking (apart from the lesser though not negligible risks of passive smoking) accrues to those who smoke.

Another catch:  The study cited was based on cardiovascular risk.  But smoking entails substantial other risks as well.  For starters, it causes cancer, remember?

An editorial accompanying the scientific report advocates federal regulations to compel food manufacturers to reduce the salt in processed food.  Michael Pollan, author of several bestselling books on nutrition, would urge you to eat less processed food.  Either strategy—or ideally, both—would undoubtedly have a great impact on the public health.

But shame on you,, for implying that cutting salt intake will produce health benefits comparable to smoking cessation without stating explicitly that this does not apply to the individual smoker.

© 2009 All Rights Reserved, Dr. Cynthia S. Pomerleau
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