Saturday, October 17, 2009

Myron's salted body floating out at sea

Myron Ebell has been producing consistently dull writings of late.

On 13 October there was Senators Lindsey Graham and John Kerry: Yes We Can (Raise Your Energy Prices and Send Jobs Abroad) containing the usual fuzzy argument about how higher prices on fossil fuel consumption is going to drive out jobs, due to now uncompetitive manufacturing costs. But he doesn't like the import tariffs on high carbon products that would balance the situation. And he doesn't want any room to be created in the market for less efficient energy production industries like wind power to displace fossil fuel production. Less efficient = more jobs. Myron doesn't actually care about jobs, which is why he always, always lies about it.

Then on 16 October was the ultra-dull Socialist International Meets, but Carol Browner Can’t Make It. Ooooh! There's that scary word "socialism" which advocates for the public administration of all strategic sectors of the economy -- not just the police, judicial, military and transportation network -- for the public interest and maximum benefit to all, rather than just for a rich elite. There would be no argument, but for the rich elite paying for Myron Ebell and his friends to lie about how their system creates a better world in the long run, even though the claim is an insult to reason.

Slightly more interesting to follow was the Junkman on the next page with his blog-post Regulation Not Worth Its Salt.
It seems likely that regulation restricting sodium in foods would be ineffective because people would unconsciously adjust their diets to compensate. As the study puts it, "[sodium intake] is unlikely to be malleable by public policy initiatives", and attempts to change consumption would "expend valuable national and personal resources against unachievable goals."
Yeah, well if that were actually true, you'd think the Salt Lobby would be a little more relaxed about the upcoming discussion on dietary regulations. If -- as they claim -- reducing the massive salt dosage in processed foods caused people to buy salt in small boxes (with a higher profit margin) and put it in their salt shakers the salt manufactures would be encouraging it.

Logic is evidently not a component in these arguments.

The salt lobby website publishes irrelevant bollocks, like new fears over low salt:
A famous study conducted in volunteer soldiers marching uphill in the heat and sweating profusely showed that the six grams of salt per day recommended by today's government as the maximum intake, is not sufficient to avoid sodium depletion in active individuals. Forty per cent of the group of soldiers on the low salt (six grams) diet either collapsed from heat prostration or had to stop because of heat exhaustion, while in the group whose salt intake was 15 grams only one (the oldest man in the study) had any sort of problem.
For salt policy vaguely relevant to everyday civilians, Dr David McCarron is particularly popular. In 2007 they got a PR article published that described him as:
an internationally recognised and independent authority on the role of diet in heart disease
Here is Dr McCarron on the Salt Institute youtube channel with his theory that high blood pressure is actually because of too little mineral intake (ie not enough salt!).



His latest scientifically pointless excretion from this October was rebutted here.

Every couple of years he comes out with a "new study" presented as "new news" to a media that is too stupid to recognize it as the same as the old one.

So, for the benefit of those who can't do the research, here is the same old horseshit in The Independent in 1998 titled "Scientists clash over health effects of salt", and here is McCarron spitting out the same theory to The New York Times back in 1984.

These old junkmen just never go away. At least McCarron has a job in a real university, and so it's not necessary for him to lie all the time every day of the week to make an income. Those who work at the CEI, like Myron Ebell for example, don't have any honest work available to them. So nothing good whatsoever can ever result from their working lives.

25 Comments:

Anonymous Anonymous said...

"At least McCarron has a job in a real university,"

No, he does not. He has an unpaid title that that gets him undeserved legitimacy in uniformed circles.

12:23 PM, October 19, 2009 Permanent link to this entry  
Anonymous Anonymous said...

sorry, uninformed, not uniformed

12:24 PM, October 19, 2009 Permanent link to this entry  
Blogger Julian said...

According to McCarron's page at UC Davis, he helped write a paper on, for example, the prenatal calcium supplementation and postpartum depression: an ancillary study to a randomized trial of calcium for prevention of preeclampsia.

