Harnessing low sodium salt to combat cardiovascular disease in India

Salt, the humble mineral found in every kitchen and dining table, has an enduring presence in human history. Its value as a commodity has sparked movements and even wars throughout history. In India, salt played a symbolic role in our fight for independence during Mahatma Gandhi’s Dandi March against the colonial salt monopoly. More recently, salt fortified with iodine has helped reduce iodine deficiency disorders like goitre in the country.

However, the overconsumption of salt can be detrimental to our health. Sodium, a key component of salt, can lead to high blood pressure, a major contributor to cardiovascular diseases (CVDs). In India, Non- Communicable Diseases (NCDs) account for a significant 63% of all deaths, with CVDs responsible for 27% of them. Most alarmingly, in India – younger individuals are increasingly affected by heart diseases, which in many cases could be preventable.

This challenge persists due to insufficient awareness about hypertension, inadequate primary care, and limited post-diagnosis follow-up.

According to the World Health Organization (WHO), the recommended average daily salt intake should remain under a teaspoon (5 grams). However, in India today salt consumption averages at roughly double that amount, at 2 teaspoons, or between eight and 11 grams per day. Excess salt intake is strongly linked to elevated blood pressure and increased risk of CVDs, including heart attacks and strokes. Overuse of salt at home, frequent dining out, and consumption of packaged foods are the primary contributors to high sodium intake. While the FSSAI regulates processed foods, other strategies for sodium reduction are the need of the hour.

Low Sodium Salt (LSS), which substitutes potassium chloride for a portion of sodium chloride, offers hope. High potassium intake is associated with lower blood pressure, offering an effective solution to keeping the sodium-potassium ratio in check, which is crucial for reducing CVD risk. LSS can not only reduce sodium intake but also address iodine deficiency disorders, making it a valuable public health intervention. Although low-sodium salt substitutes are available in India, awareness is low, availability is limited, and prices are relatively high.

We must educate ourselves on ways to reduce our salt intake, overall, and the importance of choosing low-sodium salt as a substitute for regular salt where possible. The profound impact of cardiovascular diseases on individuals and families can be mitigated by a small change in our daily routines. Low sodium salt isn’t just about reducing the saltshaker’s contents; it’s about safeguarding our heart’s health, and ensuring a future filled with vitality and well-being. By choosing LSS, we are not only taking control of our own health but also setting a powerful example for our loved ones.

For every individual to put this in practice is critical; however, action is required at the policy and programme levels too. More and more information in the public domain can help educate people about the importance of salt reduction and the safety and effectiveness of low sodium salt. Affordability is crucial, so collaboration with both government and private sectors is essential to reduce the cost of LSS, making it accessible to people from all income backgrounds. Ongoing research and advocacy efforts are needed to maintain LSS’s safety and nutritional standards, involving stakeholders from health experts to food producers. By adopting these strategies, we hope to seamlessly integrate LSS into the lives of millions of Indians, significantly reducing the burden of cardiovascular diseases and enhancing the overall health of our nation. Let us all work together for a healthier future.

In our ongoing effort to tackle the widespread issue of heart diseases in India, your choices matter more than you might think. You can make a real difference to your heart’s health by simply paying attention to what’s on your plate. Start by checking food labels for sodium content – opt for products with less salt. Try cooking more meals at home; it’s a rewarding and healthier choice. Gradually cut back on the salt you add to your dishes – your taste buds will adjust over time. Embrace fresh, natural and seasonal ingredients in your meals, and make sure you’re staying hydrated; it’s like giving your heart a refreshing drink of life. Reducing your consumption of processed and fast foods is a significant step towards a healthier you. When dining out, be mindful of condiments and go easy on them, and consider limiting your intake of processed meats. When possible, opt to use low sodium salt, which will considerably cut down the risks to your health. Your heart will thank you for these simple yet powerful changes, and together, we can build a healthier, heart-strong India.

This article is authored by Dr Balram Bhargava, chief, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi.

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