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Nanny Mayor's Anti-Salt Drive Ignores Sense and Science


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(Earlier this month, the Bloomberg administration announced a new initiative aimed at encouraging food processors and restaurants in New York and across the country to cut back on salt in the foods they sell. This one of two commentaries on the move. The other, in support of the plan, appears here.)

Mayor Michael Bloomberg is at it again with his "big government knows better than you and your doctor" attitude. He crusaded to ban smoking in New York City restaurants and bars, forced restaurants into posting calorie counts and promoted high-powered advertising campaigns against sugary drinks. Now, the mayor and his health department czar are demanding 25 percent reductions in the amount of salt in manufactured foods sold in New York City -- even hysterically comparing the popular seasoning with rooting out "deadly asbestos in the classroom."

Since manufacturers would have to change their entire food product line for New York City because of this aggressive assault against salt, Bloomberg's zealous effort will affect food policy for the entire country. Although claiming this is a "voluntary" anti-sodium campaign, his vicious and untrue comparison of salt to deadly asbestos is especially a stab in the back to the city's ethnic cuisine. It will soon affect millions of resident diners as well as tourists who visit New York City for its excellent food offerings.

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"Say it's not our business?" the mayor grumped at a news conference. "I don't think so," he declared.

In recent years the U.S. Department of Health and Human Services has been asked to run a large-scale trial to determine the impact of salt reduction in the diet upon health outcomes in the general population. Yet this has never occurred. And since there has never been a conclusive scientific trial, what Bloomberg is "making his own business" is essentially his own egomaniacal experiment. He is placing New York City's population into the largest clinical trial ever, using its residents as guinea pigs without their consent.

A Taste for Salt

Bloomberg and his health czar are again pushing a "one size fits all" model for New York City, ignoring that salt has important properties that preserve and stabilize food and, of course, often makes it taste better. Sodium cannot be manufactured in the human body, so all humans need some measure of salt. Isn't it better for Americans to be free to consult their own doctors about their salt intake r than have politicians and nanny state bureaucrats setting arbitrary government rules? What's next in Bloomberg's radical book of "health regulations"? A "bedtime" rule stipulating how long people should get their nightly rest?

By the way, one can conduct an intellectually honest debate over the pros and cons of Bloomberg's health crusades, but there's no argument that the mayor is a hypocrite for often openly indulging in junk food while at the same time attacking everything ranging from salt to sugary drinks. New York Times reporter Michael Barbaro recently listed the mayor's admitted "weaknesses," including burnt bacon, hot dogs, Big Macs, fried chicken, wine, pizza, coffee and his favorite snack of all, Cheez-It's. Think of all the sodium in all that!

New York Magazine's Chris Rovzar has mused that, because of the mayor's love of junk food and awareness of how hard it is to resist, hizzoner likes to set up "hurdles" like calorie counts and trans-fat bans for people who are subject to temptation.

Whatever the mayor's motivation, restaurant owners, chefs and their customers know that salt obviously makes certain foods taste better. Chef David Chang, owner of the Momofuku Noodle Bar, notes that cooks have been using varying degrees of salt with food almost as long as they have been using fire. "You need salt to draw flavor out of food," Chang says. "It is a skill that you teach cooks. For that to be regulated by the government is stupid and foolish."

Noma Dumich, former owner of the Manhattan French restaurant Sel Et Poivre ("Salt and Pepper"), which is now owned by her daughter and son in-law, further underscores that the city government is pursuing a restaurant-killing and job-killing strategy. "I'm very worried about what Bloomberg's campaign will mean to my family and other city restaurants," she says.

Research shows that over the past 30 years the only country that has ever reduced its salt consumption is Finland. Interestingly, though, when comparing cardiovascular performance and increases in longevity in Finland over the last 30 years with the rates in neighboring countries and the U.S., none of which lowered salt consumption, Finland's has had the worst performance of all. Could one therefore conclude that salt reduction doesn't provide any significant health benefits, and may actually lead to diminishing the health of a population?

That's one more reason why the My Food My Choice grassroots organization has emerged to join a growing number of New York City consumers, restaurant owners and food manufacturers in opposing Bloomberg's nutritional fascism. The group is calling for peoples' freedom of health choices, as well as asking the mayor to not treat his constituents as guinea pigs. Bloomberg ought to mull that over while munching on his Cheez-Its.

Orit Sklar is the national spokeswoman of the coalition My Food My Choice, a grassroots coalition of consumers and businesses that promotes the advancement of consumer choice in the marketplace and an environment of economic vitality.

Cutting Back on Salt Will Save Lives


 
 

(Earlier this month, the Bloomberg administration announced a new initiative aimed at encouraging food processors and restaurants in New York and across the country to cut back on salt in the foods they sell. This is the first of two commentaries on the move. Another, opposing the plan, appears here..)

