Salty and saltier: fast food has more sodium than ever before

High blood pressure is one of the biggest health problems in the U.S. today. The CDC estimates that 75 million American adults, about one-third of the adult population, has high blood pressure. Even more alarming is that high blood pressure "was a primary or contributing cause of death for more than 410,000 Americans in 2014," the last year for which the CDC reports data.

One of the main causes of high blood pressure (a.k.a. hypertension) is too much salt in the diet. As Americans have eaten out more and more, they've grown less aware over how much salt goes into their foods. Salt is tasty but invisible: you can't know exactly how much salt is in your food if you didn't prepare it yourself.

Everyone knows that fast foods can be salty, especially those (like French fries) that have salt sprinkled all over them. What they don't know, though, is that over the past 30 years, the amount of salt in fast foods has increased dramatically, as revealed in a new study just published by Megan McCrory and colleagues at Boston University.

The new study looked at how portion sizes, calories, sodium (salt), calcium, and iron changed in major fast food chains between 1986 and 2016. They analyzed data from these 10 restaurants:
Arby’s, Burger King, Carl’s Jr, Dairy Queen, Hardee’s, Jack in the Box, KFC, Long John Silver’s, McDonald’s, and Wendy’s
They would have looked at more, but others either didn't have data available or didn't have foods in all the categories under study.

Portions and calories all increased over the past 30 years, but I want to focus on the salt.

Back in 1986, sodium content in entrees averaged 36% of the recommended daily allowance–which is pretty high for a single entree (a burger, say). Bad as that is, though, by 2016 this had increased to 47%. Thus a single fast-food entree has nearly half of an entire day's allowance of salt. Sides increased from 14% of the RDA to 26%, which means that if you have an entree and a side (fries!), you're getting 75% of your daily salt allowance. On average, they're adding 50% more salt today than in 1986.

And that's just the average: if you order larger sizes, or one of the saltier choices (though you may not be able to tell what those are), or more than one side dish, you can easily exceed 100% of your recommended salt intake for the day. (And by the way, for the vast majority of people, having less than the "allowance" of salt is just fine.)

I remember having fast food burgers and fries back in the 1980s, and they were quite tasty. I haven't noticed that they taste better today, and it's not clear why the chains increased the amount of salt so much. Presumably they did consumer testing and found that people like more salt, but it could also be simply that adding salt, which is a preservative, allows them to store the food supplies longer and save money.

Now, most people don't think fast food is healthy. It's popular because it tastes good and it's convenient. Nonetheless, for the large numbers of people who have high blood pressure (or pre-hypertension), the fact that salt has increased should be worrisome.

For those who want to do a little homework, you can easily find detailed nutrition facts for all the major chains online now. It took me only a few seconds to find downloadable lists for McDonaldsKFCWendy's, SubwayBurger King, and others, so you can compare all their items before your next visit.

For example, a McDonald's quarter pounder with cheese has 1110 mg of sodium, or 46% of your daily allowance. Their Bacon Smokehouse Artisan Grilled Chicken sandwich has far more, 1940 mg (81%), while their Filet-O-Fish, in contrast, has only 560 mg of sodium (23%). Side dishes can be surprisingly bad (or good) too. KFC's corn on the cob is a gem, with no sodium at all, but their BBQ baked beans weigh in with 820 mg of sodium.

The bottom line, though, is that if you want to eat less salt, the best way is to prepare your own food.  It's more trouble, but it's well worth the effort.

Scientists restart bioweapons research, with NIH's blessing

For more than a decade now, two scientists–one in the U.S. and one in the Netherlands–have been trying to create a deadly human pathogen from avian influenza. That's right: they are trying to turn "bird flu," which does not normally infect people, into a human flu.

Not surprisingly, many scientists are vehemently opposed to this. In mid-2014, a group of them formed the Cambridge Working Group and issued a statement warning of the dangers of this research. The statement was signed by hundreds of scientists at virtually every major U.S. and European university. (Full disclosure: I am one of the signatories.)

