Intended for healthcare professionals

Rapid response to:

Feature Nutrition

The scientific report guiding the US dietary guidelines: is it scientific?

BMJ 2015; 351 doi: (Published 23 September 2015) Cite this as: BMJ 2015;351:h4962

Rapid Response:

Sodium-Induced Disorder Syndrome. Where have all the sciences gone?

From the beginning of Nina Teicholz's article: "... why does the expert advice underpinning US government dietary guidelines not take account of all the relevant scientific evidence?" Good question, but my question is better: Why are fully ignored the fundamentals and principles of biology, biochemistry, nutrition and health sciences? Nina Teicholz has right, but her criticism isn't strong enough. The reality is darker. Without true science of salt, all the nutrition science is a big heap of junk – including DGA 2015. The real scientific evidences (fundamentals) are totally ignored.
We eat, because we need energy. We adopted only the natural mineral content of foods, but no the added sodium salts. The salt is the greatest blunder of the Homo sapiens. Sodium content of extracellular fluids (blood and lymph) is about 140 mmol/l, but in our cells is only around 10 mmol/l (and must be within a narrow range). The continuous diffusion of sodium ions into the cells = the necessary and ordered circumstance decline. This means - the entropy (the disorder) is growing. Our cells needs continuous energy expenditure against spontaneous diffusion by continuous work of the sodium/potassium pumps (needs and expends energy of ATP molecules). "The activity of Na-K pump has been estimated to account for 20-40 % of the resting energy expenditure in a typical adult." [1] This is a significant part of our total energy expenditure (even in a breast-feed infant), and the expended (squandered!) energy depends on unnecessary sodium intakes. This is the most dangerous wasting of the humanity. The sodium intake above the optimum generates a cascade of unhealthy consequences. We cannot adopt the salted foods. The growing entropy is our fiercest enemy, and the salt is his perfect food. We squander the energy against excess diffusion and excess entropy, in our cells. The real science of salt is a taboo, but this is a fatal error because craziness or villainy to increase the water level deliberately - on an area hit with flood. The essence of the true science of salt is so simple - a kindergartener may understand it. But at least in the past 50 years the "health science" - worked on it - let nobody understand it. This work is very successful, the global ignorance is frightening. For example:
and in 226 comments, and:
and in 22 comments.
"Men are born ignorant, not stupid. They are made stupid by education." Bertrand Russell
But in the near future, men will be born stupid. Men are born humans, but they are converted into experimental animals by health sciences, and in the near future, men will be born animals.
This is an astonishing irresponsibility of health scientists. The "science" of salt, nutrition and health = hear no truth, see no truth, speak no truth! Unfortunately, this is a global epidemic among "health scientists" - this is the Three Monkeys Syndrome.
"Only two things are infinite, the universe and human stupidity and I'm not sure about the former." Albert Einstein
Third is the human irresponsibility. I'm not sure about the first also - but, unfortunately all three expand.
From a 36 years old article in the New England Journal of Medicine [2]:
"Much of the metabolic energy produced by the body is used to establish high intracellular concentrations of potassium (K+) and low concentrations of sodium (Na+), the reverse of the relative concentrations of these ions in the extracellular fluids. The extrusion of sodium requires its movement against a gradient of concentration (higher outside than inside) and electrical potential (inside about 70 mV more negative than outside); work is therefore needed to overcome this electrochemical gradient. The transmembrane pumping of sodium and potassium that establishes these gradients has been studied intensively and is among the best understood membrane transport processes."
But unfortunately it is effectively ignored by health and nutrition scientists, this is a Non-Communicable Knowledge (NCK).
A very fresh and very valuable article in Current Biology; Pontzer et al. [3], Constrained Total Energy Expenditure and Metabolic Adaptation to Physical Activity in Adult Humans
The figure 1 is the key to understand the essence (and the consequences of the unnecessary sodium intakes).
