No Eating Out For You!!!!!

[MooseMom]

I was perusing the newest blog entry over on www.thekidneydoctor.org, and it is about salt.  We all know that most Americans eat too much salt, anyway, and for kidney/dialysis patients, salt is the big bugaboo.  The Kidney Doctor says that if we are to truly avoid salt, we need to stop eating processed food (no surprise there) AND stop eating out in restaurants.  Processed and restaurant food counts for about 75% of the salt we consume.

OK, fine.  But let me ask you, and tell me honestly...could any of you never eat out again?  And I don't mean just fast food.  I mean high quality restaurants with celebrated chefs...no more of that sort of thing!  If your friends or family want to go out for lunch or dinner, you get to either stay behind or else you can go but not eat or drink anything.

Yes, we all know the dangers of salt overload.  And I'm sure we all cope with this as best as we know how.  But could you REALLY stop eating out?  My husband LOVES to eat out, so if I said, "Oh, so sorry, but I can't do that anymore," I think he'd divorce me.  And I'm not sure I'm kidding.

What do you think?  Is this a realistic goal, not eating out, EVER?

[monrein]

I think that it's possible to still eat out and I often ask for things to be prepared without added salt.  I don't expect totally salt free and I do tell them that I know that the chef will feel that the food won't be as tasty BUT restaurants CAN and many WILL prepare things less saltily and also put sauces and dressings on the side so more control is possible.  This is really only possible however in a good restaurant where things are prepped custom and per order...not so much in chain type restaurants where things arrive pre prepped and are loaded with salt.  I ate once in a place called Applebee's in the US (they don't exist here) and could find nothing edible...even when I'd asked for plain (steak) it was way too salty.  I ate salad with a touch of dressing and even the chicken breast was pre-salted.  A good restaurant though even preps their pasta "à la minute" and can do so with less or no salt in the water if asked.

[cattlekid]

As someone who is a) a self-proclaimed "foodie" and b) whose entire livelihood is wrapped up in the restaurant industry, I can tell you in no uncertain terms that I have not stopped eating in restaurants since I started dialysis.  Do I watch what I order?  Sure.  Did I cut back on going to restaurants?  Absolutely.  But I have been able to watch what I eat and drink and gain no more than 2-2.5 kilos per treatment, sometimes even less. Could I do better?  Of course.

The caveat to all this is that I still pee.  I can imagine that life would be much different if I no longer had any output.

[Dannyboy]

I eat out once in a while, just have to make sensible menu choices (as Monrein pointed out).    The recommended sodium intake (note sodium, not salt) for me as per my dietician is around 2,200 mg.    (salt is about 40% sodium).   I've found it relatively easy to stay within that limitation.    On days I know I will eat out, I try to have the absolute minimum sodium intake for my other meals.     Yeah, have to change some things, I don't salt anything with table salt, only place I really miss it is on popcorn.

I have found some of the "absolutes" food-wise I was warned about are just simply not true.    Many "bad" food items can be worked into a sensible food plan (always in moderation).   

I enjoy an In/Out meal (a popular fast food hamburger place here in California).   I order the burger without cheese, and the fries without salt and ice tea (no dark cola).    If you look at the nutritional info for this meal, it is not so bad, and can be worked in as long as you don't do it constantly.

Since I am doing NxStage, and am dialyzing 5 times a week, this is a factor in being a bit more easy on food.   

My "blood test" numbers are always excellent, every single measured item is within the recommended limits.

---Dan

[cariad]

We all know that most Americans eat too much salt, anyway, and for kidney/dialysis patients, salt is the big bugaboo.

I don't necessarily agree with the first part of this statement. Sorry, but doctors love to state this as fact, and some very articulate and talented scientists, science writers, and medical doctors have been refuting the 'dangers of salt' argument for years. Like so many dearly held beliefs that take hold in this country and are then impossible to extract from the collective ideology, the argument for sodium restriction was based on a huge but ultimately faulty study. For dialysis patients, salt will have an effect on thirst, and that is a danger for in-center dialyzors. However, there is no agreement in the scientific community that average American salt intake will damage general health, nor is there agreement that salt restriction is free of dangerous side effects.

