Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York City, USA.
Health Aff (Millwood). 2012 Dec;31(12):2738-46. doi: 10.1377/hlthaff.2012.0554.
For more than four decades, starting in the late 1960s, a sometimes furious battle has raged among scientists over the extent to which elevated salt consumption has adverse implications for population health and contributes to deaths from stroke and cardiovascular disease. Various studies and trials have produced conflicting results. Despite this scientific controversy over the quality of the evidence implicating dietary salt in disease, public health leaders at local, national, and international levels have pressed the case for salt reduction at the population level. This article explores the development of this controversy. It concludes that the concealment of scientific uncertainty in this case has been a mistake that has served neither the ends of science nor good policy. The article poses questions that arise from this debate and frames the challenges of formulating evidence-based public health practice and policy, particularly when the evidence is contested.
四十多年来，从 20 世纪 60 年代末开始，科学家们就盐摄入量对人口健康的负面影响以及盐摄入量与中风和心血管疾病死亡之间的关系展开了激烈的争论。各种研究和试验得出了相互矛盾的结果。尽管关于饮食盐与疾病之间关联的证据质量存在科学争议，但地方、国家和国际各级的公共卫生领导人都在推动在人群层面上减少盐的摄入量。本文探讨了这一争议的发展。它得出的结论是，在这种情况下隐瞒科学不确定性是一个错误，既不利于科学，也不利于良好的政策。本文提出了由此产生的一些问题，并阐述了在制定基于证据的公共卫生实践和政策方面所面临的挑战，特别是在证据存在争议的情况下。