I'd argue that doing more stuff like that is an option for him, if he was interested in benefiting society. He might have a point on salt, and he might be wrong. Hopefully he doesn't lie about any counter-evidence to his theories.

Whereas Myron Ebell has no other career options. He can do only do evil, day in and day out.

3:57 AM, October 20, 2009 Permanent link to this entry  
Anonymous Anonymous said...

"He might have a point on salt, and he might be wrong. Hopefully he doesn't lie about any counter-evidence to his theories."

No, he might not have a point. He leaves out large amounts of observational data to make the range of salt intake look much narrower than it really is. Instead of a max/min ratio of close to 1:2 that he pretends we have, the real ratio is more like 1:30. He then jumps to an illogical conclusion about salt regulation. This fits his long-standing prejudices, but no real data. He also leaves out reports of successful health advisory intervention in several countries. Among these are Japan, Finland and United Kingdom.

Because of the enormous health consequences, it is important to vigorously counteract his campaign of misinformation. In addition, it is important to let UC Davis know that they are not doing humanity any service by helping spread this misinformation.

Also, like Ebell, McCarron has to hustle.

1:15 PM, October 21, 2009 Permanent link to this entry  
Blogger Julian said...

So, your allegation is he is lying about counter-evidence to his theories. This would be scientifically indefencible, unethical, and easy to demonstrate.

I don't happen to have direct evidence of this to hand. I am only the Myron Ebell expert. Maybe it should be made available. Perhaps it should be declared on the sourcewatch page for The Salt Institute.

In general, no real scientist would be content with being cited by these CEI cowboys, so I can easily believe he is a shill. However, it would be better to have harder evidence.

1:38 PM, October 22, 2009 Permanent link to this entry  
Anonymous Anonymous said...

"I don't happen to have direct evidence of this to hand."

It has been the same story, with small variations, for about 25 years. The evidence is all over the technical literature.

You can find a major review of the effects of salt at
http://physrev.physiology.org/cgi/content/full/85/2/679

Among the data in the review is a range of measured sodium intakes. It is dramatically much wider than what McCarron claims, thus undermining his thesis.

A rebuttal of McCarron's claims
http://ndt.oxfordjournals.org/cgi/content/full/gfn550?ijkey=aJA05zs5HhXWW6G&keytype=ref

At the end of that article is an answer from McCarron. It opens with:

"I hesitate to subject the readers of NDT to the continued banter between Dr MacGregor [1] and I, which dates back over 20 years with a debate at the 1984 Annual Meeting of the American Society of Nephrology..."

Note the use of the word "banter." Its use is clearly designed to discredit the writings of Graham MacGregor. McCarron avoids any substantial debate of merits or data. The writing style is that of a crackpot. Maybe his inability to write grammatically correct English can also be taken as an indication that we are not dealing with a serious researcher.

That said, I do not believe he is deliberately lying. More likely, he lacks the ability to absorb information that is contrary to his convictions.

1:23 PM, October 25, 2009 Permanent link to this entry  
Blogger goatchurch said...

Thanks very much for those links, especially for Salt intake and cardiovascular disease (2008).

It's important to point back to the specific case that a scientist is wrong, not make generalities, so that people who don't know the story have something to start with.

I was going to say more, but I was drawn up suddenly by the note at the end of McCarron's response:

Conflict of interest statement. None declared.
David A. McCarron

Given that article critiques the cited Alderman's connection with the Salt Institute, do you think McCarron is being a little naughty here?

5:35 AM, October 26, 2009 Permanent link to this entry  
Anonymous Anonymous said...

"do you think McCarron is being a little naughty here?"
Yes, I do. Check out
http://www.academicnetwork.com/health-medical-strategic-planning
where the Salt Institute is listed as a client.

12:51 AM, October 27, 2009 Permanent link to this entry  
Anonymous Anonymous said...

For a primer on the very legitimate scientific debate about the effects of sodium restriction on health, see Science Magazine: http://www.stat.berkeley.edu/users/rice/Stat2/salt.html. P

12:13 PM, November 04, 2009 Permanent link to this entry  
Anonymous Anonymous said...