From the Summary: "Here we tested a Constrained total energy expenditure model (CTEE model), in which total energy expenditure increases with physical activity at low activity levels but plateaus at higher activity levels as the body adapts to maintain total energy expenditure within a narrow range. We compared total energy expenditure, measured using doubly labeled water, against physical activity, measured using accelerometry, for a large (n = 332) sample of adults living in five populations /9/. After adjusting for body size and composition, total energy expenditure was positively correlated with physical activity, but the relationship was markedly stronger over the lower range of physical activity. For subjects in the upper range of physical activity, total energy expenditure plateaued, supporting a Constrained total energy expenditure model. Body fat percentage and activity intensity appear to modulate the metabolic response to physical activity. Models of energy balance employed in public health /1–3/ should be revised to better reflect the constrained nature of total energy expenditure and the complex effects of physical activity on metabolic physiology."
The 84 years old Kleiber’s law [4, 5] strongly supports and predicts the Constrained Total Energy Expenditure (model).
But what will happen, when instead of physical activity, one other kind of energy expenditure increases significantly? Namely the (aerobic and anaerobic) energy expenditure of the sodium/potassium pumps significantly increases - induced by high sodium intakes (NaCl and other Na-salts) from foods of modern societies. What is the logic consequence if an obese person - eating foods highly salted - regularly makes intense exercises? Naturally, every other vital processes (functional processes of the cells and organs) receive less energy = everything work worse in the body (heart, brain, other organs, immune system, regulating systems, regeneration processes etc.) - even in healthy range of BMI.
We haven't enough energy, and we haven't enough time for the regeneration, because we enhance the entropy (by high sodium intakes) and we squander the energy in our every cell. Day by day, again and again, the excess entropy "devours" our energy. All this (including consequences) is the Sodium-Induced Disorder Syndrome (SIDS). SIDS is the real global epidemic, not the obesity or high BP etc. - obesity and high BP (etc.) is only ones among the dangerous consequences.
Note: By our technical civilisation and medical sciences we stopped natural selection = we’ve stopped evolving = we have started our devolution, which will accelerate as in a nuclear bomb the chain reaction. And nobody will be able to stop it. The entropy (the disharmony) is growing in human genome even we nourish the entropy in our every cell - in fundamentals of our existence. By unnecessary sodium salts we speed our devolution. This is really a fatal error. NCK is too much in salt science, it's time to change that.
The following articles also support the CTEE (mainly, as a consequence of high sodium intakes) [6 - 8]. From the ref. 8:
"Overall FMD (flow-mediated dilatation) was reduced 2 h postprandially. FMD was significantly more impaired after the HSM (high-salt meal) than after the LSM (low-salt meal) at 30 min ... An HSM (65 mmol Na = 3.8 g NaCl), which reflects the typical amount of salt consumed in a commonly eaten meal, can significantly suppress brachial artery FMD within 30 min. These results suggest that high salt intakes have acute adverse effects on vascular dilatation in the postprandial state. ... We speculate that one of these possible mechanisms by which salt impairs endothelial function is via an alteration in plasma sodium. Two studies have reported responses to oral salt loading over a postprandial time period, which showed a rise in plasma sodium in response to 100 mmol Na (5.8 g salt) loading in healthy persons of 3 mmol/L, which occurred within 2-3 h of consuming the test meal /16, 17/. It has been postulated that a high salt intake may acutely impair vascular function by raising plasma sodium by as much as 3 mmol/L. ... It appears that higher salt intakes have acute adverse effects on vascular dilatation in the postprandial phase."
Indisputable: Impaired vascular function = impaired oxygen supply. And less oxygen = less energy.
On 14 Aug 2012 in a comment on PLoS One [7] I wrote:
"Some consequences of high sodium intake (The specialists talk about these rarely or never):
1. bigger and longer hunger stimulus - we overeat
2. we drink many sugary soft drinks - we get fat
3. we get tired soon, we move little
4. higher energy requirements for Na-K pump, and kidney
5. all the rest of our vital processes receive less energy (because the metabolic rate - speed and capacity of enzyme reactions - is limited)
6. all of our vital processes work worse.
7. we get sick often, and we will die soon. = Extra profit in food and pharmaceutical industry and health services, and savings in the pension funds."
The salted humanity's energy expenditure presumably is in the CTEE range (independently from physical activity, that can be predicted from [4, 5 and 7]), and everything works worse in our body. Undebatable that this has many acute and chronic adverse consequences (not only the illnesses, but for example: less energy to the brain = more accidents). But the true science of salt is an ignored and censored taboo, and pseudosciences bloom.
