Health professionals often work to reduce their patients salt intake to reduce high blood pressure. Should the government get involved too? (Photo by James Gathany for the US CDC)
New research shows that Americans’ health
would benefit dramatically if we ate less
salt. But some people say it’s not the
salt in the saltshaker that’s the
problem. Julie Grant reports:
Transcript
New research shows that Americans health would benefit dramatically if we ate less salt. But some people say it’s not the salt in the saltshaker that’s the problem. Julie Grant reports:
Darryl Bosshardt comes from a salt family. His grandfather started mining salt on their farm in central Utah. When Bosshardt hears about a new study that shows 100-thousand American lives could be saved each year if everyone reduced their salt intake by just a half teaspoon – he cringes.
He says salt is being given a bad name.
“And the challenge is, how we define salt.”
Most of the salt today all looks the same – perfectly pour-able, uniform bright white grains. It’s pure sodium and chloride, but Bosshardt, whose family owns the Real Salt Company, says it’s not the same as naturally occurring sea salt.
“Sea water occurs with many trace minerals. Over 50 to 60 trace minerals. It doesn’t occur, the salt in sea water doesn’t occur, as pure sodium and chloride.”
Bosshardt says those trace minerals help the body to process sodium, but most salt today looks perfect because the trace minerals have been taken out. He says when our bodies lack the minerals needed to process sodium; it raises blood pressure, which can lead to heart problems.
There are some books by holistic doctors that make these kinds of claims,but there’s not much science to prove this.
Most doctors today say salt is salt; sodium chloride. Our bodies need it, but not as much as much as most Americans are eating.
Dr. Kirsten Bibbins-Domingo is a professor of medicine and epidemiology at the University of California in San Francisco. She’s lead author of that new study on salt – the one that finds Americans could reduce deaths from heart disease by 100-thousand just by slightly reducing salt consumption:
“I don’t think we’re saying salt is bad and one of these other types of salt would be good. I think the newer types of salt that are on the market might have a lower sodium content for the taste that they have and so that would certainly be potentially beneficial.”
But Bibbins-Domingo says most Americans only get 6-percent of their sodium from their own saltshakers. The rest comes from processed foods and restaurants. So buying expensive sea salts with those trace minerals isn’t going to make much difference to most people. She says the problem is that salt is ubiquitous – people don’t even realize they’re eating it:
“If you start out with a healthy bowl of cereal with some milk, you’ve already consumed quite a bit of salt right there. If you have that healthy turkey sandwich or tuna sandwich, you have a bit of salt right there. If you have the marinara sauce with the pasta, you have salt there. So you realize that there are so many different ways, without you choosing items that we might clearly associate with a high sodium content, that there are a lot of places that we’re all consuming salt.”
Bibbins-Domingo supports efforts like the one in New York City. There Mayor Michael Bloomburg is urging food manufacturers to reduce the salt in their foods by 25% over the next five years.
Mark Kurlansky thinks it’s a terrible idea. He wrote a book called “Salt.” When laws curb smoking – that’s one thing. But salt is something different:
“You have to deal with the fact that people like salt. There isn’t the moral imperative of cigarettes because there isn’t a problem of second hand salt. If you don’t want to eat salt and the guy at the next table wants to eat it, it’s not going to affect you. It becomes an issue of government messing around with individual choice.”
But most people don’t realize they’re making that choice – there’s just so much salt in all the foods they buy. Other countries, such Finland and England, have worked with food manufacturers to lower salt content. In the UK, they cut sodium in foods by 10-percent. And researchers say the public didn’t even notice. They’re still studying to see if it’s actually improved health.
Dr. Bibbins-Domingo says the health savings of reducing salt are comparable to cutting the number of smokers in half. (Photo by Paul Goyette)
If you read nutrition labels on food packages, you might be surprised by how much sodium there is in a lot of foods.
Some researchers say all that salt is causing a plethora of health problems – and they want the government to force food manufacturers to lower the salt content. Julie Grant reports.
Transcript
If you read nutrition labels on food packages, you might be surprised by how much sodium there is in a lot of foods.
Some researchers say all that salt is causing a plethora of health problems – and they want the government to force food manufacturers to lower the salt content. Julie Grant reports.
