Monday, January 11, 2010

The Unintended Consequences Of Health Advice

Remember when doctors told you that it was bad to go out in the sun? They warned of the problems with skin cancer and that exposure should be minimized and that sunscreen should be worn at all times.

They forgot to mention that sun exposure is a critical way to get a daily dose of Vitamin D, which is critical in preventing rickets, reducing diabetes, promoting proper bone growth and the deficiency has been shown to increase risk of death. Links to epilepsy have also been seen in some studies.

Moderation is the key to proper health, and a couple of 20 minute walks in the sunshine a week are sufficient to generate the amount of vitamin D needed.

Now, New York health officials, led by nanny stater Mayor Mike Bloomberg, are hoping to convince restaurants and other state and local nanny staters to reduce the amount of salt in food. Many food processors are already reducing their sodium levels in food products without any prodding; it's now seen as more healthy. Yet, how long will it be before we see an uptick in the amount of people with iodine deficiency?
The plan, for which the city claims support from health agencies in other cities and states, sets a goal of reducing the amount of salt in packaged and restaurant food by 25 percent over the next five years.

Public health experts say that would reduce the incidence of high blood pressure and should help prevent some of the strokes and heart attacks associated with that condition. The plan is voluntary for food companies and involves no legislation. It allows companies to cut salt gradually over five years so the change is not so noticeable to consumers.

“We all consume way too much salt, and most of the salt we consume is in the food when we buy it,” said Dr. Thomas Farley, the city health commissioner, whose department is leading the effort. Eighty percent of the salt in Americans’ diets comes from packaged or restaurant food. Dr. Farley said reducing salt from those sources would save lives.

Since taking office, Mayor Michael R. Bloomberg, who just began his third term, has gained a reputation as an advocate for healthy living, initiating prominent campaigns against smoking and harmful trans fats. To combat obesity, he has campaigned for calorie labeling on restaurant menus and warned consumers about sugary soft drinks.

The city’s salt campaign is in some ways more ambitious and less certain of success than the ones it waged against smoking and obesity. For one thing, the changes it prescribes require cooperation on a national scale, city officials said, because major food companies cannot be expected to alter their products for just the New York market.
Salt plays so many different roles in food from enhancing flavor to preventing spoilage and improving shelf life. It helps bread to rise and brown. Salt is critical in curing fish (bagels and lox are a staple in New York City, and this measure would affect the quality of those products). Salt is used in koshering meat to draw blood out and is used in brining to help make poultry more flavorful and juicy during cooking.

So, any move to curb salt would come into direct conflict with the need to make sure that food actually tastes good. Salt in the US is fortified with iodine to prevent iodine deficiencies, which can cause all manner of thyroid problems.

Then, there's the ongoing issue of smoking. Gov. Paterson is proposing yet another increase in tobacco products and cigarettes to help close the multibillion dollar budget deficit. As the taxes rise on smoking, and the number of smokers decreases, the amount of revenue that can be driven by smokers declines, so the state will never realize the amount of money they need to help close the deficit - and the state is hoping to use the money to fund health care programs. Those programs will be put at risk because the revenue source is incapable of creating the money needed to sustain the programs.

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