A new article about Salt Wars (without real science of salt): Why do we think we know what we know? A metaknowledge analysis of the salt controversy. In International Journal of Epidemiology [9 and 3 commentary].
Abstract: "Background: Although several public health organizations have recommended population-wide reduction in salt intake, the evidence on the population benefits remains unclear. We conducted a metaknowledge analysis of the literature on salt intake and health outcomes.
Methods: We identified reports - primary studies, systematic reviews, guidelines and comments, letters or reviews - addressing the effect of sodium intake on cerebro- cardiovascular disease or mortality. We classified reports as supportive or contradictory of the hypothesis that salt reduction leads to population benefits, and constructed a network of citations connecting these reports. We tested for citation bias using an exponential random graph model. We also assessed the inclusion of primary studies in systematic reviews on the topic.
Results: We identified 269 reports (25% primary studies, 5% systematic reviews, 4% guidelines and 66% comments, letters, or reviews) from between 1978 and 2014. Of these, 54% were supportive of the hypothesis, 33% were contradictory and 13% were inconclusive. ... In all, 48 primary studies were selected for inclusion across 10 systematic reviews. If any given primary study was selected by a review, the probability that a further review would also have selected it was 27.0% (95% CI 20.3% to 33.7%).
Conclusions: We documented a strong polarization of scientific reports on the link between sodium intake and health outcomes, and a pattern of uncertainty in systematic reviews about what should count as evidence."
From the article "The World Health Organization (WHO) recommends reducing sodium intake to < 2 g/day in adults. /3/ Opponents of population-based salt reduction argue that the relationship between sodium intake and clinical outcomes is U- or J-shaped and that the harms associated with low sodium intakes may mitigate any potential benefits of blood pressure reductions arising from decreased salt intakes. /4,5/ In a recent report, the United States Institute of Medicine of the National Academies of Science concluded that there is a lack of evidence for benefits of reducing sodium intake to the very low levels recommended by the WHO./6/"
It seems - the authors don’t know that before industrial revolution the salt was (very) expensive. For example the bread was made without added salt. The natural sodium content of wheat flour approximately 20 mg/kg. In Hungary - the upper limit of salt in bread is 25 g/kg (in dried matter, Codex Alimentarius Hungaricus 1-3/81-1 Certain bread and bakery products ). This is 490 times higher sodium content as our predecessors ate it about 2 centuries before. And nothing about the Na/K pump in this article and in 3 commentary.
Luck at the U- or J-shaped clinical outcomes [10 – 12, 12/c]. In the figures are no points (no curves) below ~ 1 g sodium per day. Why? In 10th ed. of RDA (1989) was 500 mg Na per day [13]. Australian recommendation now is 460-920 mg/day [14]. 460-500 mg Na/day is (approximately) calculable from the sodium and energy content of human milk, which is the evolutionary perfect food for babies, and is the perfect guide for adult nutrition. And where are the sodium intakes of healthy, isolated (hunter-gatherer) tribes - no-salt cultures, for example Yanomamos? [15] In these clinical trials - where are the really healthy control groups? Nowhere, all the modern societies are affected by sodium-induced disorder.
Comparing the x- and y-axes in the figures (U- or J-shaped), something is very strange, but not a surprise for me. Does nobody see it? Y-axes were made (especially) gummy! And why? Presumably: How to lie, cheat, manipulate, and mislead using statistics and graphical displays [16]. Naivety, if the scientists and researchers believe really, that the newer trials and meta-analyses are better than the older ones. In summary: clinical trials, meta-analyses and the salt war = lack of real science = pseudoscience.
Some of the old touchstones of the salt debate (in political science of salt by Gary Taubes, 1998)
-Midgley et al., 1996. Meta-analysis of 56 clinical trials concludes that benefit from salt reduction is small and DOES NOT SUPPORT current dietary recommendations
-Cutler et al., 1997. Meta-analysis of 32 clinical trials concludes that benefit of salt reduction is larger and DOES SUPPORT current dietary recommendations
It was 33 clinical trials. And the title of the article: "Effects of oral POTASSIUM on blood pressure. Meta-analysis of randomized controlled clinical trials." The first author was Paul K. Whelton, Cutler was the third.