When Dr. Kirsten Bibbins-Domingo sees patients with high blood pressure, she advises them to cut back the on the salt.
She says they often return to the office – happy to announce that they’ve cut out fast food and processed snacks.
“AND THEN I ASK THEM TO TELL ME WHAT THEY’RE EATING AND I AM AWAYS BLOWN AWAY WHEN THEY COME BACK WITH THESE NICE HEALTHY VEGETABLE SOUPS THAT ARE CHOCKED FULL OF SALT. AND SO ALL THE THINGS THAT THEY DON’T REALIZE ARE HIGH IN SALT ARE ACTUALLY STILL THERE IN THEIR DIET.”
Bibbins Domingo is associate professor of medicine and epidemiology at the University of California in San Francisco. She’s also lead author of a recent study published in the New England Journal of Medicine.
Researchers at Stanford and Columbia University Medical Centers co-authored the study.
They did a computer simulation – to see what would happen if every American reduced their salt intake by a half teaspoon a day. That’s 3 grams.
“WHAT WE FOUND THAT IS IF WE WERE ABLE TO REDUCE SALT IN THE U-S DIET BY 3 GRAMS PER DAY, WE WOULD ANTICIPATE 100-THOUSAND FEWER DEATHS EACH YEAR, 100-THOUSAND FEWER HEART ATTACKS, AND MORE THAN 100-THOUSAND FEWER CASES OF NEW HEART DISEASE.”
Bibbins-Domingo says the health savings of reducing salt are comparable to cutting the number of smokers in half.
But not everybody puts that much stock in the new study.
Michael Alderman is a professor of medicine and epidemiology at the Albert Einstein College of Medicine. He says the government shouldn’t act so quickly based on this new study:
“WELL, IT’S INTERESTING THAT IT’S CALLED A STUDY, WHICH I THINK SORT OF SUGGESTS THAT THERE ARE REAL OUTCOMES AND REAL PEOPLE THAT WERE STUDIED. IN FACT, OF COURSE, WHAT IT IS A SIMULATION, A MATHEMATICAL MODELING.”
Alderman says there are lots of different findings when it comes to sodium consumption. And some show reducing salt intake could have actually have negative health effects:
“WE KNOW THAT REDUCING SODIUM INTAKE, BY AN AMOUNT SUFFICIENT TO REDUCE BLOOD PRESSURE, ALSO INCREASES SYMPATHETIC NERVE ACTIVITY, IT INCREASES RESISTANCE TO INSULIN…”
If we already ate low salt diets, the researchers in this latest salt study say those concerns might be valid. But Dr. Bibbins-Domingo says salt consumption in the U.S. is higher than is recommended, and it’s on the rise.
But she says there are high levels of salt in so many foods, it’s hard to avoid. Cereal. Bread. Lunch meat. Pasta Sauce.
And she says consumers can’t really reduce salt consumption without some changes by food manufacturers.
“RIGHT NOW THERE ARE NO CHOICES THAT ARE REALLY AVAILABLE THAT MIGHT BE LOWER IN SALT. I THINK THAT’S WHERE THE EFFORTS WITH THE FOOD MANUFACTURERS ARE ABOUT REALLY MAKING A RANGE OF CHOICES SO WE CAN EAT LOWER SALT, WHICH IS VIRTUALLY IMPOSSIBLE RIGHT NOW.”
Some governments are responding. New York City has already started urging food manufacturers and restaurant chains to lower the salt in their foods by 25-percent over the next five years. Bibbins-Domingo says California is considering salt limits in foods the state buys for schools, prisons and other public institutions.
She also wants the Food and Drug Administration to require food makers to alert consumers when foods are high in salt.
In the meantime, Bibbins-Domingo advises her patients to look at food labels – and really look at the sodium content – so they know what they’re getting.
Dr. Kessler's new book describes the three components in food that keep us addicted: sugar, salt, and fat. (Photo courtesy of the National Canter Institute)
On average, people in the US
are much fatter than just 30
years ago. Obesity is an epidemic.
The Environment Report’s Lester
Graham talked with the author
of the book ‘The End of Overeating,’
which argues the American diet
is to blame:
Transcript
On average, people in the US
are much fatter than just 30
years ago. Obesity is an epidemic.
