Commentary: Evidence on salt and blood pressure is consistent and persuasive

Alderman's paper1 gives a selected and unbalanced account on salt and blood pressure, and reaches unsound conclusions. Time and again when the totality of evidence has been scrutinized by independent expert committees, they have concluded that the average sodium consumption at the population level is too high, that reductions to no more than 100 mmol sodium/day (6 g salt/day) is desirable, and that public health benefits would accrue.2–5 Alderman obliquely notes these recommendations, but quickly dismisses them as ‘… dogma …' without any attempt at specific refutation. These recommendations have received wide acceptance among professional organizations and government departments responsible for protecting the health of the public,6,7 but they have been opposed by powerful commercial interests among the salt manufacturers (represented by the Salt Institute in the US) and some food companies.8,9 Alderman's argumentation lends justification to the ‘do nothing' position of the Salt Institute and others at the expense of substantial potential gains in public health.10,11