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Salt Intake and Diet Research: The Bigger Picture and Why We Need Health Policy Makers to Keep their Judgements Under Constant Critical Review

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While it is too early to draw any conclusions about relating the findings of Glasgow University’s new chloride health study to salt intake and diet, one thing is certain – Dr Sandosh Padmanabhan and his research team’s sheer persistence in confirming their controversial evidence that having a low level of chloride in your blood slightly increases risk of death from heart or circulatory disease, reinforces the argument that science and health practitioners must be willing, encouraged and supported to challenge, and where necessary revise, their views throughout the period of any intervention.

Dr Padmanabhan, who led the research at the university’s Institute of Cardiovascular and Medical Sciences, revealed the team were so astonished that they initially refused to believe their own evidence – and have spent two years confirming it. More research is needed to establish exactly what the relationship between chloride and health risk is, but Padmanabhan must be applauded for keeping his judgement under constant critical review and not re-framing, minimising or dismissing new evidence.

More and more people are beginning to question the evidence of any long-term health benefits from restricted salt diets, raising important questions about conventional thinking on salt and health.

In our recent statement on salt and health, we said labelling salt as a uniquely problematic substance in our diet is particularly controversial. Salt is an essential nutrient which maintains the potassium/sodium balance and is critical to the overall functioning of every cell in the human body.

And while it is encouraging to hear the British Heart Foundation welcoming the “surprise” results of Padmanabhan’s study, further bias towards salt is inevitable and comes from the many ways our minds – and our media – can distort, avoid or exaggerate information.

Assessments are fallible, and contexts constantly changing and the single most important factor in minimising errors is to admit that you might be wrong. A non-judgemental acceptance that errors are inevitable makes it easier to recognise, acknowledge and learn from them.

To achieve this, the health and scientific community should routinely play their own ‘devil’s advocate’ in considering alternative actions, explanations or hypotheses.

In order to “balance the debate” about salt and health, we need this open-minded oversight and review of cases in the light of changing circumstances and new information. How people respond to new (and challenging) information, however, is arguably a greater challenge than the actual research itself.

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