The Environment Report’s Lester
Graham talked with the author
of the book ‘The End of Overeating,’
which argues the American diet
is to blame:
Lester Graham: This is The Environment Report. People in the US are much fatter than just 30 years ago. Obesity has become an epidemic. The author of the book, “The End of Overeating” argues, “It’s the American diet.” David Kessler is a pediatrician and served as commissioner of the US Food and Drug administration under George Bush I and Bill Clinton. Dr. Kessler, give me the short answer, why has obesity become so rampant in the US?
David Kessler: We’ve taken fat, sugar, and salt, put it on every corner in America, made it available 24/7, made it socially acceptable to eat any time. We’ve added the emotional gloss of advertising—you’ll love it, you’ll want it. We’ve made food into entertainment. In fact, we’re living in a food carnival.
LG: I’ve been watching restaurant commercials, especially since reading your book, and I see a lot of, “It’s a fun time, it’s a good time, bring your friends, it’s a family gathering.” There is a lot of that emotional appeal, but it doesn’t talk about nutrition.
DK: Exactly. Sometimes about the economic value of food, but always it’s the emotional gloss that’s added. And food’s very reinforcing. Fat, sugar, and salt stimulate us, we come back more. But when you add that emotional gloss: “You’ll want it, you need it, you’ll have a good time.” That amplifies the reward value of food.
LG: Now your book spends a lot of time looking at the science of why we respond to sugar, salt, and fat and how the food industry has taken advantage of our response to sugar, salt, and fat. Why do we like those things in our food, why do we always crave more?
DK: That was the question that got me started 7 years ago. I wanted to understand why it was so hard for me to resist my favorite foods. I was watching Oprah one night, there was a woman on the show who said, “I eat when my husband leaves for work in the morning, I eat before he comes home at night, I eat when I’m happy, I eat when I’m sad, I eat when I’m hungry, I eat when I’m not hungry.” And then she said, “I don’t like myself.” And it was that behavior, I could relate to that. I have suits in every size. That’s what I wanted to understand, I wanted to understand the science and we finally do have the science to explain to that woman that it’s not her fault. In fact, her brain is becoming excessively activated by all the food cues in our environment—she’s being bombarded, she’s being constantly stimulated.
LG: You infer the food processors and the chain restaurants, are using some of the same techniques the tobacco companies used to get people hooked on cigarettes. In what ways?
DK: They certainly understand the inputs. They understand that sugar, fat and salt stimulate. They understand the outputs, that you come back for more. Have they understand the neuroscience? I doubt it. But they learned experientially what works, and they optimized food, they constructed food to stimulate us to come back for more. Let me explain how it works, let me give you analogy with tobacco. We have to be careful, there are similarities but there are also differences. Nicotine: nicotine is a moderately reinforcing chemical. But add to that the smoke, the throat scratch, the cellophane crinkling of the pack, the color of the pack, the image of the cowboy, the glamour, the sexiness, the sense that it was cool, the imagery from 20, 30, 40 years ago. What did we end up with? A highly addictive product. If I give you a packet of sugar and say, go have a good time, you’ll look at me and say, “What are you talking about?” Add to that sugar fat, add texture, add mouth-feel, add color, add temperature, put it on every corner, make it into entertainment, and what do we end up with? One of the great public health crises of our times.
LG: Now I don’t think the food industry sees this as necessarily trying to build addiction or using these chemicals as a way to re-wire our brain. I think any good chef will tell you, I want to cook things that will please you, that make you happy. It just so happens that sugar, salt, and fat make us happy. So, what’s wrong with it, if that’s what we want?
DK: The argument that the food companies will use is that all their giving consumers is what they want. But we now know, we have the science to show, that these chemicals are activating the brains of millions of Americans and what happens is that we keep on coming back for more. Look at modern American food, pick any appetizer from any major American restaurant chain. What is it? It’s layered and loaded with fat, sugar, and salt.
LG: Well, let’s pick one you highlighted in your book, because I happen to like it, it’s the Southwest Egg Roll at Chilis. It’s tasty!