For a primer on the very legitimate scientific debate about the effects of sodium restriction on health..

This is not a primer of anything of technical value. The reference is to a ten-year old article by Gary Taube. The article is a collection of quotes. There is no statement explaining how the quotes were selected. In any event, Taube is not a scientist, by ant stretch of the imagination.

For another view on Gary Taube, have a look at
http://www.diseaseproof.com/archives/diet-myths-the-doughy-gary-taubes-big-fat-lies.html

The words "very legitimate scientific debate" used here have been picked out of thin air, quite possibly for the deliberate purpose of confusing the non-scientific reader. There is no scientific debate. There is a squabble originating with a small number of salt proponents directed toward a large number of legitimate researchers. The salt "debate" has many aspects in common with "debates" on evolution, on global warming, on the effects of secondhand cigarette smoke. People with an axe to grind or with some psychological quirk make the most preposterous claims. Then real scientists are supposed to take them seriously and respond with observations and logic. What do you do with someone who sincerely maintains that the sky is green and that 2+2=5?

Unfortunately, it often becomes a public relations contest. So far, no good solution in support of truth and reason has been found.

12:16 PM, November 05, 2009 Permanent link to this entry  
Anonymous Anonymous said...

For information that has not been unduly influenced by overt or covert commercial interests, or by deviant psychology, check out
http://www.worldactiononsalt.com/

Much of it is accessible to an informed lay person.

11:35 AM, November 06, 2009 Permanent link to this entry  
Anonymous Anonymous said...

I can accept that you might find Gary Taubes's scientific bona fides lacking, but it's simply ridiculous for you to dismiss the former president of the American Society of Hypertension as merely a "salt proponent." (See his commentary on salt and health here http://ije.oxfordjournals.org/cgi/reprint/31/2/320, along with some competing views on the issue.) The fact of the matter is that the data on this issue are mixed at best. You can argue that the epidemiologic data favor a slight benefit from salt restriction, but then again, these are the same kinds of studies that told us hormone replacement therapy was safe and would prevent heart attacks. The more conflict there is in the actual data, the louder people like you have to shout that skeptics are making "preposterous claims."

1:56 PM, November 09, 2009 Permanent link to this entry  
Anonymous Anonymous said...

Oh, and btw, I just checked the link about Gary Taubes that you posted. For someone who's so interested in what constitutes "legitimate scientific debate," you are awfully quick to cite a childish, Perez Hilton-style attack on Taubes's looks to make your point. Who's the real scientist here -- the guy at the podium making reasoned scientific arguments based on interviews with the top researchers, or the blogger making fun of his paunch?

2:29 PM, November 09, 2009 Permanent link to this entry  
Blogger Julian said...

I'm finding it difficult to tell you two anonymous commenters apart.

The Epidemiological papers are valuable. I am sympathetic to the quote on page 6: "Alderman's paper gives a selected and unbalanced account on salt and blood pressure, and reaches unsound conclusions."...

...given the deep conflicts of interest between salt-health advice and profits of the processed food industry.

It is not enough to show off some bought out scientists and claim that the data is "mixed at best" -- because it is too easy for business to fabricate doubt.

If the data is mixed, it certainly doesn't show up on the totally one-sided presentation by Salt Institute.

But it's no surprise. It's their job to promote salt. No evidence is ever going to change their mind, is it? How could it?

Which is why they are not qualified to have any say in the scientific debate -- because they will never allow the issue to be settled against them.

Basically, in forming a conclusion, it is reasonable to dismiss any materials produced by the salt institute and their paid-for scientists sight unseen. If their product is killing me, they will not say.

A wise person will favour advice from experts who's primary objective is to prolong people's healthy life to the best of the evidence, and dismiss that which is made by those with a clearly different agenda.

Not everyone is wise. And those who have a non-scientific agenda put all their money into salesmanship -- and none of it into finding the truth.

11:57 AM, November 10, 2009 Permanent link to this entry  
Anonymous Anonymous said...

