Ask your average New York inhabitant what the New York City Department of Health and Mental Hygiene does, and most of us will think of officials closing down restaurants containing too many cockroaches and assorted critters.

In fact this department led by commissioner, Thomas R. Frieden (also known as the “health czar”), has spearheaded a number of city-wide health campaigns that have targeted us all. With a general campaign to lower the incidence of heart disease and cancer in the City, the Health Department are behind such campaigns as the smoking ban in all workplaces (yes this is the one affecting bars and restaurants) and the ban of trans fats in restaurant food.

The most recent measure by the Department of Health is the enforcement of chain restaurants to display calorie information on their menus or menu boards. Considering that New Yorkers get an estimated third or more of their daily intake of calories away from home, knowing what’s in your meals is imperative. Subway riders may be familiar with this campaign from the colorful posters screaming “2000 calories a day is all adults should eat”, with a picture of some 1200 calorie ridden cheese-oozing burger below the title. Taking a look at around the City at some of these new calorie displays, I was shocked at the actual calorific content of some menu items. Therefore, it was not surprising to learn that in a number of studies, where less-healthy food items were involved, it was found that people generally underestimated the calorie content of food by around 50%. The estimated effects of this campaign are if people are aware of the nutritional composition of their food, that less intake through this could mean over the next 5 years, ~150,000 fewer obese New Yorkers and a reduction of ~30,000 cases of diabetes.

So what’s the next campaign for the DOHMH? Salt. Don’t worry, this doesn’t mean a ban on salt, but the reduction of the amount of salt consumed (a so-called “Salt Assault”). The idea is to get makers of processed food to reduce the salt content by 40-50% over the next 10 years. Apparently in America, we consume on average twice the recommended amount of salt per day and 80% of this is in the food we buy. It is well-known from many epidemiological studies that reducing salt intake reduces blood pressure. An equally accepted fact is that lowering blood pressure also reduces the incidence of heart attacks and strokes. Therefore, it is generally accepted that reducing salt intake reduces risk of cardiovascular disease. Generally, but not everyone.

Like many scientific fields, there are those with opposing opinions. Highlighted by an Op-ed in the New York Times by Dr Michael Alderman, from the Department of Epidemiology & Population Health at the Albert Einstein College of Medicine, he suggests reducing salt intake may in fact be detrimental to health. In a number of studies by Dr Alderman, the complete opposite was seen between salt consumption and heart disease; an inverse relationship between salt and cause of death by cardiovascular disease. As you can imagine, this has caused some heated debate, including critiques of the design of these studies and the methods of analysis. So what’s the real message? It seems that both sides may be right depending on the individual. Recent studies have shown that genetic differences may cause people to react different to sodium, where some individuals are sensitive to high levels and vice versa.

So what do these people agree on? Reduce dietary intake as a whole and hence this could be a way of reducing salt intake. As for the campaign itself, it seems reducing salt levels in food will leave a bitter taste in the mouth for some.