Unhealthful News 166 - Last tango for salt shakers

In the spirit of yesterday's q-and-a quick hit, another one.

CNN reported:

Salt shakers disappear from Buenos Aires tables 

In an effort to combat hypertension, which affects some 3.7 million residents in the province -- nearly a quarter of the population, the health department reached an agreement with the hotel and restaurant federation to remove salt shakers from the tables at their eateries. 

"On average, each Argentinian consumes 13 grams of salt daily, while according to the World Health Organization, you should consume less than five," Health Minister Alejandro Collia said when he announced the change last month.  

….Collia said that if Buenos Aires residents can reduce their daily salt intake by three grams, it could save about 2,000 lives a year.

Will this reduce salt intake?  Almost certainly.  A lot of health affecting decisions, especially those involving immediate pleasures, are sufficiently influenced by convenience that little changes of availability can have an effect.  Of course it is less controversial when that consists of adding a convenience (e.g., making sure snack packs of vegetables are as easy to get as chips) rather than removing one.  The only conceivable way in which this might not decrease consumption is if chefs increased salt use in the kitchen to make up for it, and they overshot, which seems reasonably unlikely.  Chefs might well prefer that people are not allowed to mess with their optimized seasoning.

Will this provide a health benefit?  Ah, now there is the tough question.  A social intervention like this is not like a drug, and things may not work out the way the drug addled think it will (and by drug addled, I mean those who think that drug trials are the right way to think about public health interventions).  Among the proposed problems, the salt reduction might not really improve health (there is substantial legitimate controversy about whether salt matters for other than a small minority who mostly know who they are); people might overcompensate (thinking they are more deprived than they are, or perhaps as a act of rebellion), actually consuming more salt; or people might eat more unhealthful food because the salty food sated them sooner (as happened when people tried to cut down on fat intake).  It is difficult to know.

Is this a good way to find out?  It really is, assuming (a) they try very hard to get good longitudinal data that addresses the points from the previous paragraph and (b) you do not live in Buenos Aires and like salt.  Sadly, I am afraid no one will gather good data (which requires some effort and skill, and especially an interest in honestly determining the effects).  So this will probably be yet another triumph of "health promotion": Do something that sounds like it is healthful and make sure never to honestly study the effects so you can just declare that it did what it was supposed to do; ignore the social downsides, up to and including the downfall of the government; and ten port it everywhere else saying "it was proven in Buenos Aires and everyone should follow their example."

Is banning salt shakers the most patronizing bit of nanny-statism ever?  Definitely not, because this clearly has it beat:

The measure is not as extreme as it sounds. Salt will be available by request, but only after the patrons have tasted their food.

The mind boggles at the thought of a steakhouse waiter refusing the premature request for salt, "lo siento señor, pero antes usted debe comer uno bocado" (and I am sorry for the barely remembered, and thus presumably mangled Spanish).  Treating restaurant patrons like fussy toddlers ("no yummies until you eat at least one bite!") might actually be more amusing to see enforced than Nepal's proposal to ban tobacco sales to pregnant women.