DK: The Washington Post outed me because I had to go dumpster diving in order to find out what was in restaurant foods. We worked for a decade at the FDA putting nutrition facts labeling on all foods in the Supermarket, but not so in the restaurant foods. If you look at the ingredients, some fifty ingredients: the sugars, the fat, the fat loaded on fat, the salt in that eggroll. One industry insider just called it the equivalent of a fat bomb.
LG: You spend a little bit of time in the book on how food is labeled. How, for example, cereal manufacturers hide just how much sugar is really in that box. How do they hide it?
DK: Different names on the label, not just sugar, they’ll use honey, they’ll use molasses, they’ll use other terms so its not the first ingredient listed on cereals. But, understand, its not just any one ingredient. We have made food highly stimulating. The multi-sensory nature of food, it’s a rollercoaster in the mouth. 30 years ago, we used to chew on the average of 30 times per bite. Now it’s less than half of that. Food goes down in a whoosh, it stimulates, it rarely lingers. In fact, most of what we are eating is so pre-digested. Chicken: I went in and ordered a margarita grilled chicken dish, I thought it was healthy. Little did I know it was bathed, it was mixed in these cement mixers with sugar and fat, our meat is injected with these needles, solutions are added, sure it tastes good. But in some ways it keeps us in this cycle of consumption. And understand the cycle of consumption based on past learning, past memory, we get cued. Our brains get activated. The cue can be as simple as a sight, a smell, a location, my car can be a cue! Because where I’ve gone before, I get in the car and start having these thoughts of wanting. I was walking down Powell street and I started thinking about chocolate covered pretzels. Why? Because I had been, six months earlier, a place on Powell street. I had forgotten entirely about it, we’re such effective learners—just walking down that street will create thoughts of wanting. Thoughts of wanting arouse me, they capture my attention, they pre-occupy me, I eat for that momentary pleasure. Next time I get cued, I do it again, and every time I engage in this cycle, I just strengthen the neural circuits. What am I in search of? I’m in search of this ephemeral pleasure, is there any real satisfaction? Rarely.
LG: Your book is called “The End of Overeating.” How do we stop overeating, when much of the food at the grocery store and the restaurants is prepared the way it is, we have all these visual cues, these reminders of how food is a reward in our lives. How do we stop that cycle, how do we break or rewire our brain back to a more healthy style of eating?
DK: First, we have to come to the understanding that our behavior is becoming conditioned and driven. And it’s not just our behavior, it’s the behavior of our children. And once we understand that, once we understand that food in fact has become hot stimuli, and preoccupy us and capture our brains, and hijack our brain circuits, and we can see this on the neural imaging. What we have to do is cool down the stimulus. How do you cool down a stimulus? First, you can just get rid of the cues. That sounds easy, you create a safe environment in your home, but you end up walking down the street so that’s not very practical. The other effective way is to eat with some structure. What do we do in The United States? By putting fat, sugar, and salt on every corner, eating 24/7, eating in our cars, eating all the time, we’ve taken down any boundaries. So eating with some structure—knowing what you’re going to eat, when you’re going to eat it, and if it’s food that you want, it helps protect you from being bombarded by cues, because if you know what you’re going to be eating in several of hours, the cues in the intervening time that you get hit with just don’t have the same power. In the end, what’s the best way to reduce and take the power out of a stimulus? How do you change what you want? Want something else more. What we have to do, and I think this is essential as a country, because social norms effect us, they really effect our behavior, they effect our neural circuitry. If I look at that huge plate of fries and say, “That’s my friend, that’s gonna make me feel better,” my brain’s going to get activated and then there’s nothing I can do to stop myself from finishing that plate of fries. If however, we change how we view food, psychologists call it a critical perceptual shift. How did we win, well, we haven’t quite won it but how did we succeed in the perceptual shift against tobacco? 30, 40 years ago we used to view the product as something that was cool, something that was socially acceptable, something that we wanted. We changed that perception. Now we look at it for what it is, a deadly, disgusting, addictive product. Tobacco is easy because we can live without tobacco. Food is much harder. But, all the processed foods, foods that stimulate us, that are just fat and sugar, fat and salt, fat and sugar and salt, getting us to come back for more and more, I think we have to change how we view food back, perhaps it’s very simple in the end, ho w much real food are we eating?
