A doctor calls for a kinder gentler war
I regularly read the Science Based Medicine Blog since it is an interesting combination of intelligent, rational examination of medicine and the naive monstrous morals of a toddler.
This week’s column by Dr Steven Novella does not disappoint. The good doctor reviews the medical impact of modern sodium consumption and states:
As usual, the medical and regulatory communities are tasked with making sense out of chaos – with implementing bottom-line recommendations in the face of inconclusive evidence. While there remains legitimate dissent on the role of salt in vascular health, the current consensus is something like this:
- Most of the world, including Americans and those in industrialized nations, consume more salt than appears to be necessary.
- In the US most of that salt comes from processed or restaurant food (while in other countries, like Japan, most salt intake is added while cooking).
- There is a plausible connection between excess salt intake, hypertension, strokes and heart attacks.
- There is evidence to suggest that reducing overall salt intake will reduce the incidence of these health problems, but the evidence is not yet conclusive and longer term and sub-population data is needed.
Given all this it seems reasonable (from a scientific point of view – and ignoring the role of political ideology) to take steps to reduce the amount of salt in processed and restaurant food, while continuing to study the impact of such measures. But we also have to consider unintended consequences. Part of the reason salt is added to processed food is because it helps preserve it – give it a longer shelf life. People also develop a taste for salty food, and a sudden decrease in salt content may be unsatisfying, leading people to seek out higher salt foods. But these are technical problems that can be addressed.
It should also be noted that salt requirements and tolerance may vary considerably from individual to individual – based upon genetics, and certainly underlying diseases. Therefore recommendations from one’s doctor should supercede any general recommendations for the population.
In any case it seems that the War on Salt has begun. I only hope this is a war we choose to fight with science.
The last sentence left me gobsmacked. A war fought with science? Does he understand what exactly it means when a government wages war?
The essential feature of government is the enforcement of its decrees by beating, killing, and imprisoning. Those who are asking for more government interference are asking ultimately for more compulsion and less freedom.
Ludwig von Mises, Human Action
Let’s take, for example, the war on (some) drugs. 150 years ago, if I had described the government proscribing the growth of hemp, sowing poison on illicit fields in an attempt to kill marijuana smokers, sending paramilitary forces into homes with orders to shoot first and ask questions later, and setting up checkpoints where people with large amounts of cash would have it confiscated on the grounds it must be involved in this illicit trade, it would have beggared belief. Those who lobbied for its outlawing would have denied wanting to do those things, they merely wanted to protect white women from being seduced by black jazz musicians and to preserve the social order against uppity darkies.
And once the stuff was outlawed, once the law enforcement apparatus started to wage its low level guerrilla campaign, and faced resistance the government naturally escalated, flooding the media with propaganda to buttress its position, until the war became an end to itself, with otherwise sensible people saying things like “I am a fan of freedom but we must protect the citizenry against the scourge of drugs”
I am curious why the good Dr Novella thinks that a war on salt will turn out any better than the War on Gold, the War on Sucrose, the War on Opiates, the War on Miscegenation or any of the other social crusades little petit tyrants enlist the government to engage in?
Moreover, is he blind to the fact that these wars on inanimate substances and ideas are actually wars on people? It’s not the marijuana that’s getting its child’s hand shot off in a police raid, it’s a person. It’s not the marijuana who is having their life savings confiscated, it’s the retired couple who don’t trust banks. It’s not the marijuana who has his dogs shot in his home, its the hardworking mayor of a small town.
If I were to propose a War on the North Korean Government, I would imagine that Dr Novella might be a little reluctant to support it, given the large number of innocent people who would inevitably die having been propagandized into fanatically defending the state that looted and brutalized them so thoroughly.
But here, we get nary a peep of condemnation, only a pious desire to have “science” inform the strategy of the war on a common cooking ingredient, which will really be a war on people who use to much salt (according to the government) in their food preparation.
And, I should note, this war would have savage monsters like Mary Beth Buchanan deciding what was an appropriate amount of salt, just as she decided her judgment on how much pain medicine was appropriate for patients in chronic agony was better than that of the MD’s treating them, and used that rationale as justification on her war on doctors.
Dr Novella’s blindness it encoded in an assumption in the first sentence I quoted:
As usual, the medical and regulatory communities are tasked with making sense out of chaos – with implementing bottom-line recommendations in the face of inconclusive evidence.
Why are they tasked with this? Sure, doctors are asked to give advice on questions where there is no clear answer, much like any other profession. They have the power to say “I don’t know”, however. Moreover, there is nothing wrong with doctor’s giving advice. The act of making a suggestion does not actually harm anybody.
The regulatory apparatus, on the other hand, is dangerous. When it acts, people get hurt, they go to jail, they have their finances ruined. If we assume such an apparatus should exist, then we should use it only when the harm it does is worth the benefit. Otherwise, the regulatory apparatus need do nothing! Especially where there is no overwhelming evidence to justify regulation. It’s not as if salt causes an epidemic like cholera! The notion that people with vascular disease drives up health care costs requiring such regulation is laughable. Dr Novella has never, in all the essays he has authored that I am familiar with, shown much concern with the major reasons why health care costs are so high. If anything he supports the measures that are the primary drives of the high costs.
It is a shame that otherwise rational people fail to learn the lessons of history. Their blindness would not be so bothersome, if it weren’t for the fact that their hands are helping aim the guns pointed at us.