-Graudal et al., 1998. Meta-analysis of 114 clinical trials DOES NOT SUPPORT a general recommendation to reduce salt intake.
Exactly: it was 58 trials.
On the scientific media in 2015: Why Everything We 'Know' About Diet and Nutrition Is Wrong
From the original article (in Mayo Clinic Proceedings) "The Inadmissibility of What We Eat in America and NHANES Dietary Data in Nutrition and Obesity Research and the Scientific Formulation of National Dietary Guidelines" [17]:
"Five decades of controversy surrounding basic dietary guidelines and nutrition recommendations is a public acknowledgement of a failed research paradigm."
And is a consequence of the astonishingly wrong education. A new paradigm is necessary – a new deal – back to the real science.
From the end of an article of Niels Graudal, 2005 [18]: "It is tempting to end this commentary with another provocative citation from Chapman and Gibbons: /1/ ‘Many (articles) possess historical interest only. Others, while defective in some respects, contain suggestions that have led to later and more valuable work. Still others have had influence out of all proportion to their intrinsic work and are RESPONSIBLE for VAST AMOUNTS of WASTED RESEARCH ENDEAVOUR on the part of later investigators’. In that connection, considering that the salt controversy now is dealing with an effect size of about 1 mm Hg, one may ask, has it been worth 100 years of effort?"
Unfortunately, Gradual is on the bad side in the salt war, but really the good side is not better.
From an article in J Cardiovasc Dis Res. - R. K. Mathur, 2010 [19]:
"To determine the mechanism of thermogenesis, Osaka et al. /7-9/ infused hypertonic solution of glucose, NaCl, fructose, and amino acids in the intestine of urethane-anesthetized rats. A higher core body temperature was observed with increasing amounts of the above-mentioned nutrients. Furthermore, an intravenous injection (IV) of these nutrients also caused thermogenesis accompanied by an increase in plasma osmolality. However, thermogenesis caused by IV was lesser than that caused by the intestinal infusion of NaCl and the solutions of the other above-mentioned nutrients, suggesting an involvement of intestinal osmoreceptors. This further suggests that it is unlikely that IV and intestinal osmotic stimulation induces identical mechanisms of thermogenesis. However, it does show that an increase in the plasma osmolality, within the physiological range, elicits thermogenesis. The mechanism of thermogenesis is not clear. However, it may involve intestinal osmoreceptors. The authors also found that food intake stimulated the metabolic rate of the whole body and increased the core body temperature. The core body temperature is measured by inserting a thermister in the anus. The skin or cutaneous body temperature is measured by a thermister taped to the lateral surface of a rat's tail. The mechanism of core and skin temperatures are regulated differently /10, 11/. It is this thermogenesis that is responsible for the generation of atherosclerotic plaque."
From the end of the article: "Patients are advised to stay away from fatty foods, which obviously does not help because fatty meal is not the cause for atherosclerosis. Therefore, the researchers should first examine the cause of the disease before trying to cure it; otherwise, we will be treating symptoms rather than curing the disease itself. ... Finally, this field requires some broad theories and hypotheses explaining the involvement of foods, diabetes, hypertension, cigarette smoking, and others in the formation of atherosclerotic plaque. We have a mission but are lacking the vision. That is why WE HAVE NOT MADE ANY PROGRESS even though we have worked on it FOR MORE THAN 50 YEARS."
9 years after Osaka et al., (yes, this is the censored work, cited in my first response here: ) and 45 years after Klahr & Bricker (also cited in my first response) - and why not clear? Floor gas Na/K pumps and kidneys use more energy. Our cells must "burn" anaerobically, even from the glycogen reserve for the excess ATP (re)productions. And see Henningsen 1985 (also in my first response), our cells (red blood cells, leukocytes, macrophages, endothelial cells and others - everywhere in our body) are dying. This is the ignored cause in the formation of atherosclerotic plaque. And we haven't enough time and we haven't enough energy for the regeneration. Was the mechanism not clear really? Or the scientific elite did not allow it to enlighten? Instead of theories and hypotheses would be better to use the already existing knowledges.
American Heart Association - now, Apr 13, 2016 [20]:
"Atherosclerosis. How does atherosclerosis start and progress?