The National Salt Reduction Initiative, a New York City-led partnership of cities, states and national health organizations, has announced its proposed targets for a voluntary reduction of salt (sodium) levels in packaged and restaurant foods. The goal of the initiative is to reduce the salt in packaged and restaurant foods by 25 percent over five years -- an achievement that would reduce the nation’s salt intake by 20 percent and prevent many thousands of premature deaths as well as countless hospitalizations for people with heart and kidney disease. Success would translate into major public health benefits in the U.S.

The sodium in salt is a major contributor to high blood pressure, which causes heart attacks and strokes, the leading causes of preventable death in the U.S. and, arguably, the world. Every year, heart attacks and strokes cause an estimated 23,000 deaths in New York City, more than 800,000 deaths nationwide, and cost Americans billions in health care expenses.

America's Salt Habit

Using data derived from the 1988-91 National Health and Nutrition Examination Survey, the average dietary sodium intake for adults in the U.S. is estimated at 3,400 milligrams per day, with similar amounts for all races and ethnic groups. This estimated average, however, does not include discretionary sodium use, such as using salt when cooking or at the table. This discretionary sodium use is estimated to increase the average daily intake by about 15 percent. This means that the average American adult ingests almost 4,000 milligrams of sodium daily, a level that is way above the recommendation of the National Research Council that the average adult American consume no more than 2,400 milligrams of sodium per day.

 

A study using data from over 9,000 overweight American adults in the National Health and Nutrition Survey Epidemiologic Follow-up Study has shown that an increase in daily dietary sodium intake by 2,300 milligrams results in a 32 percent increase in risk for stroke, an 89 percent increase in death from stroke, a 44 present increase in death from coronary heart disease, a 61 percent increase in deaths from all cardiovascular diseases, and a 39 percent increase in death from all causes.

This study did not find a significant association between dietary sodium intake and risk of cardiovascular disease in people who were not overweight . However, since approximately 70 percent of U.S. adults are either overweight or obese -- with that proportion increasing steadily -- the data on risks for overweight people are very relevant to our population.

The statistics bear out what we know medically. High sodium intake increases blood pressure and that in turn increases risk for these blood vessel diseases. Importantly, the large INTERSALT study has shown that lowering sodium intake by 2,300 milligrams a day, from about 3,800 milligrams to about 1,500 milligrams correlates with a 3 to 6 mm Hg reduction in systolic blood pressure. Even a 3 mm Hg reduction for the general U.S. population should result in 11 percent fewer strokes, 7 percent fewer coronary events and 5 percent fewer deaths, reducing the number of heart attacks and strokes by approximately 126,000 a year and deaths by 44,000.

A 1999 statement by the National High Blood Pressure Education Program of the National Heart, Lung, and Blood Institute concluded that a clear causal link between dietary sodium intake and blood pressure exists. The group of scientists also stated that the evidence for this relationship is sufficiently strong to warrant a specific recommendation about reducing dietary salt intake. The American Heart Association and American Medical Association have also called for reducing salt intake.

The Restaurants' Role

As with transfats, which New York City banned in restaurants in 2006, people do not go to restaurants with the express purpose of eating more salt. In the vast majority of cases, most people will not even miss the extra salt.

Millions of Americans live with congestive heart failure and kidney insufficiency. For them, excess sodium intake can result in life-threatening and costly hospitalizations. Despite this, food processors and cooks continue to add unnecessary salt to food, making it more and more difficult to obtain a low-salt meal at most restaurants without considerable effort. Many people with heart or kidney problems cannot experience the enjoyment of eating out because of the relatively high salt content of many restaurant foods.

The New York City-based initiative to reduce salt consumption by working with the food and restaurant industry warrants implementation immediately. Just as restrictions on smoking in public places have led to major health benefits, this initiative should have a similar impact on health without detrimental impacts on the food economy or on the delight people take gain from eating at their favorite restaurants. This is also a very cost-effective approach that is consistent with current efforts taken in Washington and individual states to improve the nation’s health without increasing our national debt.

Robert C. Block, MD, MPH, is a member of the Department of Community and Preventive Medicine and the Department of Medicine, Cardiology Division at the University of Rochester. John Bisognano, MD, PhD, is with the Division of Cardiology, Department of Medicine at the University of Rochester and president of the New York chapter of the American College of Cardiology.

9/11 Health Care Bill Could Get Boost in Congress


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There’s a type of wind that blows in off the North Shore of Long Island that is not only so sharp and cold it burns your face but also has enough force that if it hits you at the right angle, it can knock the air away from your mouth as you try to inhale. Just after Christmas, as firefighters gathered outside a Suffolk County church for the funeral of retired firefighter James Ryan -- who died from cancer doctors believe was caused by toxins he was exposed to while doing recovery work at Ground Zero -- the burning wind augmented another chilly reality for New York’s Bravest: Ryan was not the first front-line responder to die from a 9/11-related illness, and he will certainly not be the last.

Exactly a week later, many of those same responders gathered by the World Trade Center site to read the names of 9/11 responders and Ground Zero recovery workers who have died from illnesses related to their duty. It was the fourth anniversary of the death a another notable responder, New York Police Department Detective James Zadroga, whose name is attached to a bill in Congress that would establish permanent funding for health treatment and monitoring programs for 9/11 response workers and lower Manhattan residents, students and workers.

