I've been thinking a lot lately about the fine balance between educating the public and overplaying your message. Partly because I see this ad during every morning's transit commute:
Let me be clear that this is not a cheap shot at the worthy cause of preventing stroke, or even at the agency that created the campaign. I'm sure they're all very determined to help Canadians reduce the salt in their diet.
But "Sodium kills 30 Canadians each day"? That's kind of hard to swallow.
I checked out the web site, looking for the research behind the claim. In short, it's this:
* Excess sodium raises your blood pressure.
* Optimal blood pressure is less than 120/80 mmHg.
* A blood pressure of greater than 140/90 mmHg is the clinical definition of hypertension. One in four adults in Canada has hypertension.
* Reducing your blood pressure by just 10/5 mmHg by lifestyle change or medication reduces your risk of heart failure by 50 per cent, stroke by 30 per cent, heart attack by 15 per cent and premature death by 10 per cent.
I have to assume the 30 people killed are actually the reverse of the 30 people who will die of heart attack, stroke, and related premature death today who could have been saved by reducing sodium. But beyond downloading and reading the academic PDFs and doing math (I was told there would be no math!) as lazy consumer I remain unconvinced that salt will be directly responsible for 30 people dying today.
Of course, I also have to admit to myself that death stats on smoking may be derived much the same way. And that's a hard comparison to make as someone who has campaigned hard to reduce smoking rates. (Truth be told, my personal focus is on secondhand smoke around children and captive audiences, which also has to do with human rights.)
Of course, death statistics are rarely isolated to one cause. It's hard to control variables for heavy smokers, since their high-risk behaviour and socio-economic factors come into play. That doesn't mean that a decrease in smoking won't save lives. Quitting, cutting back, and keeping it out of other people's lungs will still have a powerful effect.
With salt, it could be that the highest consumers are also living off of fast food, which is also full of fat, sugar, and not-nutritious filler. Plus they may also be inactive, overworked, or just plain uninterested in their own health.
For example, the linked article on "salt and obesity" cites a study with this conclusion:
The authors conclude that the increased intake of salt, through its effect on thirst, has lead to an increased intake of high-energy beverages, which has in turn remarkably contributed to the increase of obesity in the United States.
...which is the sugar problem once again.
I guess lifestyle issues will always be complicated. And just as with any health issue, the dangers of salt has its detractors.
So why does this campaign bother me? Is it because the health issue about salt is not yet on my radar? Because salty foods (homemade and artisinal, mostly) are a lifestyle sin that I'm just not willing to give up? Am I a hypocritical skeptician?
Maybe it's just the mainstream social marketer in me that feels uneasy with the broad claims of the campaign. I'm not advising anyone to eat more salt. But I'm just not sure telling people that pickles, pizza and pasta (all based on God-knows-what recipe) are deadly poison is really the right approach to changing behaviour. Nor is the deceit some other unrelated campaigners in the U.K. have practised. I always believed that mainstream campaigns should be forthright, credible, and asking for achievable action.
I'm just not ready to take the pickle out of my diet yet. I might even eat poutine again. I'll just do it all in moderation, keep exercising, and try not to panic.