Egan, in his editorial of the re-analysis of the DASH-sodium data, appears to endorse universal salt reduction in the entire population, which has, according to him, a substantial foundation. 1 However, in the last paragraph, he seems to pour cold water on this conclusion and one is left uncertain as to what he is saying. The results of the re-analysis of the DASH-sodium study 2 support the large body of other evidence 3 that salt reduction should be directed at the entire population rather

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... "susceptible individuals." Much of this evidence Egan does not mention. A recent expert committee in the United Kingdom re-examined all of the evidence on salt and concluded that, since the early 1990s, the evidence has increased and recommended a reduction in all adults to 6 g/d or less and much larger reductions in children dependent on age. 4 Egan, in previous publications, has studied the acute effects of large salt reductions. It is bizarre, therefore, that he quotes Graudal's meta-analysis as the only evidence against population salt reduction. Graudal's meta-analysis included very short-term (eg, 5 days) and large changes in salt intake (eg, from 20 to Ͻ1 g/d). The average duration was only 8 days in normotensives. To draw any conclusions about the long-term effects of modest salt reductions from Graudal's meta-analysis is misjudgment. Would blood pressure(BP)-lowering drugs be assessed on their action for only 5 days? We recently published a meta-analysis of the studies of 1 month or more of salt reduction 5 and demonstrated significant reductions in BP in both normotensives and hypertensives and, in both, there was a dose response. For a 3 or 6 g/d reduction in salt intake there would be major public health benefits. From a public health perspective, reducing salt intake is one of the easiest strategies to carry out in that, both in the United States and Europe, Ϸ80% of salt consumed is hidden in processed, canteen, restaurant, and fast food. A strategy of small reductions (10% to 20%), which are not detected by the human salt taste receptors, across all foods where salt has been added, repeated at 1 to 2 yearly intervals, would mean that within 5 years salt intake would be reduced to the target without the consumers' knowledge, although this would be helped if they did not add salt at the table or in their cooking (only Ϸ10% to 15%). The evidence for universal salt reduction is strong when compared with other dietary constituents eg, saturated fat, fruit and vegetables, although we would agree that action should also be taken about these, but unlike salt, this will require major changes in eating habits. The re-analysis of the DASH-Sodium Study 2 reinforces the large amount of existing evidence that population salt intake should be reduced by gradual and sustained reductions in the salt content of all foods that have salt added. The public health benefit will be very large, eg, in the UK 35 000 deaths/year from stroke and ischemic heart disease would be prevented and much larger numbers would result in the United States if they follow the example of the UK. 6 Feng J. He