In response to these and other concerns, in October 2014 the U.S. government called for a "pause" in this dangerous researchNIH Director Francis Collins said that his agency would study the risks and benefits before proceeding further.

Well, four years later, the risks and benefits haven't changed, but the NIH has (quietly) just allowed the research to start again, as we learned last week in an exclusive report from Science's Jocelyn Kaiser.

I can't allow this to go unchallenged. This research is so potentially harmful, and offers such little benefit to society, that I fear that NIH is endangering the trust that Congress places in it. And don't misinterpret me: I'm a huge supporter of NIH, and I've argued before that it's one of the best investments the American public can make. But they got this one really, really wrong.

For those who might not know, the 1918 influenza pandemic, which killed between 50 and 100 million people worldwide (3% of the entire world population at the time), was caused by a strain of avian influenza that made the jump into humans. The 1918 flu was so deadly that it "killed more American soldiers and sailors during World War I than did enemy weapons."

Not surprisingly, then, when other scientists (including me) learned about the efforts to turn bird flu into a human flu, we asked: why the heck would anyone do that? The answers were and still are unsatisfactory: claims such as "we'll learn more about the pandemic potential of the flu" and "we'll be better prepared for an avian flu pandemic if one occurs." These are hand-waving arguments that may sound reasonable, but they promise only vague benefits while ignoring the dangers of this research. If the research succeeds, and one of the newly-designed, highly virulent flu strains escapes, the damage could be horrific.

One of the deadliest strains of avian flu circulating today is H5N1. This strain has occasionally jumped from birds to humans, with a mortality rate approaching 50%, far more deadly than any human flu. Fortunately, the virus has never gained the ability to be transmitted directly between humans.

That is, it didn't have this ability until two scientists, Ron Fouchier in the Netherlands and Yoshihiro Kawaoka at the University of Wisconsin, engineered it to gain this ability. (Actually, their work showed that the virus could be transmitted between ferrets, not humans, for the obvious reason that you can't ethically test this on humans.)

Well, Fouchier and Kawaoka are back at it again. NIH actually lifted the "pause" in December 2017, and invited scientists to submit proposal for this type of research. Fouchier confidently stated at the time that all he had to do was "find and replace" a few terms in his previous proposal and it would likely sail through peer review. It appears he was correct, although according to the Science article, his study has been approved but not yet actually funded. Kawaoka's project is already under way, as anyone can learn by checking the NIH grants database.

And by the way: why the heck is a U.S. funding agency supporting research in the Netherlands anyway? If Fouchier's work is so great (and it isn't), let the Netherlands fund it.

I've said it before, more than once: engineering the flu to be more virulent is a terrible idea. It appears the review process at NIH simply failed, as multiple scientists stated to Vox last week. This research has the potential to cause millions of deaths.

Fouchier, Kawaoka, and their defenders (usually other flu scientists who also benefit from the same funding) like to claim that their project to engineer a deadlier bird flu will somehow help prevent a future pandemic. This argument is, frankly, nonsense: influenza mutates while circulating among millions of birds, and no one has any idea how to predict or control that process. (I should mention that I know a little bit about the flu, having published multiple papers on it, including this paper in Nature and this paper on H5N1 avian flu.)

Fouchier and Kawaoka have also argued that we can use their work to create stockpiles of vaccines in advance. Yeah, right. We don't even stockpile vaccines for the normal seasonal flu, because it mutates too fast, so we have to produce new vaccines each year. And the notion that anyone can predict a future pandemic strain so precisely that we could design a vaccine based on their prediction is laughable.

I can't quite fathom why NIH seems to be so enraptured with the work of these two labs that, rather than simply deny them funding, it has ignored the warnings of hundreds of scientists and now risks creating a new influenza pandemic. Much as I hate to say this, maybe it's time for Congress to intervene.