But is it even possible to get the public to permanently reduce salt consumption? Researchers have had a hard enough time getting people to cut back during short-term supervised experiments.

Image Credit... Viktor Koen

The salt reformers say change is possible if the food industry cuts back on all the hidden salt in its products. They want the United States to emulate Britain, where there has been an intensive campaign to pressure industry as well as consumers to use less salt. As a result, British authorities say, from 2000 to 2008 there was about a 10 percent reduction in daily salt consumption, which was measured by surveys that analyzed the amount of salt excreted in urine collected over 24 hours.

But the British report was challenged in a recent article in The Clinical Journal of the American Society of Nephrology by researchers at the University of California, Davis, and Washington University in St. Louis. The team, led by Dr. David A. McCarron, a nephrologist at Davis, criticized the British authorities for singling out surveys in 2008 and 2000 while ignoring nearly a dozen similar surveys conducted in the past two decades.

When all the surveys in Britain are considered, there has been no consistent downward trend in salt consumption in recent years, said Dr. McCarron, who has been a longtime critic of the salt reformers. (For more on him and his foes, go to nytimes.com/tierneylab.) He said that the most notable feature of the data is how little variation there has been in salt consumption in Britain  and just about everywhere else, too.

Dr. McCarron and his colleagues analyzed surveys from 33 countries around the world and reported that, despite wide differences in diet and culture, people generally consumed about the same amount of salt. There were a few exceptions, like tribes isolated in the Amazon and Africa, but the vast majority of people ate more salt than recommended in the current American dietary guidelines.

The results were so similar in so many places that Dr. McCarron hypothesized that networks in the brain regulate sodium appetite so that people consume a set daily level of salt. If so, that might help explain one apparent paradox related to reports that Americans are consuming more daily calories than they used to. Extra food would be expected to come with additional salt, yet there has not been a clear upward trend in daily salt consumption evident over the years in urinalysis studies, which are considered the best gauge because they directly measure salt levels instead of relying on estimates based on people’s recollections of what they ate. Why no extra salt? One prominent advocate of salt reduction, Dr. Lawrence Appel of Johns Hopkins University, said that inconsistent techniques in conducting the urinalysis surveys may be masking a real upward trend in salt consumption.