LG: You did the research, started 7 years ago, you wrote the book, now you’re talking about food on interviews like this. How has it changed your life?
DK: What’s very interesting, being trained as a physician, I thought I would go into the world and understand the metabolism, the endocrinology, the bariatrics, the physiology. What I actually gained in understanding was that we’re all wired to focus on the most salient stimuli in our environment. That’s what makes us so successful as a species. It could be alcohol, tobacco, illegal drugs, it could be gambling, but for many of us, food has become the most salient stimuli, and what about that food? It’s the fat, sugar, and salt. I look at that food and I say, I need it, it’s going to make me feel better, and I’ve come over time to understand that I can feel just fine, eat about half as much as I was eating but feel just as satisfied.
LG: David Kessler is the author of “The End of Overeating: Taking Control of the Insatiable American Appetite.” Thanks very much for speaking with us.
Melissa Rosen and her husband Greg Horos opened Locali's - LA's first "ecovenience" mart. (Photo by Devine Browne)
The only convenience store staples you won't find on Locali's shelves are cigarettes and lotto tickets. The owners say there are no clean versions of those. (Photo by Devine Browne)
Vegan condoms are Locali's most-blogged about item for sale. (Photo by Devine Browne)
Not that long ago, if you wanted to buy eco-friendly at the grocery store, your options might have been limited to the granola and beans in the bulk bins. Then stores started carrying organic produce. Later vegetarian fast food appeared. Devin Browne reports now eco-friendly is hitting convenience stores:
Transcript
Not that long ago, if you wanted to buy eco-friendly at the grocery store, your options might have been limited to the granola and beans in the bulk bins. Then stores started carrying organic produce. Later vegetarian fast food appeared. Devin Browne reports now eco-friendly is hitting convenience stores:
They’re called ecovenience stores and they’re showing up all over the country. The point is that they sell convenience store food, only greener.
(sound of a store)
“This is our organic hot pretzel, we have organic hot pretzels. It’s organic flour.”
That’s Melissa Rosen; she co-owns a new ecovenience store in Los Angeles, called Locali. Which is actually spelled L-O-C-A-L-I.
And they’ve got hot pretzels, but organic. Hot dogs, but grass-fed. The store even looks like a convenience store: It’s in a strip mall, it’s near a freeway. They’ve got cold drinks in the fridge and impulse buys like candy near the cash register. The customers are in a hurry, but a happy hurry. They rave about the chips
“It is a flavor explosion in your mouth, it is beyond savory.”
and the slushies.
“Slushies! There you go, the slushies are amazing.”
But then you get closer and you see that the cold drinks are not soda or beer: They’re Kombucha, the fermented tea. The candy is vegan gummy bears and organic lollipops. And the slushie, their signature item, is sweetened with agave.
There are a few 7-11 staples that are missing from the shelves, like cigarettes and lotto tickets. The owners say there are no green versions of those.
Some of Locali’s products are really pragmatic and not that exciting like energy efficient light bulbs and ecological laundry drops. Others are kind of sensational, silly, really.
“For example the vegan condoms. What is that, what is Glyde? I didn’t know my condoms weren’t vegan.”
So, vegan condoms, vegan caviar. Snow cones sweetened with brown rice syrup. They have this really big variety of products that have never been greened before.
And so the question becomes: will new green products like these, however silly, really mean new green consumers? Matt Kahn is an Environmental Economist at UCLA. HE thinks maybe so.
“So the goal might be to create buzz. That if you only sell green light bulbs and a tofu turkey burger, people might say oh yeah, that’s the green place. But if you do some truly wacky stuff, generating this green buzz, might tip, that even a Dick Cheney might come with his grandson hearing that it’s this wacky.”
Which is more or less the point – Locali wants to recruit new green consumers. Consumers who right now live in neighborhoods that don’t really have supermarkets and so they buy most of their food at liquor and convenience stores.
Of course, one of the problems will probably be price. A 16 oz slushie at Locali is $5.49, while a 22 oz slurpee at 7-11 is just $1.40. But Kahn, the economist, thinks because Locali is smaller and more flexible than say a Whole Foods, it might actually have a better shot at making it in new neighborhoods.
