One more reason to avoid watching presidential addresses on the teevee

Our friend Roger is managing with a diagnosis of hypertension. In case you didn't think I could squeeze a political rant out of this, the epidemic of high blood pressure in the United States happens to be largely a social problem with a clear policy solution.

Because you are vile commoners, I can only give a link to the abstract, but Havas, Dickinson and Wilson, on behalf of the American Medical Association, discuss this problem in the new JAMA. Not that I didn't already know all this, but the JAMA commentary is a good occasion to talk about it. Hypertension contributes to more than half of all deaths from heart disease, which is the leading cause of death in the U.S. Of course something's gonna get you sooner or later, but high blood pressure will do more than just about anything but tobacco to hasten that day, and put you at risk of stroke, heart attacks, and disability along the way.

As Roger points out, about half the population has high blood pressure (that's if you include so-called "pre-hypertension," i.e. systolic pressure above 120 and diastolic above 80), but as the incidence increases with age, almost 90% of us can expect to develop it eventually. Is that just nature? Nope. The main reason the condition is so prevalent in the U.S. is that there is so much sodium in our diets.

But that isn't because we're wearing out our elbows with the salt shaker, it's because there are incredible amounts of salt in restaurant meals and processed foods. As Havas et al point out, it is nearly impossible for an American to consume a low-sodium diet. You would have to make all your meals from scratch, from raw produce. Average sodium intake in the U.S. is 4000 mg/day per 2000 kilocalories -- which is a good amount of calories to consume but most people consume considerably more than that. You want to get your daily sodium consumption down to no more than 2300 mg, equivalent to about a teaspoon of salt, but good luck with that -- one restaurant meal will put you over the top, and may well double it. One hot dog roll will give you almost 300 mg, and the hot dog gives you 500 more. Add ketchup, thats 200 more per hot dog, and you're done for the day.

Don't eat hot dogs? How about a can of beans? Almost 1000 mg right there. Like pizza? One slice will give you more than 1500 mg. Do you cook Chinese style at home? Two tablespoons of soy sauce contains 2000 mg of sodium.

Well guess what. In Finland, the health ministry has required labels on high sodium foods and has worked with the food industry on voluntary reductions. Combined with public education, that alone has reduced sodium intake by 40%. In Britain, the government has set standards and threatened regulatory action if they aren't met. But since we get 80% or more of our sodium from restaurant and packaaged foods, we just can't do it as individuals. This is a political problem and it requires a political solution.

Here's a place to start. Check the label on a can of V-8. It says, in huge letters, "100% vegetable juice." Then, in tiny letters printed in a subtle color that blends in with the background so as to be nearly invisible are the words, "with added ingredients." And what's the main added ingredient? You got it. Salt. And lots of it. Now, if there are added ingredients, it is not 100% vegetable juice. Therefore, the words "100% vegetable juice" are a lie. So let's start by making it 100% illegal to print blatant lies on food packages. Is that too much to ask?