I don't understand this doctor. I've gone to his blog and read a few entries, and most people seem to like him, but I still find myself wrestling with the friend or foe question. Salt restriction has been shown to increase risk of myriad problems, including risk of heart attack, one of the very problems he lists and claims salt reduction will ameliorate.

The fastest way to drive patients toward non-adherence and wholesale rejection of medical advice is to impose ludicrously unrealistic expectations upon them. Of course most restaurants, as monrein has pointed out, will want to help you with dietary issues - they want your business. My father used to order my french fries unsalted at the McDonalds when I was a kid, and even that mindless corporate monster could handle this request. French fries were the most special food in the world to me as a wee lass, and I rarely was allowed to have them (you know, never allowed to stop obsessing about calories and my appearance) then they would arrive unsalted, would not taste right, and I would still eat them, but what a waste. Limit my calories, then ruin the taste of the food that I was allowed to eat. Is it any wonder that after all of these years, I can count the doctors I trust on one hand?

[Cordelia]

I could not and would not. I associate it with socializing also, that's what my one friend and I do, we go out to eat and talk so I can't imagine doing without it ever again!  I just try to make 'healthier choices" is all when I'm eating out as best I can.   I also try to stay away from fast food like mcdonalds.  I can count the number of times I've eaten at McDonalds on less than one hand in the last year and a half. Likely twice is all and I had a the smallest size french fries and that was it, no soda and no Big Mac.

When I was told by the dietician in the hospital i'd be going on this renal diet I felt devastated feeling like I could never eat out again, that's so the case though for me. I also watch how 'many' time I eat out in a month too. If I eat out too much, it can really show on the phosphorus levels, so it's best to be careful.

Something else, I have never made a habit of adding any salt to anything at the table. The salt and pepper shakers never go on the table in my house. My adopted father died of heart disease and I watched him die, he was a heavy smoker and he was told to leave the salt off the table and switch to skimmed milk, so that's what I grew up with that, no added salt on the table and I was completely fine with that growing up being exposed to that.

In general, I've really cut back in eating out and all I can say is that it really saves $$ on the pocket book too, for a family of 5 to eat out regularily, is not cheap, that's for sure.  My kids aren't exactly in the realm of age anymore where kids under 12 can eat for free anymore, some places they even cut the age to 10 and under.  So, for a meal for us to out and eat it at a decent restaurant (not fast food like mcdonalds) it can cost us up to $70 to eat out just for one meal, it really sucks!     

[boswife]

Its very social with our family as well.  We try to discuss it before we go out and figure what we'll have.  Being breakfast is hubbys favorite meal, i "can" be easier.  He will even agree to get poached eggs, french toast, and then have a bite or so of the potatoes, and mabie a half a meat.  In and out burger,,yum!!  And again, we have cut WAYYYYYYYY back on our outings, but to take that from him would just hurt more than it's outcome.

[MooseMom]

To be fair to the Kidney Doctor, he DID say that if you REALLY wanted to control salt, you wouldn't eat out.  He didn't say that you mustn't.  He was just making the point that taking the salt shaker off the table isn't enough.

As to whether he is "friend or foe", any neph who advocates more dialysis and is concerned about issues like "cherry picking" is "friend" as far as I am concerned.  Also, any neph who openly blogs about these issues is pretty brave in my book.  I may not agree with everything he has ever posted, but I'm no expert and so I often have questions.  But I think it's pretty cool for a neph to go online and actually invite comments from all and sundry.

So, basically, the answer to my question is "no."   That's pretty much be my answer, too!  I don't want a divorce!

[lmunchkin]

To be honest, we haven't really changed our restruarants where we go to eat: Mexican-Caminorea; Chinese- ChinaPan; Gyro; Chicago Style and Burger King. But most times we eat at home.  The biggest change we have made is in portion size and a "tone-down" of the extras.