It's a complex process. Exactly how atherosclerosis begins or what causes it isn't known, but some theories have been proposed. Many scientists believe plaque begins to form because the inner lining of the artery, called the endothelium, becomes damaged. Three possible causes of damage to the arterial wall are:
Elevated levels of cholesterol and triglycerides in the blood
High blood pressure
Cigarette smoking"
Where is the progress of the health sciences in the past 60 years? In the shadow of the multinational big food and big pharma industry - the science is blowing in the wind. How much is the worthless article in the indexed medical literature? These may be some millions. While noncommunicable diseases prematurely take 16 million lives annually and WHO urges more action [21].
Well, look at the WHO.
Diet, nutrition and the prevention of chronic disease. Report of a Joint WHO/FAO Expert Consultation. 2003 [22]
From this report (TRS-916), on page 90 (100 of 160): "Potassium Adequate dietary intake of potassium lowers blood pressure and is protective against stroke and cardiac arrythmias. Potassium intake should be at a level which will keep the sodium to potassium ratio close to 1.0, i.e. a daily potassium intake level of 70-80 mmol per day. This may be achieved through adequate daily consumption of fruits and vegetables."
But are no explanation, no evidence and no references for this (molar) ratio. Is this science - or what?
Again the WHO (2006) - Reducing salt intake in populations [23]
On page 26: "Several national and international agencies recommend individual dietary sodium intakes of no more than 100 mmol/day (6 g salt/day) and in some cases no more than 65 mmol/day (4 g salt/day). Two WHO expert consultations recommended that the population average for salt consumption should be < 5 g/day (WHO, 1983; WHO/FAO, 2003).
While well below the average salt consumption in most countries, this recommendation reflects a pragmatic COMPROMISE since well-conducted trials clearly indicate that even greater sodium reductions (to 50–60 mmol/day) would achieve greater health benefits. (Denton, 1982; WHO – International Society of Hypertension, 1999; Sacks et al, 2001; He & MacGregor, 2004)
Additionally, numerous countries worldwide have set adequate intake levels for sodium. In Australia and New Zealand the adequate intake for adults for sodium was set at 460–920 mg/day (20–40 mmol/day) to ensure that basic nutritional requirements are met and to allow for adequate intakes of other nutrients (Nutrient Reference Values for Australia and New Zealand, 2005)."
This compromise is a pact with the enemy. The unnecessary sodium intakes = we deliver weapons and ammunition for our fiercest enemy, "who" uses it without hesitation - against us. This fiercest enemy = the LAW of ENTROPY (the second law of thermodynamics). The life on Earth, our history and our entire individual life is a continuous war against entropy. Even we nourish the entropy in our every cell, but the health scientists do not speak about this. And this is a fatal error. With our life quality, with illnesses, with our shorter life - we pay for this expensively.
Nutrient Reference Values for Australia and New Zealand, Sodium [24]
From this:
"The Intersalt Cooperative Research Group (1988) found that the rate of sodium excretion ranges from less than 0.2 mmol of sodium/day in the Yanomamo Indians of Brazil to 242 mmol/day in Tianjin in China (Intersalt Cooperative Research Group 1988). Estimated intakes in Australia are about 150 mmol/day (Beard et al 1997, Notowidjojo & Truswell 1993). An almost identical figure has been found in New Zealand (Thomson & Colls 1998).
There many healthy populations with estimated intakes of less than 40 mmol/day (Intersalt Cooperative Research Group et al 1988). Survival at extremely low levels such as that of the Yanomamo reflects the ability to conserve sodium by reducing urine and sweat losses. With maximal adaptation, the smallest amount of sodium needed to replace losses is estimated to be no more than 0.18 g/day (8 mmol/day). However, a diet providing this level of sodium intake is unlikely to meet other dietary requirements in countries such as Australia and New Zealand."
The optimum is in human milk. Less and more are not good. But we can adapt only to the less. This is the evolutionary heritage of many million years.
Back to WHO (2012, published online in January 2013): WHO issues new guidance on dietary salt and potassium [25, 26]
Sodium intake for adults and children - from this - on page 2 (10 of 56):
"WHO recommends a reduction in sodium intake to control blood pressure in children (strong recommendation). The recommended maximum level of intake of 2 g/day sodium in adults should be adjusted downward based on the energy requirements of children relative to those of adults."
