Why Are Healthcare Bodies Asking Indians To Reduce Their Salt Intake?

The recent call to action by several health bodies for reducing salt intake to address increasing rates of Hypertension in India is a much-needed step towards tackling an acute health issue. Excessive salt (Sodium) intake can increase blood pressure, leading to Hypertension. High salt intake also impairs the function of endothelial cells, the inner lining of blood vessels, causing them to constrict. This creates additional strain on the heart and contributes to Hypertension.

In its current form, the usual Indian diet contains several hidden Sodium sources. Often the dough for Chappatis is mixed with salt to make it soft, and salt is also added to rice for flavor. Pickles, Papads, and raita the common accompaniments in Indian meals are loaded with salt. Chutneys, though homemade, can still have significant salt in it. We also have a habit of sprinkling table salt on salads and fruits, this adds to our Sodium count.

 We have started leading hectic & busy lives, and this has led to a rise in the consumption of processed foods like instant noodles, chips, and canned soups - all of which contain a substantial amount of Sodium. Ordering food has become the norm and restaurant food, even traditional vegetarian meals, and street foods often exceed the recommended Sodium limits. The World Health Organization (WHO) recommends salt consumption to be less than 2 grams of Sodium (that means 5 grams of salt) per day, but in its current form, the Indian diet contains twice the recommended amount of Sodium, as the study highlighted. 

Excess salt intake has both direct and indirect adverse effects. High salt intake over a long period impairs Kidney's ability to regulate blood pressure. The Glomeruli, the functioning units where the blood is filtered, end up overworking, leading to a condition called Hyperfiltration. Hyperfiltration perpetuates damage to these filters and the cycle continues. This leads to progressive loss in Kidney function. Sodium-induced hypertension contributes to the thickening of heart muscles, which is also known as Left Ventricular Hypertrophy, this increases the risk of heart failure over time. It also leads to elevated Blood Pressure (BP) levels which continues to be the most significant modifiable risk factor for Stroke.

Reducing Sodium intake is one of the key lifestyle modification strategies for managing Hypertension. Cutting down on salt intake not only helps bring down Blood Pressure but also reduces the risk of heart attacks and strokes. In patients with Chronic Kidney Disease, salt restriction slows down the progression of the disease. It reduces protein loss in the urine to an extent and there are several simple strategies we can deploy to limit salt intake. 

For starters, we can start cooking at home. That gives you the freedom to prepare meals with measured salt quantities. Avoid or restrict intake of pre-packaged snacks and ready-to-eat meals. Use fresh vegetables and fruits instead of canned or preserved products. Watch out for Sodium content in foods marketed as "healthy." When you cook at home you can also enhance the taste with alternatives like Cumin, Coriander, Lemon, or Garlic.  The commercially available salt substitutes like "low sodium salt" may not be a good idea if you have Kidney problems. 

Managing salt intake is the first essential step towards prevention and treatment of Hypertension. While small dietary changes might seem insignificant, they can significantly improve cardiovascular and Kidney health over time. However, a comprehensive approach, which inculcates both dietary changes and lifestyle modifications, remains critical for long-term Hypertension control.

Dr Vaibhav Keskar

Guest Author Consultant-Nephrology, Fortis Hospital Mulund