My attention was taken by a Tweet from @samphireshop linking to a panic-stricken press release from an organisation called CASH, Consensus Action on Salt & Health.
Well, it certainly alarmed me! Let me quote the headlines from this paper. The use of capitals for emphasis is theirs, by the way:
• NEW research demonstrates that some cheese makers are not going far enough when it comes to salt reduction; putting their customers’ health at risk.
• Despite many cheeses meeting the recommended Department of Health 2012 salt targets, 81% are HIGH in salt, with some cheeses containing more salt than SEAWATER!
• The Department of Health MUST force the food industry to sign up to the new 2017 salt reduction targets now; to help save the maximum number of lives.
• Then, much more challenging targets need to be set.
Wow! That’s hard-hitting stuff. And by an organisation that claims to be based on serious medical and scientific analysis.
Certainly most of the newspapers bought it, and more or less published the press release. Here’s the Telegraph.
Only the Guardian, having published the story like all the others, made room for a contrary note. Word of Mouth Blog. The author poses two questions about CASH. “Who are these people? What on earth do they eat?”
So, who are they? Or, rather, who do they claim to be?
“Consensus Action on Salt and Health is a group concerned with salt and its effects on health, supported by 25 expert scientific members.
CASH is successfully working to reach a consensus with the food industry and Government over the harmful effects of a high salt diet, and bring about a reduction in the amount of salt in processed foods as well as salt added to cooking, and the table. To date we have been successful with many supermarkets and food manufacturers choosing to adopt a policy of gradually reducing the salt content of their products, and a Government-financed a campaign to raise awareness of the effects of salt on health.”
I started with the claim to have 25 expert scientific members. No doubt all worthy men and women, but heavily biased towards the medical profession. Many of them are long retired from practice, and have joined the ranks of the great and the good who populate so many NGOs.
I counted: 9 x heart disease or blood pressure specialists, plus 11 other medics including a stroke consultant, a public health specialist and food labelling activist, a kidney diseases specialist, now deceased but still listed on CASH website, and specialists in diabetes, cot death, obesity, preventive medicine (2), human nutrition (2), and fibroids.
The three non-medics comprised a food safety consultant, a food policy and social justice professor, and a vet.
That comes to 23, or 22 if you exclude the chap who died, rather than the 25 that CASH claim. But, as we’ll see, mathematics isn’t their strong point.
Anyhow, what is important is the study. I was fascinated to see how they’d carried out the research, and whether they could back up such claims as “Salt content was significantly higher in branded cheddar and cheddar-style cheese compared to supermarket own-label products. This demonstrates that it is technically possible to produce cheese with less salt in it.”
I read the paper with increasing disbelief. At first I became annoyed, then amused, then ended by feeling quite warm towards CASH. It was like reading a GCSE project by a class of 14 year olds. Ah, bless their little cotton socks, you can’t be cross with them. They’re doing the best that they can.
The biggest laugh was that they hadn’t tested the salt content of a single cheese. They had (it still makes me giggle) merely read the labels of packaged cheeses in supermarkets.
In all they’d read nearly 800 labels. They’d used 612 of them, because in many cases the salt or sodium content wasn’t provided. Many French cheeses list the fat content, but not salt, even on their manufacturer’s website.
It’s not clear how the sample was selected, other than simply browsing the shelves and picking up each variety in turn. They read 250 cheddar labels, and 32 Parmesan labels. Do we as a nation eat only 8 times more cheddar than Parmesan? That’s not credible. And if I wanted to calculate (as they do) the standard deviation of salt content of cheddar as opposed to Parmesan, I’d pick a comparable sample size.
And it’s when we start looking at the statistical basis of the study that things really go awry. They’ve only done the simplest of stats, deriving the mean and standard deviation of their samples. But it’s all pretty meaningless.
Given that their base data is cheese labels, not the cheese itself, it’s worth a glance at the Food Labelling Regulations 1996:
“4. All amounts given—
(a)are to be per hundred grams or hundred millilitres of the food, as is appropriate, ….
(c)shall be averages based, either alone or in any combination, on—
(i)the manufacturer’s analysis of the food,
(ii)a calculation from the actual average values of the ingredients used in the preparation of the food,
(iii)a calculation from generally established and accepted data,
and “averages” for the purposes of this sub-paragraph means the figures which best represent the respective amounts of the nutrients which a given food contains, there having been taken into account seasonal variability, patterns of consumption and any other factor which may cause the actual amount to vary.
So there’s an unknown bias. One label may be based entirely on a chemical analysis of the finished product, another on a commonly accepted recipe around which there will be production variations.
Although the study doesn’t acknowledge it, they’ve self-selected only commercial cheeses that are factory packed in consumer portions. Large blocks of cheese cut up on a deli counter and wrapped in store don’t have nutritional labels, so they’re excluded. All artisan cheeses are excluded. Many French cheeses are excluded. I’ve already mentioned the differing sample sizes.
You can see why I started to laugh.
But of course, these clowns aren’t actually 14 years old. Indeed many of their scientific advisers are well into old age. Old enough to know better.
So what about the Guardian writer’s other question. “What on earth do they eat?”
I think I can answer that, if only from personal experience. Some years ago I was prevailed upon to go on a diet, monitored by an NHS Nutritionist. She was a very well-meaning lady, but we didn’t really see eye to eye. I monitored my diet ruthlessly, and turned up to our meetings armed with a detailed analysis of what I’d eaten. I can still remember wondering at her enthusiastic response to one of my graphs, headed “Non-milk extrinsic sugars”. By dint of taking vitamin tablets I managed to keep everything within her prescribed limits. Except salt. Unless you’re prepared to eat salt-free bread and eat unsalted vegetables, and abstain from salt on eggs, there’s no practical way to meet the guidelines.
But she saw nothing particularly arduous about her recommended regime. And the difference was that I very much enjoy good food. To her, and to the CASH activists, it’s just a necessary nuisance, like going to the lavatory. They’d be quite happy to live on porridge and jam sandwiches. Quick ‘n’ easy.
I mentioned rather wistfully to the nutritionist that under my new regime, the thing I’d miss most was cheese, which was absolutely proscribed. She could see that I was struggling, and wanted to be kind. “Well” she said, “if you can get down to your target weight, we’ll allow you half an ounce of cheese each month, as a cheese treat.”
No more need be said.