...it's simply ridiculous for you to dismiss the former president of the American Society of Hypertension as merely a "salt proponent."

This is a good illustration of a couple of their techniques.

(1) Use rank and academic affiliation instead of actual facts to influence the unsophisticated reader.

There is no unassailable dogma that says the president of AHS is infallible. (Not even the president of the United States is infallible. Remember the “mission accomplished” statement by president George W. Bush? You are of course also free to remember other mistakes by him, or other presidents.) The affiliation technique is a favorite of Dr. McCarron, whose irresponsible writings are at the root of this exchange. He milks his tenuous affiliation with a has-not-quite-made-it university for all it is worth, and then some.

(2) Omit inconvenient data. Dr. Alderman was a president of AHS. He is also a spokesman for the Salt Institute.

It may be worth noting that the current AHS leadership does not favor Dr. Alderman’s position. Here is a quote from their web site: “Essential hypertension is also greatly influenced by diet and lifestyle. The link between salt and high blood pressure is especially compelling. People living on the northern islands of Japan eat more salt per capita than anyone else in the world and have the highest incidence of essential hypertension. By contrast, people who add no salt to their food show virtually no traces of essential hypertension.”

I repeat: The link between salt and high blood pressure is especially compelling.

Perhaps dismissing that former ASH president as a "salt proponent” is not so ridiculous after all? (Note that I did not use the word “merely.” That word is a result of my opponent’s not so refined “debate” technique.)

A detailed exposition of the tactics of the salt lobby can be found at http://www.ndt-educational.org/Qais%20Al-Awqati%20SALT%20COUNCIL.pdf It is a Kidney International editorial that should be readily understandable for readers of this site.

I realize that the present exchange is unfair. My opponent obviously lacks the background to read and absorb the technical literature on this subject. He does not know the history of the topic. Anything he comes up with is easily dismissed on the basis of relevant analyses of measured data.

As an example, his reference to the oxfordjournals file illustrates his lack of professional insight. There is a poorly composed article by Dr. Alderman, followed by several well-reasoned responses that completely dismantle Dr. Alderman’s exposition. There is also one not so well reasoned response.

At the very end is a standard, hypocritical statement by Alderman about the “need for solid scientific evidence.” Who could possibly be against that? The major problem here is that the solid, scientific evidence has existed for many years. It just does not suit the interests of the Salt Institute and other salt proponents. So it is necessary to resort to obfuscation techniques.

Here is the statement: “The fact of the matter is that the data on this issue are mixed at best.” This statement has no truth value. The basic questions have been answered. There are no “mixed data” of fundamental consequence. There may be poorly designed studies, with outcomes that are eagerly gobbled up and misused by the salt lobby. But the science is clear.
(I am Anonymous #1)

1:09 PM, November 10, 2009 Permanent link to this entry  
Anonymous Anonymous said...

“For someone who's so interested in what constitutes "legitimate scientific debate," you are awfully quick to cite a childish, Perez Hilton-style attack on Taubes's looks to make your point.”

I do not know that I am obliged to have tunnel vision. My clearly stated point was to show that different people have different opinions about Gary Taubes. I do not think it is my fault that you do not understand what that means.

“ Who's the real scientist here -- the guy at the podium making reasoned scientific arguments based on interviews with the top researchers, or the blogger making fun of his paunch?”

An obviously silly, meaningless question. Of course, neither is a real scientist. We are looking at a publicity contest. Humor and sarcasm are acknowledged, legitimate weapons in such contests. In this context, reference to the paunch of a self-professed health expert can be acceptable. And the paunch is not even all that conspicuous.

2:05 PM, November 10, 2009 Permanent link to this entry  
Anonymous Anonymous said...

Anonymous #2 here. The comments by Julian and Anonymous #1 illustrate the techniques often used by public health officials to obfuscate and create "consensus" on an issue where in fact no consensus exists.

The primary method is to denigrate anyone who disagrees with you as "bought out" by industry and claim that your side's only interest is in "prolonging people's healthy life to the best of the evidence."

