The salt debate – far more salacious than salubrious

The scientific evidence supporting dietary sodium reduction as a means of improving overall health outcomes is not yet confirmed and continues to generate considerable controversy. As previously with fat reduction, sodium reduction has become the dominant research subject in the global food industry. To comply with perceived public opinion, the largest multinational food companies have made public commitments to major reductions in sodium to meet current recommendations. This is the precise approach taken when fat came under criticism by public health agencies in the past and many believe that this precipitated our current obesity epidemic. The contradiction between the published scientific evidence on overall health outcomes and the aggressive promotion of sodium reduction policies by health authorities has inspired the characterization of this strategy as, '… the largest delusion in the history of preventative medicine' and others have concluded '… the concealment of scientific uncertainty in this case has been a mistake that has served neither the ends of science nor good policy'. While policy makers may occasionally be forced to act in the face of limited evidence to attempt to limit risks at the population level, this exception cannot be taken as a broad license to deny all new evidence that contradicts a planned agenda, if policies are to be the product of evidence rather than dogma. As was the case with fat, the strategy of sodium reduction may well qualify as a 'Trojan Horse' of preventative medicine – a policy with an outward façade of great value but simultaneously concealing a significant risk to the population.