American Medical Association's Uneducated Attitude on Salt

By David Feder, R.D., Managing Editor

It seems the American Medical Assn. (AMA) has decided MDs know more about nutrition than nutrition scientists. They don’t. Few medical schools in this country require anything more than a single course in basic nutrition.

Despite this collective dearth of knowledge, last month the AMA – a for-profit association – officially called for measures to reduce sodium intake in the U.S. diet. The organization “urged” the FDA to take the mind-boggling step of revoking salt’s GRAS (generally recognized as safe) status and called for a “minimum 50 percent reduction” of sodium in foods. The group also wants warning labels – yes, warning labels – on foods containing what the organization decides is too much salt.

The problem with this AMA action is, it involves a serious disconnect from logic and science. I’ve said it in our pages before and I’m saying it again: To date, there is no definitive scientific backing for reducing the amount of sodium in a healthy person’s diet. It just isn’t there. (See the Salt Institute’s white paper, “Evidence-based public health: More than a platitude,” on this website.)

A responsible physician wouldn’t prescribe the entire country a drug targeting a specific condition when not everyone had, or was even at risk for, that disease. It would be unethical.

Not all in the AMA believe in sidestepping science. "I don't understand why it's necessary to set a universal standard when healthy people have no need to restrict their sodium intake," says Byron Rovine, M.D., a long-standing member of the AMA. “Standards apply only to people who require them.”

The force behind this antisodium witch hunt has been the Center for Science in the Public Interest (CSPI), headed by Michael Jacobson, Ph.D., (note: his doctorate is in microbiology, not nutrition). The Washington-based organization is well-known for its sensationalist attacks on foods and food ingredients.

These attacks tend to be based on research misrepresented or taken out of context, poorly conducted research, hearsay and Jacobson’s personal phobias. (See "As Different as Salt and Pepper," on this website.)

No. 1 on CSPI’s mission statement is “To provide useful, objective information to the public and policymakers…” but I’ve yet to see any objective report produced by CSPI.

As for the AMA, in contrast to the average physician’s profound lack of nutrition knowledge, a doctorate in nutrition or certification as an RD (registered dietitian) requires a multiyear, multidisciplinary curriculum in the science of nutrition.

As an RD, I would never presume to tell a surgeon how to operate. You can be damn sure the American Dietetic Assn. would never hold a national referendum insisting all medical practitioners in the country use fruits and vegetables to treat appendicitis.

The solace for food processors is that, in practice, the AMA-CSPI canard could work in favor of food manufacturers and salt processors. Manufacturers will save money by buying less salt, yet salt processors will make more profit selling salt as a retail product. After all, it’s been proven people add salt at the table to make up for whatever food processors leave out.

As for the AMA, it should focus its attention on issues it’s supposed to know about – like how to care for sick people. Around 100,000 people die from hospital-contracted infections each year. Kind of puts this whole salt thing into perspective, doesn’t it?