The difference between this story and the story we reviewed on the same topic by the New York Times can be seen even in the headlines. This one leads readers to believe that there is a risk in eating less salt. The New York Times, though, took the more cautious approach of saying, “Low-Salt Diet Ineffective, Study Finds. Disagreement Abounds.” We think that given the problems with this study, the more cautious approach was appropriate.
As with the harms, the benefits were not quantified.
There is no quantification of harms or benefits in this story. Instead we are told, “They found that systolic blood pressure (the top number) was slightly lower in those who excreted less sodium, but this didn’t translate into a lower risk of cardiovascular death — in fact, those with lower sodium excretion had an increased risk of cardiovascular death. The findings were consistent in participants younger and older than 60 years.” The New York Times story put the harms (and benefits) in absolute terms, showing both the small sample size of the number of people who died and the differences in the categories.
Unlike the New York Times story, this one did not evaluate the quality of the evidence. The story said, vaguely, “The research is already drawing fire from medical experts here. Ralph Sacco, president of the American Heart Association and chairman of neurology at the University of Miami, says this is only one study of a relatively young, mostly white population and blood pressure tends to rise with age and affect African-Americans disproportionately.” Again, this might lead most people in the United States to think that they are at risk when, in fact, there were other significant limitations to the study that were ignored.
The story did not engage in overt disease-mongering, but we do feel readers will be confused about whether they should be worried about their salt intake. There is so little information presented about the specifics of the study that many people might assume that they are eating too little salt.
The story does quote an independent expert but then turns around and cites a spokesman for the Salt Institute, a salt advocacy organization. Why should they be given a platform in this story? We thought that more weight should have been given to the independent analysis, as was done in the New York Times story. The Times, for example, sought out a well respected expert, Dr. Lawrence Appel.
(Addendum added May 6: It’s worth noting that the independent experts in this field, such as Dr. Appel and Dr. Sacks (who are also quoted in the Times story), are closely affiliated with NHLBI which funds much of the research on sodium. And as Gary Taubes posited many years ago in Science magazine, the NHLBI may not be a dispassionate arbiter of the evidence. (The full text of his story can be accessed at the National Association of Science Writers website: http://www.nasw.org/1999-science-society-awards.)
This criterion does not apply in this story.
This study is presented as just another study of equal weight with everything else that has been published on heart disease and salt. It should have been presented as an one study with significant flaws.
The story does not rely on a news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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