I accept that having ties to the salt industry may lead to an unconscious bias on the part of some scientists who question the wisdom of salt restriction. However, it is not only salt industry consultants who question salt restriction; read the Taubes article instead of dismissing it and you will see that many of the key pillars of the anti-salt argument (e.g. INTERSALT) are viewed as deeply flawed, negative studies by the very researchers who conducted them. Moreover, it is a complete fiction to claim that salt restriction advocates are not conflicted in their own research and statements about salt. The NIH and NHLBI are the major funders of research into the links between sodium and health, and their position on the issue has been clear for some 30 years or more. They think salt restriction is a good idea, and this is a conviction that verges on gospel for them. They are certainly not going to fund researchers who question the wisdom of salt restriction, and so it would effectively be career suicide for most researchers in this field to disagree with the conventional wisdom on salt.

The logic of anonymous #1 would be hilarious if it weren't so dangerous to good science and public health. His/her argument is that Dr. Alderman, a noted hypertension specialist who is an unpaid consultant to the Salt Institute, is so conflicted by this association that he is willing to ignore the best evidence and poison millions of Americans with excessive sodium. Meanwhile, NHLBI-affiliated researchers, whose research and academic positions are funded largely by the millions of dollars they receive from an agency that campaigns vigorously against salt, are in no way conflicted on this issue and are merely independent researchers providing us with unbiased facts.

You would think that someone with anonymous #1's vast intelligence and limitless ability to absorb the relevant data would be able to recognize this essential contradiction, but apparently it is difficult to see such things from high upon the mountaintop where he/she decrees what the data show and how they shall be interpreted by the uninformed masses below. The fact is you have to consider the messenger on both sides of this debate very carefully. And even if you come to the conclusion that the data support salt restriction, keep in mind that these data come from epidemiologic studies -- again, the same kinds of studies which told us hormone replacement was safe and would prevent heart attacks. Why the government is unwilling to fund a decent clinical trial of sodium restriction to settle this question once and for all is baffling. But until that study is done, regulations to require population-wide sodium restriction will constitute an experiment whose outcome is uncertain.

7:21 AM, November 11, 2009 Permanent link to this entry  
Anonymous Anonymous said...

Anonymous #1 to readers at blogger.com. I see that Anonymous #2 has adopted the New Testament habit of announcing at the beginning of the epistle who the writer is. That seems polite and useful to me. It may also help Julian keep track.

There clearly are too many directions of thought for Anonymous #2 to keep track. He also attributes Julian’s statements to me. I admit, there are many things to keep straight, so I will limit this response to a small number of ideas.

One problem with this exchange is that my opponent clearly has no concept of how scientific ideas develop. He sees it as limited to the temporary outcome of a publicity contest. That is not at all how science works.

“His/her argument is that Dr. Alderman, a noted hypertension specialist who is an unpaid consultant to the Salt Institute, is so conflicted by this association that he is willing to ignore the best evidence and poison millions of Americans with excessive sodium.”

This is not my argument at all. It is also totally irrelevant. It is not who Dr. Alderman is that counts. What he produces is what is relevant. My argument is that Dr. Alderman, entirely on his own, has compromised his own credibility.

He has authored articles devoid of scientific integrity. He omits observational results that conflict with his convictions. He presents conclusions that are not logical consequences of his arguments. I have already given a link to one such instance. That is enough. There is a lot more.

Dr. Alderman also without reservation lends his name to the Salt Institute. A researcher with sound judgment would not so unreservedly give his support and undivided loyalty to a one-sided commercial advocacy group.

This is not a trivial matter. The ability of Dr. Alderman to control large chunks of research money approaches the level of a national scandal. No person with his proven record of unsound judgment should have access to serious research funds.

Recently he was involved in a study of anti-hypertensive drugs. The published results must be (and are) looked at with great suspicion. (I am not saying they are wrong. I am also not saying they are right. I am saying one cannot know. That is a serious problem.)

“is so conflicted by this association that he is willing to ignore the best evidence and poison millions of Americans with excessive sodium”

Unfortunately, our history shows that presumably decent people do just that. What do you make of tobacco executives who continue to promote cigarette smoking?

