CDC, NYC Dept. of Health, scholars respond to IOM report on sodium

The Centers for Disease Control (CDC) and the New York City Department of Health and Mental Hygiene (NYC DOHMH) have published their first official responses to a controversial Institute of Medicine (IOM) report that challenged current national guidelines recommending sodium intake as low as 1,500 milligrams for many Americans.

The responses, whose authors include CDC Director Thomas Frieden and NYC DOHMH Commissioner Thomas Farley, will be published on September 16 in a series of commentaries and editorials in American Journal of Hypertension. They argue that the CDC and NYC DOHMH should - and will - continue to promote current established guidelines for reduced sodium intake despite the IOM's findings, which may suggest that those guidelines are not only ineffective at controlling hypertension, but could actually generate other public health risks.

The official CDC commentary contends that the IOM report does not make a case for altering current policy and that popular media outlets, such as the New York Times, have distorted the findings therein: "The [IOM] does not suggest that individuals should consume more than 2,300mg of sodium daily or that we should abandon efforts to lower population sodium intake at large. When highly regarded media outlets frame health messages inaccurately, as they did here, we risk losing the achievements made as a result of long-standing public health messages. Given that sodium intake is high and that the benefit of lowering intake is well established, innovative policies and programs to lower population sodium intake should be pursued aggressively."

Many leading hypertension researchers hold a different opinion, however. In addition to the official CDC and NYC DOHMH responses, AJH's comprehensive collection comprises a full range of independent opinions on how the report should influence future dietary sodium policy and practice on the national scale.

"Both the CDC and NYC DOHMH, in invited commentaries, indicate that the IOM report will not deter them from vigorously pursuing efforts to reduce the sodium intake of all Americans," American Journal of Hypertension Editor-in-Chief Dr. Michael H. Alderman and Co-executive Editor Dr. Hillel W. Cohen write in an editorial for the collection. "Science is a powerful, evolving force that will ultimately produce evidence to define the 'healthy range' for sodium intake. Until that evidence becomes available, calls to reduce long established sodium intakes... must be viewed with great skepticism."

Alderman and Cohen have commissioned responses to the IOM report from leading researchers in the field including Dr. Salim Yusuf, Executive Director of the Population Health Research Institute; Dr. Andrew Mente of McMaster University's Department of Clinical Epidemiology & Biostatistics; and Dr. David A. McCarron of UC-Davis's Department of Nutrition, who argue that current national sodium guidelines should be reevaluated in light of the IOM report.

Dr. Lawrence J. Appel, Director of the Welch Center for Prevention, Epidemiology, and Clinical Research at The Johns Hopkins University, offers independent commentary in support of the CDC's decision to continue pursuing population-wide sodium reduction.

Drs. Alderman and Cohen note in their Editorial; "The IOM report's balanced review and analysis has the credibility to make [it] a paradigm shifting publication." Altogether, these articles - from public agencies and informed scientists - are designed to inform the emerging debate about whether existing scientific evidence supports current US guidelines for sodium intake.