“And so a smaller business might have to pay only a couple hundred thousand dollars rather then multi million dollars to build a big boxed store. And that lower fixed cost of entering a market makes it more likely that smaller green stores might experiment more.”
And apparently, the ecovenience experiment is something that a lot of people want to try. In the first six days of business, the owners received phone calls from people in Seattle and DC and cities all over Southern California. And they all asked the same thing: how soon can we open a locali in our local neighborhood.
The "Great Plate" - a 10-inch plate: half non-starchy vegetables, a
quarter lean protein, a quarter starchy vegetable or whole grains (Photo courtesy of the University of Michigan)
Lots of companies are starting new programs
that teach their employees how to eat healthier.
Because healthier employees can save companies loads
of cash. Kyle Norris has more:
Transcript
Lots of companies are starting new programs
that teach their employees how to eat healthier.
Because healthier employees can save companies loads
of cash. Kyle Norris has more:
So, Stacy Witthoff is teaching people about healthy snacks.
“We have some 100 calorie packs. We have fresh fruit like bananas, peaches, pears,
apples, any kind of canned fruit is good too.”
Witthoff is a dietician with the Michigan Healthy Community – basically it’s a group that
does health education for University of Michigan employees.
The people at this expo are learning about how to eat healthier, and the idea is that they’ll
share this info with their co-workers.
Witthoff stands in front of a little booth and she’s all friendly. She snags people as they
walk by.
She’s just caught Jason Maynard. He’s a nursing administrator. And he goes to a lot of
meetings where there are a lot of snacks.
“So at meetings it’s probably donuts or bagels, cookies.”
But he thinks people would go for fresh fruit like raspberries or strawberries, if they were
offered.
Stacy Witthoff is promoting a guide that helps people make better food choices.
It’s called the Great Plate. It’s a picture of a plate that’s divided into different sections.
“Basically you take a 10-inch plate and half of it should be non-starchy vegetables, a
quarter of it lean protein, and a quarter of it starchy vegetable or whole grains. So it’s just
an easier way to eat healthy without having to think about portions.”
Ok let’s recap.
Divide your plate in-half and fill that half with non-starchy veggies – carrots, broccoli,
cauliflower, green beans, asparagus and peppers. And aim for a variety of colors.
Then divide the other half of the plate into quarters. Fill one-quarter with grains &
starchy veggies – that’s things like brown rice and whole-wheat pastas and whole-wheat
bread. And starchy veggies are things like potatoes, corn, peas, and squash.
Then the last quarter of the plate should have meats and proteins. Things like grilled
or baked chicken, fish, turkey, lean cuts of meat. And non-meat options like tofu, beans,
and eggs.
And the Great Plate says go for way smaller serving sizes.
The Great Plate encourages people to eat what they call “whole
foods.” That means eat the food in its raw form and not it’s processed equivalent. So
like eat the apple – as opposed to apple juice. Or as opposed to the apple-flavored gummi
worms, if you were someone like me.
Steve Aldana helps companies start employee healthcare programs. He says that
culturally we eat pretty bad stuff. And that we’re way stressed-out.
And all that can affect an employer’s pocketbook, for real.
“So 2 things: poor behaviors are leading to onset of chronic diseases. And those chronic
diseases are costing an inordinate amount in health care. And it’s that cost alone that’s
driving most companies to start to look very, very intently at worksite wellness
programs.”
Businesses are starting to see healthy employees as a smart investment. Companies like
Johnson & Johnson, IBM, and Dow Chemical have all taken note.
They hope programs like this one will help shave-off millions of dollars from their
employee health care costs.
And these programs can also help save money in the long run – by boosting employee
morale and leading to fewer employee absences.
Ethiopia is in the news again, as drought causes renewed famine
in the country. Meanwhile, the United States is experiencing record
high
obesity rates, with 1 out of every 4 children overweight. Great Lakes
Radio Consortium commentator Julia King wonders if our nation’s
pampered youth can ever feel kinship with their starving counterparts:
Health professionals often work to reduce their patients salt intake to reduce high blood pressure. Should the government get involved too? (Photo by James Gathany for the US CDC)
