Meals ready to eat: a brief history and clinical vignette with discussion on civilian applications.

Meals ready to eat (MRE) have undergone many revisions of their origins in the trench ration from World War I. The MRE was implemented in 1980. Its design allows extended storage and easy, safe meal preparation. MRE sodium content varies by meal and may range from 1.6 g/meal to 2.3 g/meal. The average MRE contains 1,200 kcal. When consumed as intended, MREs are adequate for maintaining a soldier's physical parameters without undesirable consequences. The average soldier has a healthy cardiovascular system, has the ability to excrete high sodium loads, and has high insensible losses. The American Heart Association recommends limiting sodium to 2.3 g/day for the general population. Additionally, those with heart failure should limit sodium to 2 g/day. Excess intake of calories and electrolytes may lead to adverse outcomes in certain populations. We describe a case of heart failure exacerbated by regular MRE consumption and the "perfect storm" of risk factors encountered with postdisaster distribution of MREs to a civilian population.