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Study shows Tamil Nadu tops in excess salt intake
With a fondness for spicy rasam, pappadams and pickles, people are putting themselves at health risk. Doctors say more awareness and government intervention is needed to ensure burden of non-communicable diseases is down
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Chennai
Indians and more specifically South Indians consume more than the World Health Organisation-prescribed salt intake of five grams per day, indicating that the high intake of salt needs to be addressed to control the growing burden of non-communicable disease.
A study carried out by the Australia-based George Institute for Global Health published recently, found that while most of India consumed more salt, way beyond the 5 grams per person per day limit, the southern and eastern states topped the list in the country. Tamil Nadu fell in the 7-8 grams per day category, thanks to the high salt-intake diet.
Talking to DTNext, Dr Vivekanand Jha, executive director, The George Institute of Global Health said that there was not much difference between the urban and rural intake patterns. He said, “The diet filled with pickles, appalams/ pappadams and hot, spicy rasam are some of the biggest contributors to high salt intake. Even when we compare the rural and urban eating patterns, the levels are in the same category only the sources differ.”
High salt intake and CVD
In Tamil Nadu, the crude mortality death rate due to cardiovascular disease (CVD) is highest in the country, according to doctors. The recent National Family Health Survey-4 (201516) found the prevalence of above normal systolic and diastolic levels among men in the state— 11.5 per cent —and 6. 2 per cent among women.
Dr M Somasundaram, consultant cardiologist, says that the first thing that a person with higher blood pressure levels is asked to do is to cut salt intake. He said, “Over a period, excess salt makes your body retain water and increases blood pressure, raising the strain on the heart.”
Today it's ‘all eat and no play'
Dharini Krishnan, consultant dietician, says that originally when people hours spent out in the sun, the excess salt in the body was pumped out as sweat. “Today, have air conditioned homes, air-conditioned offices and we travel between them in air conditioned cars. Thus there is no scope for sweating,” she said. She also pointed out that despite home cooked food, the high salt intake in our diet today is due to increase in consumption of packaged foods. “The soup you make at home may contain 2 mg of sodium, but the same goes as high as 20 mg when we have ready-made soups. World over, people eat oats with sugar, only here do we have processed masa la oats which is again high in sodium,” she added.
Dr Jha said that the study shows that the high intake of salt calls for government action and proactive measures from all parties concerned. He said, “The manufacturers of food products should be made to follow global guidelines with regard to packaging. There must be an awareness created about abundance of salt in street food. Moreover, manufacturers should be socially responsible for the content of the food.”
Iodised salt
Salt may be indispensable as it also meets nutritional requirements on a large scale. Iodised salt has been a formula to make up for the deficiency in iodine among people. Salt being the most affordable has become the medium. However, experts feel that that alone cannot make up for the gap in iodine requirements. More recently, the iron deficiency that is prevalent among 30 per cent of the population is being met through double fortified salt with iodine and iron.
WHERE IT PINCHES
The World Health Organisation (WHO)'s guidelines on salt intake are rarely followed in India, with the southern and eastern states liberally helping themselves to more salt in their daily food intake
Recommendations for salt reduction:
FOR ADULTS: WHO recommends that adults consume less than 5 g (just under a teaspoon) of salt per day 1.
FOR CHILDREN: WHO recommends that the recommended maximum intake of salt for adults be adjusted downward for children aged two to 15 years based on their energy requirements relative to those of adults. This recommendation for children does not address the period of exclusive breastfeeding (0–6 months) or the period of complementary feeding with continued breastfeeding (6–24 months).
All salt that is consumed should be iodised or “fortified” with iodine, which is essential for healthy brain development in the foetus and young child and optimizing people’s mental function in general.
WHO on salt, sodium and potassium
- Sodium is an essential nutrient necessary for maintenance of plasma volume, acid-base balance, transmission of nerve impulses and normal cell function.
- Excess sodium is linked to adverse health outcomes, including increased blood pressure.
- The primary contributors to dietary sodium consumption depend on the cultural context and dietary habits of a population.
- Sodium is found naturally in a variety of foods, such as milk, meat and shellfish. It is often found in high amounts in processed foods such as breads, processed meat and snack foods, as well as in condiments (e.g. soy, fish).
- Sodium is also contained in sodium glutamate, used as a food additive in many parts of the world.
- Potassium is an essential nutrient needed for maintenance of total body fluid volume, acid and electrolyte balance, and normal cell function.
- Potassium is commonly found in a variety of unrefined foods, especially fruits and vegetables.
Study findings
The study titled ‘Mean population salt consumption in India: a systematic review’ found that mean daily salt intake showed a geographic pattern of higher salt intake in southern and eastern states compared to northern and western areas.
- Tamil Nadu rural and urban population had an average salt intake between 7 and 8 grams per day per person.
- South saw a high intake of salt through pickles, appalams and spicy rasam.
- High BP is the leading risk for non-communicable disease in India where the prevalence.
- Rates of hypertension are anticipated to nearly double from 118 million in 2000 to 213 million by 2025.
- Salt is a leading cause of high BP and has been associated with the risk of vascular disease as well as other serious health problems.
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