Cut down on salt and step up your health

In decades past, when companies wanted to test-market a product meant to enhance health and well-being, they often tried it first in California — where people were reputed to be the most health-conscious in the country. But now companies might be wise to consider field-testing their wares in New York City.

If he can take credit for nothing else, the city's mayor, Michael R. Bloomberg, can rightfully claim to have launched a national effort to help people live more healthfully. He began with a prominent campaign to curtail smoking, the single leading killer of Americans, by banning it in restaurants and bars, and followed that with a campaign to get heart-damaging trans fats out of packaged and restaurant foods.

Next Bloomberg attacked rampant obesity (though New York, being a walking city, is leaner than most other metropolitan areas) by promoting a requirement that chain restaurants prominently display the calorie content of all their offerings.

In a scientific analysis published last week in The New England Journal of Medicine, researchers at the University of California, San Francisco; Stanford University; and Columbia University College of Physicians and Surgeons calculated that if Americans reduced their salt intake by half a teaspoon a day, or 3 grams (the equivalent of 1,200 milligrams of sodium, the health culprit in salt), the nation would save up to $24 billion a year in health care costs.

The research team, led by Dr. Kirsten Bibbins-Domingo, an epidemiologist and biostatistician at UCSF, concluded that even a much more modest reduction — one gram a day, achieved gradually by the year 2019 — “would be more cost-effective than using medications to lower blood pressure in all persons with hypertension.”

And money is not the only thing that would be saved. The researchers calculated that the half-teaspoon reduction would “reduce the annual number of new cases of coronary heart disease by 60,000 to 120,000, stroke by 32,000 to 66,000, and myocardial infarction ((heart attack)) by 54,000 to 99,000, and reduce the annual number of deaths from any cause by 44,000 to 92,000.”

“With our current high-salt diet, all our blood pressures are increased, and the risk of heart disease with each rise in blood pressure is continuous.”

About 80 percent of the salt in the American diet comes from processed and restaurant-prepared foods, the main targets of Bloomberg's proposal. But for some people, including the mayor, meaningful cutbacks in how much salt they consume will also require restraint at the table.

The mayor is reported to add salt to almost everything, even saltine crackers, already-salted popcorn and bagels. If so, he is probably well above the amounts of sodium recommended by federal health authorities: 2,300 milligrams a day for otherwise healthy individuals; 1,500 milligrams for the elderly, those who already have high blood pressure and African-Americans, who are especially prone to developing high blood pressure.

City health officials acknowledged that it would be hard to legislate a reduction in salt, as finally happened with trans fats when a call for voluntary elimination fell on deaf ears.

But several companies have already expressed support. The supermarket chain A&P plans to follow the city's recommendation to reduce salt in the hundreds of store-brand products it sells. And the fast-food chain Subway announced its commitment to the guidelines at its nearly 23,000 stores nationwide.

Consumers, meanwhile, would be wise to check the sodium content per serving on food labels. When eating out, consider asking that salt not be added to the foods you order. You can always sprinkle on a little at the table. If you cut back gradually, your taste buds will adapt painlessly.