We're finally catching up with reality, at least in one arena. In the past week I've read two local newspaper articles, one article in the Annals of Internal Medicine and an accompanying editorial in the same monthly journal from the American College of Physicians, all on our need to decrease our salt intake.

Those of us who've spent much of our medical careers dealing with the treatment and the consequences of high blood pressure, medically termed  hypertension, have been on a low-salt kick for years. Both of my parents and, eventually my older brother had hypertension, so I watched my blood pressure for years and, when it went up to high normal, cut way back on my salt intake. I also started to lose weight and to exercise more.

So two days ago I read an article titled "Shaking the Salt Habit." That was written for our Fort Collins paper and was followed by one today, from the Associated Press, titled "Too Much Salt: Report urges FDA to force rollback. Then there were the two medical pieces which came out in the April 20th edition of the  Annals. The editorial encapsulated the concept: "We Can reduce Dietary Sodium, Save Money, and Save Lives.

The bottom line is the American diet contains roughly twice as much salt as is optimal for health, nearly 4,000 milligrams vs. the maximum recommended of 2,300 mg. for young, healthy adults, and the 1,400 to 1,500 mg. that is the suggested maximum for people with high blood pressure, for African-Americans and for anyone older than 40. Much of the excess comes from processed foods.

Other countries have already made progress along the lines of cutting average salt intake (salt, of course, is sodium chloride, but I'm used to using either term). The UK started in 2003, and cut salt intake by an average of 9.5% The Annals article suggests if we were able to do the same, gradually perhaps so people didn't think the taste of food was inferior and started salting things at the table, we'd save lots of lives.

The consequences of hypertension include heart attacks, strokes and kidney failure. That less than ten percent decrease in our dietary salt could prevent over a half million strokes and just under a half million heart attacks in our 40 to 80-year old group. That would save over $32 billion dollars in medical costs.

The UK plans further cuts in salt intake, up to a 40% decrease by 2012. Japan, Finland, Ireland, Australia and Canada plus other countries are also implementing similar programs.

We don't cook with salt for ourselves, decrease the amounts specified in recipes when we cook for others, don't add salt at the table and tend to avoid processed foods. I wondered if we were getting enough iodine, added to most or all salt you purchase, but the salt that goes into processed foods, according to the articles I read, doesn't have idoine anyways. Plus our senior vitamins have the RDA (recommended daily allowance) for iodine anyway. So I quit worrying that we'd develop thyroid problems.

The bottom line is we Americans need to wean ourselves off our excess salt habit and doing so will both improve health and save a healthy chunk of change.

I got a copy of the monthly magazine Reform Judaism yesterday and read Rabbi Eric Yoffie's article titled "Guess Who's Coming to Dinner?" In it he urged a decision to reduce red meat intake by at least one fifth. When I read some of the rationale behind his recommendation, I was impressed. One table listed the average amount of water needed to produce a variety of foodstuffs; those numbers ranged from 13 liters for a tomato to 135 liters for an egg to 2,400 liters for a hamburger. We're facing a water shortage in Colorado where I live, so that got my attention.

I started thinking about the Why behind that huge quantity of water as well as the Why Not about Rabbi Yoffie's suggestions. Most of our beef, at least that available in the supermarket, comes from animals that are corn-finished. So in order to bring a cow to the slaughterhouse, most producers, wanting as much meat as possible per animal, raise them in feedlots and feed them corn for a large portion of their lives. Raising all that corn consumes a lot amount of water.

The meat industry is responsible for a goodly share of our greenhouse gases; the article mentions a U.N. paper ranking  animal agriculture above the total of all transportation modalities.  One academic has suggested that cutting our meat intake by one fifth would be the equivalent of each US citizen driving a Prius instead of an ordinary, non-hybrid automobile.

At that point I thought, "For once I'm ahead of the game." Lynnette and I each bought a Prius at the end of 2006 and, as I've previously said in one of my blogs, we've cut our red meat intake markedly in the last three years. We've also purchased non-corn-finished meat, splitting a bison with three other families and recently trying some Beefmaster beef from a Colorado company that grass feeds and finishes all their animals.

Well that's a good start, but I still need to be careful of my portion control when I do eat red meat; Michael Pollan's Food Rule #23 says, "Treat meat as a flavoring or special occasion food." He's concerned about the other consequences increasingly linked to red meat; those include heart disease and some forms of cancer.

I think Lynnette is making a vegetarian dinner while I'm writing this; tonight I'll be content to eat no meat at all, red or otherwise. It seems like that is a good start on cutting my water use and staying healthy.  (more…)

I read two scary newspaper articles yesterday, one in our local paper and the other in The Wall Street Journal. Both mentioned a research study, reported by a University of North Carolina pediatrician, that showed obese kids had a high blood levels of a significant chemical marker of inflammation. What that translates into is three to five year-old American kids already having signs they are increasing their risk for early-onset heart disease. I remembered seeing a New England Journal of Medicine article from December of 2007 (NEJM, vol. 357: 2329-2337) that had first warned me of this issue. That one followed over a quarter million Danish schoolchildren and concluded that a high body-mass-index during childhood (BMI is a term that correlates weight and height) is associated with an increased risk of coronary heart disease as an adult.

The other study, reported on in the Associated Press article that was reprinted locally, pointed toward an increased risk of being obese in Black and Hispanic children. That is partly due to income levels, but partly also to cultural factors, according to the authors of the study. Twenty percent of these kids, all under the age of twenty, were obese, vs. fifteen percent of Caucasian kids. The NEJM article had a footnote saying an estimated 19% of US kids age 6 to 11 have a BMI greater than the 95% percentile for their age and gender.

So what's going on here and how can we change this grim picture?  Number one is to let people know about this issue.  Secondly we can look really hard at what we're feeding our kids from an early age on and what kind of food they eat as they get older. Thirdly we have to have a realistic look at our kids. I hear lots of young parents wanting their child to have weights high up on the growth charts; that's not the only way to measure their progress, folks. Is your kid (or grandkid) slender, chunky or just plain fat?

There are other factors in the lives of our children that we can all influence: what about our own BMI; how does that send a signal to our kids? And what about food choices? Can we start them eating the right things (mostly vegetables and fruits; less red meat). And can we, the American public, influence what the fast-food industry offers to their customers and to the kids in particular? Is there a way to get young people interested in more exercising and less sitting in front of their computers, TVs and all those hand-held devices?

I've heard people speculate that the Boomer generation may be the first to live average shorter lifespans than their parents. I don't know the data here, but these are adults who presumably are fully competent to make their own choices. That's not true of our kids. it's time we turn this slide into obesity around for their sakes.