2:42 PM, November 13, 2009 Permanent link to this entry  
Anonymous Anonymous said...

More:

I am not suggesting that people like Dr. Alderman or Dr. McCarron are inherently evil. I am suggesting that there is a problem with their brain function that prevents them from perceiving reality the way most people perceive reality. Take an example from this exchange. In a previous post I wrote

“It may be worth noting that the current AHS leadership does not favor Dr. Alderman’s position. Here is a quote from their web site: “Essential hypertension is also greatly influenced by diet and lifestyle. The link between salt and high blood pressure is especially compelling. People living on the northern islands of Japan eat more salt per capita than anyone else in the world and have the highest incidence of essential hypertension. By contrast, people who add no salt to their food show virtually no traces of essential hypertension.

I repeat: The link between salt and high blood pressure is especially compelling.”

This would seem to be an issue that Anonymous #2 should have responded to. There is only silence, while less important issues receive attention. I think it is quite likely that Anonymous #2 could not see that part of my post.

“...often used by public health officials to obfuscate and create "consensus" on an issue where in fact no consensus exists.”

My opponent thinks it is almost hilarious that I question the judgment of one individual (or maybe a few). Now, he himself does not hesitate to assign less that honorable motives (and abilities) to a whole class of workers. To followers of Rush Limbaugh this may be eminently logical. After all, they are associated with the government, and are thus automatically undesirable. To the rest of us, that connection does not exist.

It is not just government. The National Academy of Sciences also causes grief for the salt lobby, as do many other prominent organizations and institutions.

The salt promotion is mostly (but not totally) an American phenomenon. Others can figure out why that is so. It is a serious, expensive problem for the USA.

3:02 PM, November 13, 2009 Permanent link to this entry  
Anonymous Anonymous said...

This is the end:

Here is a statement: “keep in mind that these data come from epidemiologic studies --”

The notion that there is nothing beyond the epidemiologic studies is just based on gross ignorance. It again shows how completely out of his league Anonymous #2 is. The professional literature contains large amounts of data that are not epidemiologic, but go from animal studies, studies on individuals, and all the way to the molecular level. This literature typically is only freely available via libraries at universities and other reserearch institutions, so it is not suprising that Anonymous #2 is not aware of its existence (this comes in addition to his psychological block). But it is there. Let me give you a couple of names, almost randomly selected: Mordecai P. Blaustein, Takahiro Iwamoto, Heikki Karppanen. There are many, many others.

Most readers may not have Medline or other library access. Google Scholar has by now become a remarkably useful tool.

To finish, here is another, recently released tidbit:

The Japanese Society of Hypertension working group report on dietary salt reduction for hypertension management concludes the following:



1. Excess salt intake is associated with occurrence and progression of hypertension, in addition to exerting adverse effects on the cardiovascular system independently of blood pressure (BP).



2. The depressor effect of salt restriction is dose-dependent, and despite marked individual variation, BP has been shown to decrease about 1 mmHg on average with each decrease in salt intake of 1 g/day.



3. Salt reduction is fundamental for hypertension prevention and treatment and there is adequate evidence for the current salt-restriction target of less than 6 g/day (Na <100 mmol/day).

The report is much longer. It does not mention Drs. Alderman or McCarron, but it unequivocally puts opinions like theirs in the deviant category.

As I said before, I know this is an unfair exchange. Anonymous #2 can wriggle all he wants. He will only succeed in making things worse for his cause, which is fine with me.

3:14 PM, November 13, 2009 Permanent link to this entry  
Anonymous Anonymous said...

Anonymous #2 here -- Anonymous #1 suggests that my "gross ignorance" is based on lack of access to the appropriate studies about sodium and health. In fact, I have plenty of access to all of the relevant data; the problem is that no study has ever been conducted to conclusively answer the question that has been put before us -- namely whether reducing the population's consumption of sodium will result in a net public health benefit.

