sodium salt

A study released this week is fueling the polarized debate on sodium consumption and health outcomes and is already being used as fodder in the New York City court fight over high-sodium menu warning icons.

The research, published in the International Journal of Epidemiology online Wednesday, consisted of an analysis of 269 reports – including primary studies, systematic reviews, guidelines, comments, letters and reviews – published between 1978 and 2014.

The researchers — Sandro Galea of Boston University School of Public Health, and  Ludovic Trinquart and David Merritt Johns from Columbia University’s Mailman School of Public Health — found that 54 percent of the material supported the hypothesis that salt reduction leads to “population benefits.”

About 33 percent of the materials were contradictory to the link, and 13 percent were inconclusive, the study found.

“We found that the published literature bears little imprint of an ongoing controversy, but rather contains two almost distinct and disparate lines of scholarship,” the article’s authors wrote.

The trio said they received no funding from any public agency, commercial entity or nonprofit organization for the research.

“The idea of this work came from our interest in the production of knowledge in public health, as well as complex systems approaches,” Trinquart said by email.

“We do not here intend to ‘take sides’ in the salt debate: we neither endorse nor oppose the central hypothesis at hand. Our intention in this article was not to be part of the debate, and our findings should not be used to fuel it,” the article’s authors wrote, adding they intended only to “lay bare and begin to unravel the challenges underlying the dispute.”

Despite their reticence to become involved in the disagreements over the health implications of salt consumption, the research is already being used.

The article “further confirms what we have asserted from the outset of this case,” said attorney Preston Ricardo in an emailed statement.

Ricardo is representing the National Restaurant Association in its lawsuit to block a New York City regulation requiring high-sodium menu warnings, a regulation that was effective Dec. 1.

Restaurants that don’t comply by posting icons of a saltshaker inside a triangle next to menu items high in salt face fines starting March 1.

A hearing on the dispute is scheduled next week.

Ricardo added that the new law contains “a controversial scientific message, with which many covered restaurants disagree, and violates those restaurants’ First Amendment rights by forcing them to voice the government’s controversial opinion relating a so-called ‘high’ level of daily sodium intake to the possibility of a risk factor for cardiovascular disease.”

Americans currently consume more than 3,400 milligrams of sodium daily, more than double the amount recommended by the American Heart Association for ideal cardiovascular health.

The New York Health Department said in an email statement that the article’s evidence about health concerns over high sodium intake is “solid and conclusive”

“This paper explains how any area of scientific study will include studies with a mix of supportive, contradictory or inconclusive findings,” the statement read. “Public policy is made by looking at the totality of the evidence to reach a conclusion to advance public health.”

According to New York’s Health Department, the average New Yorker consumes nearly 40 percent more sodium than the recommended daily limit.

In a news release the day before the label rule went into effect, the city claimed it was first in requiring the warning labels for chains. Such labels have been known to inform customers of health risks and otherwise educate the public.

This isn’t the first time the restaurant association has clashed in court with the Big Apple. In 2012, when the city tried to limit the size of sugary drinks, the association sued and eventually halted implementation of the limitation after the New York State Court of Appeals ruled the health board “exceeded the scope of its regulatory authority.”

In recent years, several companies worked to cut down on sodium in their food. Walmart had suppliers reformulate thousands of packaged food items to reduce sodium by 25 percent; food giant ConAgra Foods said it cut sodium by 20 percent; and Subway restaurants reduced sodium from its Fresh Fit sandwich menu. General Mills Inc. announced in December that it had reduced sodium by at least 20 percent in seven product categories.