Like Danny, it is a little easier when doing NxStage 5 to 6 days a week.  But all in all, we really haven't stopped eating anything we like, we just eat less of it!

lmunchkin
 

[cariad]

Yes, I completely agree with you that openly writing about any issue is brave, at least in my estimation. I don't know enough about the politics of nephrology to say there is anything extraordinarily courageous in advocating for better dialysis - I would have to assume that most nephrologists (especially the ones that do not own dialysis clinics) would agree with him. More of them should add their voices to this push, it sounds well within their job description to register an expert opinion.

However, he is currently advocating for nephrologists to lecture patients on salt intake, with the implication that if they eat out, they must not want to control their salt that much; further implying that we are not smart enough to handle restaurant eating and make our own choices within our own dietary limits. That is the sort of statement that would have seen him sacked as my nephrologist. I don't eat out that often, but this all or nothing approach is detrimental to patients. It does not help that I do not believe there is strong enough science to support salt restriction in my particular case, and I would not appreciate a one-size-fits-all recommendation regarding diet or anything else.

I am all about patient autonomy and empowerment, so if that is his ultimate goal, then I am sure I will eventually come to the same conclusion that you have.

[MooseMom]

Yes, I completely agree with you that openly writing about any issue is brave, at least in my estimation. I don't know enough about the politics of nephrology to say there is anything extraordinarily courageous in advocating for better dialysis - I would have to assume that most nephrologists (especially the ones that do not own dialysis clinics) would agree with him. More of them should add their voices to this push, it sounds well within their job description to register an expert opinion.

I'm surprised that you are not more aware of the "politics" of nephrology these days.  You only have to look at Bill Peckham's and Hemodoc's blogs to see that there is a real battle between providing better dialysis and getting the funding for it.  Patient outcomes vs profit.  Read Bill's entries about EOD dialysis; this shouldn't even be an issue.

However, he is currently advocating for nephrologists to lecture patients on salt intake, with the implication that if they eat out, they must not want to control their salt that much; further implying that we are not smart enough to handle restaurant eating and make our own choices within our own dietary limits. That is the sort of statement that would have seen him sacked as my nephrologist. I don't eat out that often, but this all or nothing approach is detrimental to patients. It does not help that I do not believe there is strong enough science to support salt restriction in my particular case, and I would not appreciate a one-size-fits-all recommendation regarding diet or anything else.

I don't agree that he is "lecturing".  I may be wrong, but I think that what he is saying is if nephs and their patients are serious about drastically reducing their salt intake, then the best way to do that is to not eat out. That is his professional opinion based on studies that he believes have merit.  Remember that this is a blog mostly for other nephs, so I imagine that he is telling his fellows that advising their patients who are having difficulty with salt-related issues might benefit from this particular tactic.  I don't interpret this as him believing patients are not smart enough to make their own choices.  In your particular case, since you are not a dialysis patient, I suppose all of this is happily irrelevant.  YAY!!

I am all about patient autonomy and empowerment, so if that is his ultimate goal, then I am sure I will eventually come to the same conclusion that you have.

I don't know if he has an ultimate goal unless it is simply to share ideas with other members of the "renal community".  But I have observed that blog entries about dialysis seem to attact the most responses both from patients who are pushing for better dialysis and providers who are more interested in cost.  If you read the "Dialysis Unplugged" blog entries posted by a grand assortment of invited posters, you will see this dynamic.  It's quite interesting, though also frustrating.

[cattlekid]

The other complaint that I have with these draconian statements (e.g., "never eat in a restaurant again") is that there never seems to be any thought given to options for patients.  For example, how is someone who is going on vacation never to eat in a restaurant?  Or my personal pet peeve, how is someone who is working 40 hours a week and on in-center hemo supposed to cook every meal, when getting home from dialysis after a full day of work means sometimes barely having the energy to leave the couch? 

