When I first meet Morton Satin, he's seated in an office chair on a Tuesday morning, shaking his head at his computer screen. He glances over, sighing, and motions toward the monitor. Displayed is a press release from Science Daily claiming that salt depletes the body's calcium stores. "Every morning brings a new headline," he says sadly before launching into a diatribe about the supposedly shoddy science used in the article. "Sometimes, you feel like you're spinning your wheels, not moving forward but trying to prevent misinformation."
"More people die when they are on a low-sodium diet than when they are on a regular-salt diet," he proclaims.
The misinformation he's worried about concerns one of the most ubiquitous substances in our daily lives: salt. This week, experts convened by the Institute of Medicine concluded that "the evidence on direct health outcomes does not support recommendations to lower sodium intake ... to or even below 1,500 mg per day." The current recommendation is not to exceed 2,300 mg per day, though most Americans do. This slight paradigm shift -- to an idea that less salt is not always better, which is already disputed and will be slow to be accepted -- comes after years of advocacy from people like Satin.
Satin, a molecular biologist, has begrudgingly accepted the nickname "The Salt Guru," after coming out of retirement to be the Vice President of Science and Research at The Salt Institute, a non-profit trade association based in Alexandria, Virginia. Before that, Satin spent sixteen years as the Director of the United Nations Food and Agriculture Organization's Agribusiness Program. It was there he achieved two of his most important successes: a patent for coconut water and one for the creation of gluten-free bread.
His office is more that of a man who writes coffee table books on coffee (which he recently did, to warm reception by The New Yorker) than of a molecular biologist who thinks the public institutes of health are spouting untruths. But, he does think that. He says the 2,300 mg line is too low, and he's not the only one.
Science writer Gary Taubes, a salt defender and author of Good Calories, Bad Calories and Why We Get Fat, has written columns for The New York Times in which he defends salt's health properties. The problem with Satin as the loudest salt advocate, though, is that even while a close look at data does seem to lend credence to his claims, he works for the Salt Institute -- which salt companies help support. Credibility goes out the window, Taubes says, and it doesn't matter how loud you are, no one will listen.
Satin has a propensity for ambling off into his life's stories, eyes racing around the room as he wanders lazily into these arbitrary yarns. When telling these stories, he seems calm, at peace. And he stays that way until he speaks about salt's reception. At that point, his eyes narrow and mouth pinches, his voice rises, and his anger is prominent, ardent. "More people die when they are on a low-sodium diet than when they are on a regular-salt diet," he proclaims. "You have to look this thing with a truly open mind, and it's difficult because we really don't like to think of public institutions fooling us and screwing us ... [But] nothing justifies lying. Nothing justifies exaggerating. Nothing justifies misleading the public."
And that's exactly what he thinks most public health institutions, such as the United States Department of Agriculture and the Centers for Disease Control, are doing. The American Heart Association (AHA) has argued that 2,300 mg is too high. The argument is that high sodium intake increases blood pressure and leads to cardiovascular disease, strokes, and kidney disease. Consuming 2,300 mg at most helps keep this in check, according to the AHA.
Satin readily admits, though, while disagreeing with these guidelines, that he doesn't know what the right amount is. His bible is the Dietary Reference Intake, which is an Institute of Medicine study supported by the National Academy of Sciences, The National Heart, Lung, and Blood Institute of the National Institutes of Health and the U.S. Department of Health and Human Services' Office of Disease Prevention and Health Promotion, among others.
The six-page letter refutes the Times piece, concluding that it could lead to "more hypertension, heart disease, deaths, misery, and medical costs down the road" if taken seriously.
The book offers an estimated average requirement (EAR) of various elements and minerals. Satin eagerly points at the top of page 270, which reads, "Because of insufficient data from dose-response trials, an EAR could not be established, and thus a Recommended Dietary Allowance could not be derived. Hence, an Adequate Intake is provided."
In plain language: It was impossible to determine how much salt we should be consuming, leaving Satin further incensed that someone would claim to know how much we shouldn't be eating. "You can guarantee if they had the evidence, it'd be there," he says. His view of the 2,300 mg line is that it was invented out of thin air. "It was a lie," he says. "I know scientists, and I know how they think: if there is no evidence, they made it up."
This, of course, raises the question: why would someone launch a national campaign against salt? Satin thinks it's a mixture of laziness, convenience, and the easy path to scientific popularity. It's easy to launch a campaign against something, and it becomes easier as more people think it's detrimental to their health
Satin cites Michael Jacobson, PhD, cofounder of the D.C.-based Center for Science in the Public Interest, as one of the leaders of the anti-salt movement. The website for his foundation states, "Salt, at the levels present in the diets of most people around the world, is probably the single most harmful substance in the food supply," and he's written an incendiary article titled "Salt: The Forgotten Killer and FDA's Failure to Protect the Public's Health."