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Study: Lower salt intake could be riskier than thought


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Study: Lower salt intake could be riskier than thought

Our Review Summary

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.


Why This Matters

Researching the impact of salt, or any dietary factor, on health can be tricky, as both of these stories explain, and this study attempted to provide a deeper look at the connection between salt and health. But, as the authors themselves acknowledge in the paper, there are significant limitations to this study that should have given reporters more pause when reporting the findings. The biggest one was acknowledged by the New York Times in saying, “was observational, considered at best suggestive and not conclusive.” USA Today missed this point.


Does the story adequately discuss the costs of the intervention?

Not Applicable
As with availability, the cost of salt is not really applicable in this context.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

As with the harms, the benefits were not quantified.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

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.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

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.

Does the story commit disease-mongering?


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.

Does the story use independent sources and identify conflicts of interest?


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:

Does the story compare the new approach with existing alternatives?

Not Applicable

This criterion does not apply in this story.

Does the story establish the availability of the treatment/test/product/procedure?

Not Applicable
Not applicable.  The availability of salt is not in question.

Does the story establish the true novelty of the approach?

Not Satisfactory

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.

Does the story appear to rely solely or largely on a news release?


The story does not rely on a news release.

Total Score: 3 of 7 Satisfactory


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