My opponent categorizes me as some kind of Rush Limbaugh-following fringe character who has a "psychological block" when it comes to inconvenient or government-generated data. Nothing could be further from the truth. I am merely arguing that you must consider the conflicts that all scientists may have when they report on their conclusions. And this applies equally to scientists who depend on the NHLBI for funding as it does to Alderman and McCarron.

I accept that there are large amounts of data showing that reducing sodium consumption would result in a small reduction in blood pressure in the population and that this *may* be beneficial for health. The problem is, small changes in blood pressure have unclear value for predicting "hard" health outcomes such as heart attacks and deaths in a healthy population. Although it seems like it would be beneficial, lowering sodium intake in the entire population might have adverse effects that we don't know about. And while these effects may be small, they might be enough to counterbalance the small benefit that sodium restriction is expected to have.

Tellingly, anonymous #1 doesn't seem to understand the standard of evidence that is typically required to institute a health intervention in the population. He says the data in support of sodium include "animal studies, studies on individuals, and all the way to the molecular level." Alas, these kinds of studies are not sufficient to prove that reducing salt consumption will provide a net benefit to the population. The only way to tell for certain is to conduct a controlled clinical trial examining this question specifically.

While scientists advocating salt restriction may have mountains of molecular, animal and epidemiologic data to support their view, they have never conducted(nor do they seem to want to conduct) the large clinical trial that would prove their point conclusively.

Unfortunately, we have seen too many times what happens when health recommendations are made based on lesser evidence. In the 1980s, again in the absence of clinical trial data, health officials recommended that everyone in the population consume less total fat to reduce their risk of heart disease. Only later did they conduct large clinical trials showing that, in fact, the amount of total fat consumed does not affect heart disease or cancer risk. Unfortunately, the population had already absorbed the low-fat messaage, with the unexpected result being that people began to consume more refined carbohdydrate and more total calories (the snackwell effect), contributing to the obesity epidemic and ultimately *increasing* the burden of disease. Similarly, large epidemiologic studies of the type cited on this thread in support of sodium restriction showed unequivocal benefits for hormone replacement therapy in the 1990s. But when they finally got around to conducting the clinical trials that they still haven't done for sodium, the researchers discovered that -- surprise --
HRT didn't prevent heart attacks, it caused them.

An interesting comment on the HRT debacle, and on the perils of relying on lesser evidence in general, can be found here: http://www.cmaj.ca/cgi/content/full/167/4/363. The parallel to the sodium situation is apt, the exception being that instead of the pharmaceutical industry being cast in the role of villain, in this case we have anti-salt advocates arrogantly pushing preventive measures that have never been validated in rigorous randomized trials.

1:07 PM, November 17, 2009 Permanent link to this entry  
Anonymous Anonymous said...

"we have anti-salt advocates arrogantly pushing preventive measures that have never been validated in rigorous randomized trials."

We are back to where we began - with a sanctimonious request for rigorous trials. The main trouble with this is that more than enough trials have been done and the outcome is known. Salt pushers just cannot grasp that fact.

Note that in the entire world there is not a single public health agency, national or international, that finds that the opinions of the salt lobby have any merit. There is not a single scientific organization in the whole world that finds that the opinions of the salt lobby have any merit.

So, for some few people the sky is green and 2+2=5. For the rest of us, the sky is blue and 2+2=4.

8:47 PM, November 22, 2009 Permanent link to this entry  
Anonymous Anonymous said...

Well, given the terseness of his (her?) last missive, it seems that my opponent is finally getting exasperated. This is a good thing, because his strategy is shout down all objections and declare the debate prematurely closed.

Indeed, we are back where we started with a call for more rigorous studies. My opponent claims that these studies have been done, but the simple truth is that they have not. Show me one prospective randomized trial of salt restriction that demonstrates reduced cardiovascular events and/or reduced mortality from the intervention and I will gladly concede that salt restriction should be mandated as a public health measure.

No such study has been done, nor does it seem likely to be done, and without such a study we cannot know for certain whether population-wide salt restriction improves health.