It is statments like this that made me come to despise my dietitian at the clinic I will be leaving in ONE DAY.  I am really excited about seeing the new dietitian because I hear that she is younger and hopefully a little more "hip" to real life.

[Bill Peckham]

The Salt Institute spent a fair bit of time lobbying DSEN to be more welcoming to salt use but I told them that whatever the debate is among urinators the case is closed among dialyzors, if you don't limit your salt you'll pay the price when you go for treatment. If you read the Salt Institute's argument closely you'll notice the supporting studies find no harm in salt intake of 2 to 3,000mg. Right now there are people eating 6 to 8,000mg every day. Not just a few people, a lot of people who eat out for their meals, are mindlessly eating a poisonous amount of salt. Check out a Denny's menu or an Olive Garden, they are what constitutes eating out to the targets of this advise.

That said I didn't think his post was very helpful. One area he didn't mention that I think is an affront to all that is good a decent is plumped chickens and enhanced meat. I've met a number of dialyzors who take the advise and go to the trouble of cooking their own meals only to get cut off at the knees by grocery chain profiteering. Injecting salty water into your fresh chicken or beef and then charging people the same or even more per pound is a con.

The easiest advise is to keep the mg of sodium less than the calories. If you just do that at every meal you're fine.

MM I eat out all the time. I know a great Chinese restaurant that doesn't seem to own a salt shaker and go there for lunch several times a week. I love their soup. I love no salt McDonalds fries they're always hot when you get them. If you're going to eat out be diligent the rest of your meals and you'll be fine. A couple salty meals are going to happen it's when you're eating 6,000mg of salt day after day that you will shorten your life. Dialyzor or urinator as near as I can tell.

[cariad]

I'm surprised that you are not more aware of the "politics" of nephrology these days.  You only have to look at Bill Peckham's and Hemodoc's blogs to see that there is a real battle between providing better dialysis and getting the funding for it.  Patient outcomes vs profit.  Read Bill's entries about EOD dialysis; this shouldn't even be an issue.

I understand the politics of profit vs. optimal dialysis, I guess what I was trying to say is I do not understand what makes it brave for a nephrologist to advocate for better treatment for his patients. I remember reading that gobsmacking article about a nephrologist who dared open a non-Davita clinic near their Colorado headquarters and was being sued to within an inch of his life. Aside from opening himself up to written criticism, is there some consequence that The Kidney Doctor could face within the renal community? Are there people trying to silence him? Does he run his own clinic? I feel like I'm missing something here. I don't know loads about dialysis nephrologists, but the transplant ones, the field is microscopic. Gwyn could tell you about the time that I told the wonderboy about this nephrologist I detested, because this cretin had told me I would die horribly if I underwent the trial. I do not know what possessed me to open my mouth and confess this to my doctor. I knew better! Anyway, the surgeon immediately said "Oh, are you talking about Madison? Dr. XXXX?" (D'oh! Then I had to nod along as the wonderboy defended this jerk.) They will not criticise each other, but that is not what The Kidney Doctor is doing as far as I've seen. If he were publicly calling out his peers, OK then, I get how that is taking a gigantic risk.

Sharing ideas is a nice goal. Advocating is a better one. He's in a position of power, but of course I'm sure his time is limited and I do not mean to judge. The low-salt issue is terribly controversial, and salt restriction can be dangerous. It has been shown to not really have an effect on blood pressure, and increase risk of heart attack. I know this probably sounds like a delusional pipe dream, but it would be nice if a nephrologist out there would be willing to admit that salt restriction is not the best advice for every last renal patient.

[cariad]

Oh, and now I see that Bill has written a response that I want to read, but it will have to wait for now.

I shall return to this discussion....

[MooseMom]

Cariad, it would be very interesting if you were to go to the Kidney Doctor's blog and tell him just what you've posted here, which is what I have done.  You'll notice that I opined that this idea of don't eat out, ever, is unhelpful.  If you do choose to add your own comment, please don't post as "anonymous".

