By Dennis Archambault

The medical direction is often simply stated: lower your salt intake. Easier said than done, when your eating habits take you to various fast food restaurants routinely. Self-discipline at home is one way of changing your taste for salt in meals, but when your diet is heavily influenced by fast food, it may be a losing battle.

If hypertension is the “silent killer,” salt is the covert agent, conducting clandestine operations across all types of eating practices. According to Thomas A. Farley, a physician and fellow in public policy at Hunter College, “The reason that nearly everyone eats way too much sodium is that our food is loaded with it, and often where we don’t taste or expect it.” In a commentary published recently in The New York Times http://www.nytimes.com/2014/04/21/opinion/the-public-health-crisis-hiding-in-our-food.html?_r=0, Farley says it’ not the usual suspects. Blueberry muffins, for example, can have more than double the salt of a serving of potato chips. And how about wholesome whole wheat bread? That can have nearly 400 milligrams of sodium, he says.

As a physician, he says traditional medical advice to adopt a low salt diet is “virtually impossible” because nearly 80 percent of the sodium consumed by Americans comes in packaged and restaurant food — no matter where you go or what you eat. It’s not just fast food or processed food products.

Farley cites a 2010 Institute of Medicine recommendation for mandatory federal standards for sodium in food http://www.iom.edu/Reports/2010/Strategies-to-Reduce-Sodium-Intake-in-the-United-States/Report-Recommendations-Strategies-to-Reduce-Sodium-Intake.aspx. But, of course, it’s more complicated than establishing new regulations. The good news, he says, is that 21 companies have pledged to reduce sodium. The bad news is that far more are ignoring the recommendation.

Farley’s commentary is worth noting as community health advocates grapple with how to deal with salt and reduce the incidence of hypertension in society.

Dennis Archambault is director of Public Affairs for the Detroit Wayne County Health Authority.