Why downward? Why not from mature human milk?
On page 3 (11 of 56):
"Addressing the optimal ratio of sodium to potassium was outside the scope of this guideline; however, if an individual consumes the amount of sodium recommended in this guideline and the amount of potassium recommended in the WHO guideline on potassium intake, the ratio of sodium to potassium would be approximately one to one, which is considered beneficial for health /12/."
And on page 19 (27 of 56):
"These recommendations do not address the optimal sodium to potassium ratio; however, if this guideline and the WHO guideline on potassium intake are achieved, the molar ratio of sodium to potassium would be approximately one to one."
Potassium intake for adults and children - from this - on page 3 (11 of 52):
"... however, if an individual consumes sodium at the levels recommended in the WHO guideline on sodium intake, and potassium as recommended in the current guideline, the ratio of sodium to potassium would be approximately one to one, which is considered beneficial for health /8/."
And on page 16 (24 of 52):
"These recommendations do not address the optimal ratio of sodium to potassium; however, if this guideline and the WHO guideline on sodium consumption are achieved, the molar ratio of sodium to potassium would be approximately one to one."
But Ref. /12/ = Ref. /8/ = WHO Diet, nutrition and the prevention of chronic disease. Report of a Joint WHO/FAO Expert Consultation. Geneva, World Health Organization (WHO), 2003. This is the TRS-916 [22]. This is just a pseudoscientific self-reference, and this is a perfect example – how to make (and spread) pseudoscience. No evidence for beneficial effect of 1 to 1 sodium/potassium molar ratio. And WHO urges more action?
The CSPI, Bonnie Liebman, and the 173 scientists (and thousands of health scientists worldwide) simply tolerate the pseudoscience? Does nobody want to retract it? Shameful irresponsibility! Attacking Nina Teicholz's article - they believe that they do defend the science and the public interest? The new DGA is only a selected collection from the big heap of worthless junk. That is lack of scientific fundamentals. In reality, they do defend the pseudoscience and the public ignorance. By this they damage public health severely worldwide (not only in US).
From the ref. 18 of Nina Teicholz's article [27]: "Furthermore, many trials of advice to modify dietary intake of fat have included 1 or more other elements of dietary and non-dietary advice; examples include advice to increase fibre intake, reduce meat consumption, reduce body weight, stop smoking, reduce salt intake, increase fruit and vegetable consumption, increase physical activity, or reduce alcohol consumption."
That's all about the salt. But high fat diet = high sodium content, and high fruits and vegetables = less sodium. But this is an ignored difference. Randomised controlled trials and meta-analyses don't make health science, especially when the fundamentals are ignored and the results (and trials) are manipulated.
From an article appearing promising - A multidisciplinary reconstruction of Palaeolithic nutrition that holds promise for the prevention and treatment of diseases of civilisation. In Nutrition Research Reviews, 2012 [28]:
"While iodide is added to table salt in many countries, margarines and milk have become popular food products for fortification with vitamins A and D."
This is a review article, more than 30 pages and with 450 references. But that's all about the salt. Is this true science and a real promise? Not, this is lack of real science = pseudoscience, and this article is a goldmine for nutrition charlatans - both amateur and professional (universities educated) "doctors". Why the medical doctors and nutritionists cannot understand that the diffused amount of sodium (into the cells) is proportional with the surface? They don't understand the entropy law?
For example Christopher B Scott in Nutrition & Metabolism (2005): Review - Contribution of anaerobic energy expenditure to whole body thermogenesis [29].
Some important keywords in this article: entropy, energy, sodium pump, anaerobic pathway, lactate. From the article: "The second law describes how energy is transferred from one form to another. For example heat, as an expression of energy, always flows in one direction – from hot to cold. Other ways of stating this are that energy flows "downhill" or, from a state of lower entropy to one of higher entropy. Entropy represents energy that is not available to perform work so that simply put, energy transfer is inefficient. Inefficiency also appears in the form of heat production that is usually discarded into the environment. ... Brisk activity of the sodium pump necessitates a rapid rate of ATP re-synthesis. If this is true then it is important to recognize that in some cells lactate with presumed heat production is better correlated with sodium and potassium pumping than is oxygen uptake"
This is not too much. Would this be the progress of the health science over 40 years (between Klahr & Bricker 1965 and 2005)? And even now in 2016 the progress and the pure science are practically in deep freeze.