Public health agencies around the world can say whatever they like about the merits of salt restriction, but we know that these agencies can be and have been wrong in the past. As I have already explained, 1995 dietary guidelines in the U.S. recommended lowering total fat intake in the absence of definitive data showing that this would be beneficial. The result, as we now know, is that total energy intake increased, triglycerides went up, HDL went down, and the population was put at increased risk of cardiovascular disease.

Now, it may seem inconceivable to my opponent that reducing the population's sodium intake could have similar adverse effects, but it is precisely this lack of imagination that makes him and his ilk so problematic. They don't take the first principle of medicine, "First, do no harm," seriously, and they don't spend enough time considering the unintended consequences of their "health" policies.

6:52 AM, December 01, 2009 Permanent link to this entry  
Anonymous Anonymous said...

Anonymous #2 seems to have picked up a few slogans (e.g. "randomized trial" and other fancy words), without possessing any understanding of the nature of statistics, or of physiology for that matter. If he were to be taken seriously, he would also complain about the lack of randomized trials before recommendations of smoking cessation became public policy.

Let me be clear: This has not been a debate about anything. Therefore, this is not and end to a debate, premature or otherwise.

There are always pompous ignoramuses who have picked up some technical-sounding phrases, who claim to be debating this or that. Examples abound; evolution, climate, health issues, thermodynamics, UFOs, moon landings, etc. These people usually cannot be educated. What can be accomplished is to show others that there are considered, rational ways of going about problem solving, and in some measure show how one can distinguish between empty-headed pomposity and substantial knowledge.

People have a right to express their thoughts. They have a right to be respected as humans. They do not have an automatic right to respect for their thoughts.

There is much research work to be done. I spend most of my time on real work. I do not want to spend more time here.

2:41 PM, December 12, 2009 Permanent link to this entry  
Anonymous Anonymous said...

From Anynomous 1: Here is a reference to a recent New England Journal of Medicine article, with a copy of the article abstract. How much longer will we tolerate the antisocial behavior of Anonymous 2 and related gang of salt proponents?

Published at www.nejm.org January 20, 2010 (10.1056/NEJMoa0907355)

Projected Effect of Dietary Salt Reductions on Future Cardiovascular Disease

http://content.nejm.org/cgi/content/full/NEJMoa0907355

ABSTRACT
Background The U.S. diet is high in salt, with the majority coming from processed foods. Reducing dietary salt is a potentially important target for the improvement of public health.
Methods We used the Coronary Heart Disease (CHD) Policy Model to quantify the benefits of potentially achievable, population-wide reductions in dietary salt of up to 3 g per day (1200 mg of sodium per day). We estimated the rates and costs of cardiovascular disease in subgroups defined by age, sex, and race; compared the effects of salt reduction with those of other interventions intended to reduce the risk of cardiovascular disease; and determined the cost-effectiveness of salt reduction as compared with the treatment of hypertension with medications.
Results Reducing dietary salt by 3 g per day is projected to reduce the annual number of new cases of CHD by 60,000 to 120,000, stroke by 32,000 to 66,000, and myocardial infarction by 54,000 to 99,000 and to reduce the annual number of deaths from any cause by 44,000 to 92,000. All segments of the population would benefit, with blacks benefiting proportionately more, women benefiting particularly from stroke reduction, older adults from reductions in CHD events, and younger adults from lower mortality rates. The cardiovascular benefits of reduced salt intake are on par with the benefits of population-wide reductions in tobacco use, obesity, and cholesterol levels. A regulatory intervention designed to achieve a reduction in salt intake of 3 g per day would save 194,000 to 392,000 quality-adjusted life-years and $10 billion to $24 billion in health care costs annually. Such an intervention would be cost-saving even if only a modest reduction of 1 g per day were achieved gradually between 2010 and 2019 and would be more cost-effective than using medications to lower blood pressure in all persons with hypertension.
Conclusions Modest reductions in dietary salt could substantially reduce cardiovascular events and medical costs and should be a public health target.

11:32 AM, January 22, 2010 Permanent link to this entry  

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