The medical centers treating the thousands of 9/11 responders as well as lower Manhattan residents and workers suffering from respiratory ailments and mental illness such as post-traumatic stress disorder survive on annual appropriations funding from Congress. Already a precarious situation, the financial crisis makes things shaker, which is why advocates are intensifying their push for a more reliable funding source.

Show Us the Money

The hold-up -- legislatively speaking -- is in the House Energy Committee. The bill has two parts. The compensation and health component was approved with bipartisan support in the Judiciary Committee on the former aspects terms, but the health subcommittee of the Energy Committee hasn’t voted on it, as its chair, New Jersey Democrat Frank Pallone, is not sure there is enough support for it.

The bill’s supporters -- among them New York Reps. Carolyn Maloney and Jerrold Nadler, both Democrats, and Peter King, a Republican -- say the votes are there.

However, it has been difficult for lawmakers outside the tri-state area to commit to it, since the measure carries an undetermined price tag. "I am more confident than I have ever been, but like anything it's never done until it’s done," Maloney said, noting that the Zadroga Act has the support of House Speaker Nancy Pelosi.

The bill has had a complicated history among the various groups who support long-term federal funding. The main city police union -- the Patrolmen’s Benevolent Association -- has opposed the bill’s current language because it does not specifically mention certain cancers. They have feared this means that members who develop those cancers would not be covered. Other police and first-response unions believed it is more important to pass the bill now and tweak conditions -- such as adding the cancers -- later.

Resident and worker groups such as Beyond Ground Zero have had similar reservations and also noted that the bill covered residents, students and workers only from Houston street to South Ferry in Manhattan. They believe that the coverage area should extend at least to 14th Street, of not higher.

Even if the activists can push the measure through the House, the Senate will be another story. If the health-care reform bill is any indication, the Senate is far more averse to government funding for health-care than the House. And the senator who had been credited with pushing for much of the current temporary funding, Hillary Clinton, is now secretary of state.

At the ceremony on the anniversary of Zadroga’s death, John Feal -- who heads a 9/11 responders group called the Feal Good Foundation-- showed his technique for passing the bill as soon as possible by displaying his chief weapon: a piece of Whole Foods pork.

"That’s how we get votes right? We give someone in Washington some pork," he said, citing the recent drive to pass the health-care reform bill by offering funding provisions geared to specific states. "So what I’m going to do is mail every member of Congress one these pieces of pork, and I'm going to put a 9/11 responder’s name on it."

Death and Glory

Meanwhile, the 9/11 first responders, their families and supporters face other issues as well.

Ryan’s funeral, at first glance, looked like the typically ornate send-off the city's fire department is famous for: the Emerald Society’s rendition of "Amazing Grace" and a salute by columns of uniformed members. But it wasn’t an official Fire Department event with eulogies from the mayor and commissioner. Those events are reserved for firefighters who die on or as a result of injuries sustained on their shift. Those who die years later don’t count, and 9/11 responder families take this as a snub.

Fire Department officials responded that while members who die long after 9/11 don’t get the official "line of duty" funeral, Ryan and many others did retire with a disability pension, meaning they get three fourths of their average annual salary for their last three years on the job, as opposed to half the salary, which is the standard benefit. In addition, they said, Ryan's family was virtually guaranteed a full death benefit.

But for many first responder advocates, including the heads of unions and fraternal groups, the pomp and circumstance matters. They have voiced their protests for people, such Paramedic Deborah Reeve, a dead Ground Zero worker whose death was designated an "administrative line of duty death." One activist joked that this sounded like she died from a paper cut.

There is a split between how the police and fire departments handle this kind of death in terms of memorials. Police officers like Zadroga, have their names displayed on the police department's memorial wall in lower Manhattan, along with cops who died on their shift, such as officers shot and killed by assailants. Ryan’s name, though, will not be affixed to the Fire Department's memorial wall at its downtown Brooklyn headquarters, along with the 343 FDNY members perished as the towers collapsed.

Mayor Michael Bloomberg has the power to set a single standard for honoring uniformed responders who die in the line of duty. But he has said he won’t. "I think each agency has to make its own policies," he said at a recent press conference. "There are great traditions that go back a long ways in both these departments."

Uniformed Firefighters Association president Steve Cassidy said that after Ryan’s funeral, much of the media coverage treated his as a line-of-duty death -- more than had been the case for another responder who had died before him. This, Cassidy said, gives him hope that pressure has increased not only on Washington to enact the Zadroga bill but also for the city to give further honors to responders like Ryan.

"A sense of change is in the air," he said.

Ari Paul is a reporter for The Chief-Leader, a weekly newspaper covering city government and the civil service, and a correspondent for Free Speech Radio News. Due to a computer error that deleted key words, this article originally incorrectly identified Rep. Pallone and Rep. Maloney. The error has been fixed.



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