Why not judge?  Tell him you think he's full of crap and that his opinion is based on crap science.  If that's what you believe, you may well be right.  Why not say this to him?  If he's brave enough to open himself up to online criticism, then you can comment as you see fit.  I'm sure he could learn something from not only you but also from any of us who are actual patients.

I was unaware that the salt issue is so controversial and that salt restriction is so perilous.  My guess is that Dr. Singh probably has a wife who cooks for him, and I'd bet the north forty that he has no idea how much salt he consumes in a day. 

My own nephrologist at one time actually told me to use more salt in my cooking to combat acidosis.  I take 12 sodium bicarb tablets a day, so that just goes to show that there is at least one neph who admits that salt restriction is not appropriate for every single renal patient.

I don't know if there is some consequence The Kidney Doctor could face from the renal community as I don't know the extent of his financial involvement with any particular medical institution.  But I personally applaud anyone who goes online and advocates for a frail population against big corporate concerns, particularly in this day and age where anyone can pretty much post anything, and oftentimes does with a particularly vicious and snarling tone.  In these times when no one seems to want to spend money on sick people...when profit comes before patient outcomes...it does strike me as "brave" to see a doctor stand up for his patients and openly call out those corporate interests.  But perhaps it doesn't take much to impress me anymore.  I am gobsmacked these days to hear of the smallest act of goodwill and kindness.

Bill, I don't think there is anything horrible about eating out; I treated myself to lunch out today, and it's a practice I intend to continue.  But I think you are reiterating the point, and that is that most of our salt consumption comes from restaurant foods, and if you are looking to radically reduce your intake (which I understand most dialysis patients should do, but maybe cariad is right in that this is just a bunch of hooey), then your neph should be telling you that cutting back on eating out will be helpful.  That is all.

And good point about the enhanced chicken and meat.  I'll watch out for that; thanks for mentioning it!

PS.  I find it fascinating that there have been several topics about food that have surprisingly erupted in controversy (well, it's been a surprise to me).  Are salt restrictions stupid?  Is wanting your spouse to refrain from eating chocolate covered bananas with a milk chaser in front of your renally compromised self cruel and unusual punishment?  It just goes to show that food and the way we eat it are deeply and emotionally ingrained in ourselves.  Cariad, I think you should find a course on dietary anthropology or some such thing!  I think that would be a fascinating topic! 

PPS:  If anyone could provide links to well-constructed studies that illustrate any dangers in restricting dietary sodium, I'd love to read those studies because this is new to me.  I don't think I've ever heard of anyone warn against consuming too little salt in their diet.  Now, I can understand that some condition may exist that results in too little sodium, and that this may screw up someone's biochemistry, but I've not heard of any danger in consuming too little salt from food.  Thanks!  I'm always eager to learn something that flaunts conventional wisdom.

[Bill Peckham]

I, being firmly in the Scribner camp and thus a strict salt restricter, am occassionally harassed by those in the pro salt camp. As a result I have read a fair bit about salt. Let me tell ya, if you're going to be harassed into reading up on something, salt is not a bad choice at all. Salt is pretty interesting.

So first you asked for the counter research, here is a comment on DSEN from the President of the Salt Institute
http://www.billpeckham.com/from_the_sharp_end_of_the/2009/02/salt-putting-profit-before-health.html?cid=6a00e54fc659eb88340112791a53eb28a4#comment-6a00e54fc659eb88340112791a53eb28a4

He writes:

On behalf of the Salt Institute, let me make just two points:

1 Paterna S ; Gaspare P ; Fasullo S ; Sarullo FM ; Di Pasquale P., “Normal-sodium diet compared with low-sodium diet in compensated congestive heart failure: is sodium an old enemy or a new friend?” Clin Sci (Lond)., 2008; 114(3):221-30 (ISSN: 1470-8736).

2 Paterna, S., et al., “Medium Term Effects of Different Dosage of Diuretic, Sodium, and Fluid Administration on Neurohormonal and Clinical Outcome in Patients With Recently Compensated Heart Failure,” American J. Cardiol., 2009;103:93–102.