The surface (billions) of our cells is extreme large. Consequently, little increase in extracellular Na concentration induces significant excess diffusion and significant excess work for Na/K pumps = significant excess energy expenditure against excess entropy. But our capacity is limited. Our ancestors and for example Yanomamos and Hadza hunter-gatherers do not eat salt. We cannot adopt the salted foods. The entropy is nourished in us with sodium salts, but the health scientists do not talk and do not write about this. Even Graham A. MacGregor - a popular chairman of the salt reducing movements - doesn't use the real science of salt [30]. The bad side does not have a real weapon in the salt war. The good side has very strong weapons, but these are not used. Both side in the salt war - use only the pseudoscience, so this is a never ending war. Good education and really responsible scientists are needed, and will end of the pseudoscientific lies and meaningless salt wars – forever.
Really, the growing entropy is our number one public enemy on every level of our existence. But – if nobody knows this enemy (because it is kept in secret), nobody can fight against it. The race is on. We will be champions, or the growing entropy destroys us? I don't know the answer, but we have little chance to win, if we nourish the entropy longer in our own body. Scientists and researchers, wake up - before it's not too late!
1. Oregon State University, Linus Pauling Institute, Micronutrient Information Center
Sodium (Chloride)
2. Kathleen J. Sweadner and Stanley M. Goldin:
Active Transport of Sodium and Potassium Ions - Mechanism, Function, and Regulation
N Engl J Med; 302:777-783 April 3, 1980 DOI: 10.1056/NEJM198004033021404
3. Herman Pontzer, Ramon Durazo-Arvizu, Lara R. Dugas, Jacob Plange-Rhule, Pascal Bovet, Terrence E. Forrester, Estelle V. Lambert, Richard S. Cooper, Dale A. Schoeller, Amy Luke: Constrained Total Energy Expenditure and Metabolic Adaptation to Physical Activity in Adult Humans
Current Biology Jan 2016 Volume 26, Issue 3, p410–417, 8 February 2016
4. Kleiber, M.: Body size and metabolism.
Hilgardia 6(11), 315-353 (1932) DOI:10.3733/hilg.v06n11p315
Pdf of full article:
5. Fernando J. Ballesteros, Vicent J. Martínez, Andrés Moya and Bartolo Luque:
Energy balance and the origin of Kleiber’s law (2014)
6. Pete C. Trimmer, James A.R. Marshall, Lutz Fromhage, John M. McNamara, Alasdair I. Houston: Understanding the placebo effect from an evolutionary perspective
Evolution & Human Behavior Volume 34, Issue 1 , Pages 8-15, January 2013.
(Received 13 September 2011; accepted 24 July 2012. published online 30 August 2012.)
7. Herman Pontzer, David A. Raichlen, Brian M. Wood, Audax Z. P. Mabulla, Susan B. Racette, Frank W. Marlowe: Hunter-Gatherer Energetics and Human Obesity
(2012), PLoS ONE 7(7): e40503. doi:10.1371/journal.pone.0040503
8. Kacie M Dickinson, Peter M Clifton, and Jennifer B Keogh:
Endothelial function is impaired after a high-salt meal in healthy subjects.
Am J Clin Nutr March 2011 vol. 93 no. 3 500-505
9. Ludovic Trinquart, David Merritt Johns, Sandro Galea:
Why do we think we know what we know? A metaknowledge analysis of the salt controversy
Int. J. Epidemiol. (2016) doi: 10.1093/ije/dyv184 First published online: February 17, 2016
9/c1. Bruce Neal: Commentary: The salt wars described but not explained - an invited commentary on ‘Why do we think we know what we know? A metaknowledge analysis of the salt controversy’
Int. J. Epidemiol. (2016) doi: 10.1093/ije/dyw005 First published online: February 17, 2016
9/c2. Martin O'Donnell, Andrew Mente, Salim Yusuf:
Commentary: Accepting what we don’t know will lead to progress
Int. J. Epidemiol. (2016) doi: 10.1093/ije/dyw014 First published online: February 17, 2016
9/c3. John P.A. Ioannidis: Commentary: Salt and the assault of opinion on evidence
Int. J. Epidemiol. (2016) doi: 10.1093/ije/dyw015 First published online: February 17, 2016
10. M.J. O’Donnell, A. Mente, A. Smyth, and S. Yusuf:
Salt intake and cardiovascular disease: why are the data inconsistent?
