New York City’s Salt Warning: Useless and Potentially Harmful

You may have heard on the news that New York City is, once again, on the cutting edge of interfering with consumers and businesses. This time they’ve decided to mandate that chain restaurants add a warning to items that are too high in salt. The rule is supposed to be aimed at informing consumers and helping to reduce hypertension and cardiovascular risk. However, it will not reduce peoples’ overall sodium consumption and may end up putting them at greater risk for disease.

Unanimously approved by the New York City Board of Health Board of Health, that notorious government body fond of overstepping its legal authority (recall the big soda ban?), the new rule requires chain restaurants in the city to put a symbol—a salt shaker in a black triangle—next to menu items with more than 2,300 milligrams of sodium. Why 2,300? Because that is the recommended daily limit the U.S. Department of Agriculture and Centers for Disease Control and Prevention continue to recommend despite the fact that in 2013 researches at the Institute of Medicine, at the request of the CDC itself, found “studies on health outcomes are inconsistent in quality and insufficient in quantity to determine that sodium intakes below 2,300 mg/day either increase or decrease the risk of heart disease, stroke, or all-cause mortality in the general U.S. population.”

Sodium is an essential requirement for the human body. It regulates blood plasma volume, is used for muscle contractions, nerve transmissions, and pH balance. It is vital in maintaining fluid balance and cardiovascular function. And research seems to show that how much salt we eat is physiologically determined that even extreme interventions do little to alter.

You might think that Americans eat more salt now than ever. In reality, Americans have been eating the same level of sodium since at least the 1950s. In 2010, Harvard researchers analyzed 38 studies, published between 1957 and 2003 and found that decade after decade, we consumed about 3,700 mgs per day. And it’s a worldwide trend. In 2013, researchers at the University of California-Davis looked at urine-extraction information for more than 50,000 people in 45 countries over the span of five decades. They found that across cultures and time, people ate an eerily similar amount of sodium (with a few exceptions and daily variation) and they were higher than the recommended 2,300 mg. But the USDA, CDC, and NYC Board of Health know better than the rest of the human population.

Even if it were true that we eat too much salt, it is foolhardy to think that this salt-warning will to do much, if anything, when even extreme clinical interventions (and three decades of public policy) fail to alter our sodium intake. For example, during a clinical trial half of the participants were given a 1,000 mg sodium tablet or a placebo. Those who got the placebo unconsciously raised their intake by nearly 1,000 mg through dietary choices, while those on the sodium tablet actually cut their dietary-sodium consumption to compensate. As Dr. McCarron (who led many of the sodium studies mentioned here) speculated, if governments enact policies to reduce the average amount of salt in food, people might compensate by seeking out saltier foods or by eating more of everything.

To be sure, there are some individuals with conditions that prompt their doctor to recommend cutting sodium consumption. On the other hand, they might be advised to increase their consumption of potassium, which also reduces blood pressure and for many is a much easier remedy than trying to fight their unconscious physiological drive to consume sodium. The bottom line is reducing sodium consumption is not a universal good—in fact, recent studies have found that very low sodium diets increase mortality, including death from CVD, diabetes, and heart failure. Individuals, with their doctor’s advice, should decide for themselves how little or how much sodium they should eat—not the NYC Board of Health, not the CDC, and not the FDA. It might feel good to put a warning on a menu, but that doesn’t mean the effects will be good.