And offer our summary athttp://www.saltinstitute.org/content/download/8099/43917.

These reports are from the only prospective randomized controlled trial of health outcomes from a low-salt diet. Look at the data...please.

Dick Hanneman
President
Salt Institute

>>>>>>>>>>>>>>>>>--------------<<<<<<<<<<<<<<<<

This was pretty irritating because it was Anna who got him to comment first, I would have liked to have written the post that got him to type something.  I think I was who found the horrible Oz menu she is commenting on.  BTW Anna is totally on the Salt Institutes list ... if anything ever happens to her that's where I am looking first.

If you want to know my view on it DSEN has a Salt tag - there are 12 posts

Hilariously he commented two months later on one of my posts, his comment just pretty much made my year. My little dig hit its target - behold the internet.

The main things I've learned in my reading (there's a great book Salt: A World History [Paperback] by Mark Kurlansky)  is Salt was critical to the formation of human society and people eat a lot of it. The problem just about all the studies seem to have is the issue of how do you measure how much salt someone is eating, especially over the long haul - months, years.

The Salt Institute likes the studies that model salt intake from urine output. But the models aren't calibrated for each person so, well you should take the studies with a grain of salt.

But just a grain.

[MooseMom]

I'll never think of asparagus again without giggling.

[cariad]

Cariad, it would be very interesting if you were to go to the Kidney Doctor's blog and tell him just what you've posted here, which is what I have done.  You'll notice that I opined that this idea of don't eat out, ever, is unhelpful.  If you do choose to add your own comment, please don't post as "anonymous".

Why not judge?  Tell him you think he's full of crap and that his opinion is based on crap science.  If that's what you believe, you may well be right.  Why not say this to him?  If he's brave enough to open himself up to online criticism, then you can comment as you see fit.  I'm sure he could learn something from not only you but also from any of us who are actual patients.

OH MY GOD!!! WHAT??!!
I have read one of his postings (this one) and skimmed a few others. I don't believe he is 'full of crap' and would never, ever stomp onto someone's personal site and say anything of this nature. Just because I can does not mean I should or would.

I was unaware that the salt issue is so controversial and that salt restriction is so perilous.

I have been researching this for Public Health, because the EMT who wants to be a doctor asked me for proof that salt was not a significant factor in blood pressure. I would not say salt restriction is so perilous across the board, I would say that salt restriction as a public policy, and especially as a knee-jerk response to a patient in renal failure, could have negative consequences. It's nice to hear that yours is not like this. My first Milwaukee nephrologist was.

Maybe my confusion with The Kidney Doctor stems from the fact that I considered myself a renal patient, but he seems to be speaking more to the dialysis community. As Bill has pointed out, there are different issues for people in different stages of renal therapy. My mother, who severely limited my salt as a child, demanded to know why anyone post-transplant would limit their salt intake. (I was telling her about Vegas) Bizarrely, this is one issue that we seem to agree on at the moment. I told her that it was none of my business how someone else ate, and that once you start limiting sodium, you lose your taste for it, so chances are people who limit salt would shudder if they tasted foods that I eat on a regular basis.

I don't know if there is some consequence The Kidney Doctor could face from the renal community as I don't know the extent of his financial involvement with any particular medical institution.  But I personally applaud anyone who goes online and advocates for a frail population against big corporate concerns, particularly in this day and age where anyone can pretty much post anything, and oftentimes does with a particularly vicious and snarling tone. 

Well, advocating for patients would suggest that he wants to see change, and would be for patient education, empowerment, autonomy, etc. I really do not see how anyone could be called an advocate in this age without being for those things. So, again, I have barely read anything from this person and wrote about my initial confusion about this person's place in the renal world. However, if he IS advocating, then he is doing more than most and like I said, I'm sure I'll come to the conclusion that he is an excellent addition to the pro-kidney patient side.