European Heart Journal (2013) 34, 1034–1040 doi:10.1093/eurheartj/ehs409
11. Andrew Smyth, Martin O’Donnell, Andrew Mente, Salim Yusuf:
Dietary Sodium and Cardiovascular Disease
Current Hypertension Reports June 2015, 17:47 First online: 17 May 2015
12. Heaney, Robert P.: Making Sense of the Science of Sodium
Nutrition Today: March/April 2015 - Volume 50 - Issue 2 - p 63–66 doi: 10.1097/NT.0000000000000084
12/c. Cheryl A. M. Anderson, Rachel K. Johnson, Penny M. Kris-Etherton, Emily Ann Miller: Commentary on Making Sense of the Science of Sodium
Nutrition Today: March/April 2015 - Volume 50 - Issue 2 - p 66–71 doi: 10.1097/NT.0000000000000086
13. RDA 10th ed. 1989
14. Nutrient Reference Values for Australia and New Zealand - Sodium
15. W J Oliver, E L Cohen, J V Neel: Blood pressure, sodium intake, and sodium related hormones in the Yanomamo Indians, a "no-salt" culture.
Circulation 1975; 52: 146-151
16. How to lie, cheat, manipulate, and mislead using statistics and graphical displays
17. Edward Archer, Gregory Pavela, Carl J. Lavie:
The Inadmissibility of What We Eat in America and NHANES Dietary Data in Nutrition and Obesity Research and the Scientific Formulation of National Dietary Guidelines
Mayo Clinic Proceedings July 2015 Volume 90, Issue 7, Pages 911–926
18. Niels Graudal: Commentary: Possible role of salt intake in the development of essential hypertension Int. J. Epidemiol. (October 2005) 34 (5): 972-974. doi: 10.1093/ije/dyi016
19. Ram K. Mathur: Role of diabetes, hypertension, and cigarette smoking on atherosclerosis
J Cardiovasc Dis Res. 2010 Apr-Jun; 1(2): 64–68.
20. American Heart Association – Atherosclerosis (Apr 2016)
21. Noncommunicable diseases prematurely take 16 million lives annually, WHO urges more action, WHO 19 January 2015
22. Diet, nutrition and the prevention of chronic disease. Report of a Joint WHO/FAO Expert Consultation. Geneva, World Health Organization (WHO), 2003
23. REDUCING SALT INTAKE IN POPULATIONS Report of a WHO Forum and Technical meeting 5-7 October 2006, Paris, France
24 Nutrient Reference Values for Australia and New Zealand, Sodium
25. Sodium intake for adults and children (WHO 2012)
26. Potassium intake for adults and children (WHO 2012)
27. Skeaff C.M., Miller J.: Dietary fat and coronary heart disease: summary of evidence from prospective cohort and randomised controlled trials.
Ann Nutr Metab 2009; 55: 173-201. (DOI:10.1159/000229002)
28. Remko S. Kuipers, Josephine C. A. Joordens and Frits A. J. Muskiet: A multidisciplinary reconstruction of Palaeolithic nutrition that holds promise for the prevention and treatment of diseases of civilisation
Nutrition Research Reviews (2012) 25, 96–129 doi:10.1017/S0954422412000017
29. Christopher B Scott: Review - Contribution of anaerobic energy expenditure to whole body thermogenesis
Nutrition & Metabolism 2005, 2:14 doi: 10.1186/1743-7075-2-14
30. Feng J. He, Graham A. MacGregor: Reducing Population Salt Intake - Time for Global Action
The Journal of Clinical Hypertension Volume 17, Issue 1, pages 10–13, January 2015
DOI: 10.1111/jch.12404

Competing interests: No competing interests

13 April 2016
Zoltan Sandor
Research fellow
Research Centre for Natural Sciences, Hungarian Academy of Sciences
Hungary 1117 Budapest, Magyar tudosok korutja 2