Could Prison Studies End the Salt Wars?

Medical research studies involving prison inmates have a bad reputation, but now a group of nutrition researchers proposes to use prisoners to answer a long running question in nutrition: what is the connection between salt intake and health? They recently published their proposal in the journal Hypertension, reported by Gina Kolata in the New York Times.

Arguments over the role of dietary salt in heart health — the “Salt Wars” — have been raging for years. David McCarron, a nephrologist and former faculty member with UC Davis’s Department of Nutrition is a prominent “Salt Skeptic,” arguing that Americans eat about the same amount of salt now as 40 years ago, and that salt intake in humans is regulated by the brain, not by how much is added to food.

After considering options, McCarron and his coauthors concluded that a large, randomized controlled trial involving thousands of prisoners could be a way to resolve the issue. Prisoners are a good population to study this question because they have no control over their diet — they can only eat what their facility provides. According to the Times article, the ethical issue is eased if prisoners can be seen to potentially benefit from the research. If it leads to new dietary guidelines that improve health (even on prison food) that would be the case.

The researchers plan to request NIH funding for the trial, which would begin with a pilot study then if promising continue with a five-year study involving thousands of people.

More information

Can We End the Salt Wars With a Randomized Clinical Trial in a Controlled Environment? (Editorial, Hypertension)

Trying to solve science’s salt wars, researchers may have found the ideal study subjects — prisoners (National Post/New York Times)

Normal Range of Human Dietary Sodium Intake: A Perspective Based on 24-Hour Urinary Sodium Excretion Worldwide (American Journal of Hypertension)

TierneyLab Blog: Salt Wars (New York Times)

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