Bill, I don't think there is anything horrible about eating out; I treated myself to lunch out today, and it's a practice I intend to continue.  But I think you are reiterating the point, and that is that most of our salt consumption comes from restaurant foods, and if you are looking to radically reduce your intake (which I understand most dialysis patients should do, but maybe cariad is right in that this is just a bunch of hooey), then your neph should be telling you that cutting back on eating out will be helpful.  That is all.

Let's not conflate what I am saying - that there is compelling evidence that salt restriction is not healthy for the entire country, and not even for all renal patients - with what Bill is saying, which is that dialyzors who no longer urinate need to limit salt, and that there is really no controversy over that particular issue. I defer to his vastly greater knowledge on this. I, too, find salt fascinating. (Definitely, food as a topic in anthropology is huge. I had a prof who used to say that all anthropologists ever study is food, sex, and death.) I guess in rereading The Kidney Doctor's post, he is not saying that all kidney patients need to limit salt, so I don't want to put words in his mouth. Suggesting that doctors tell renal patients to stop eating out - I am having a difficult time not taking this as an insult. That to me assumes that renal patients cannot handle the challenge of negotiating restaurants and diet restrictions.

I also cannot be the only one who is tired of hearing the exact same diet advice for 30+ years. Are there really people out there who haven't heard the sodium/fat/calories rhetoric to death? I took the boys to a new pediatrician the other day. He had his little computer out and was showing me where they are on the BMI scale. Gah! Really?! I don't care! Am I the only mother who finds it presumptuous of a doctor to offer unsolicited advice on how to feed my kids? I don't want them to turn out like me, refusing to see a doctor for years because I did not want to hear the same tired lines that were totally irrelevant to my life. This has nothing to do with what The Kidney Doctor wrote, but I'm sure it was informing my initial response to your post.

[Traveller1947]

This is all getting much too complicated.  Dannyboy and monrein have it exactly right.  Whether we eat out frequently or seldom, share meals with family or friends that others have prepared or prepare every meal ourselves, we as renal patients know we should make careful choices about what we eat.  Do that and then relax and enjoy!

[Meinuk]

BTW Anna is totally on the Salt Institutes list ... if anything ever happens to her that's where I am looking first.[/left]

I am having an excellent time with my guerrilla war against Salt (and maybe the NKF too) 

Some of the highlights of my life are when people realize "Crap, that's the woman from the internet".

It just feels good that now, three years later, the rest of the world is catching up with us.

[sullidog]

as someone who doesn't have a salt/fluid restriction I can tell you that if I did I would still eat out every once in a while. I am totally blind so I don't cook from scratch so this would be hard for me.

[jbeany]

I don't eat out much these days, but it's got less to do with my doc telling me I can't have salt than it does with my bank telling me I don't have silver.

 Are there really people out there who haven't heard the sodium/fat/calories rhetoric to death?

Maybe just the woman who is leading the class action lawsuit against the makers of Nutella.  She's written right in her federal complaint that she couldn't have know that Nutella was "no better than a candy bar" because she wasn't a medical professional who reads "scholarly publications."  Funniest thing I've read all semester, especially when she described the class for the class action as everyone who had purchased Nutella in the last 4 years since no one would have bought it if they had known it wasn't a health food.  Apparently, she's never actually tasted it...

[Jean]

What would be the point of being alive, if you could not do anything you liked on occasion. We dont eat out much, but that is the way I was raised, the woman cooked. Plus, I do enjoy cooking and such. The point of the whole thing is to still enjoy yourself and enjoy your life.

[lmunchkin]

What would be the point of being alive, if you could not do anything you liked on occasion. We dont eat out much, but that is the way I was raised, the woman cooked. Plus, I do enjoy cooking and such. The point of the whole thing is to still enjoy yourself and enjoy your life.

My sentiments exactly, with the exception of cooking!  Lol.  I don't like cooking, but love to eat! The thing is, if things are done in moderation, I believe you can enjoy your food and the Family!  With the Holidays rapidly approaching, I hope ALL will do just that! I think sometimes we concentrate too much on trying to stay alive, that we forget to enjoy while living!

lmunchkin