Low sodium salt unsuitable for patients with renal issues: Doctors
For patients with renal issues, more potassium in their diet is counter-productive.
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CHENNAI: In a recent study by Indian Council of Medical Research and National Institute of Epidemiology (ICMR-NIE), it was found that Indians consume 2.2 times more salt than the amount recommended by WHO. As an alternative for salt, low sodium salts – containing potassium or magnesium – are available in the markets.
This is suitable only for healthy people, as potassium is a mineral that doctors strongly disapprove of for kidney patients.
“Less sodium and more potassium is advisable for healthy people. But in this current lifestyle, it’s less sodium and more potassium as consumption of junk food is high and less of vegetables. When consumption of sodium increases, it leads to thicker blood vessels. More salt also leads to diseases like hypertension,” said Dr N Gopalakrishnan, a nephrologist and member secretary, Transplant Authority of Tamil Nadu.
For patients with renal issues, more potassium in their diet is counter-productive. “Low sodium salt is fine for people with kidney issues but not high in potassium, as around 95% of the excretion of potassium occurs through kidneys. With kidney failure, patients are at a higher risk for hyperkalaemia (elevated potassium levels in the blood), so we restrict them,” he added. “For instance, tender coconut water which contains 140 moles of potassium is like a poison for kidney patients. They are required to follow the diet prescribed by doctors.”
Major hidden salt sources in the Indian diet are pickles, instant noodles, biscuits, cookies, bread, vada pav, chips, papad, namkeen, canned and packaged food. According to the study, an Indian consumes around 11 gm of salt per day, which is 2.2 times more than the WHO recommendation (5 gm/day).
“The increased sodium intake will lead to hypertension which is linked to cardiac issues. Kidney problems can also lead to heart failures. Patients who have both kidney and heart problems are advised to take a maximum of 2 gm of salt,” opined Dr P Anbuselvan, cardiologist, Kilpauk Medical College.
Lesser sodium consumption helps reduce blood pressure and improves overall heart health, making low-sodium alternatives a meaningful switch, especially for those with hypertension, said Dr Sharan Murali, a senior scientist at National Institute of Epidemiology (NIE) and principal investigator of the study.
The NIE conducted a market survey across 300 retail outlets in Chennai to assess the availability and pricing of low-sodium salt (LSS). They found that LSS was available in only 28% of retail outlets. It was seen in 52% of supermarkets, but a dismal 4% in small grocery shops. The price of LSS averaged Rs 5.6/100 gm, more than twice the price of normal iodised salt (Rs 2.7/100 gm).
The study suggests cutting down salt intake and reformulating processed food, front-of-pack labelling and also raising awareness. The strategies to reduce the sodium intake are to eat mostly fresh, minimally processed foods, cook with little or no added sodium or salt, choose foods with lower-sodium content, or low-sodium products, remove salt-shaker/container from the table, use herbs and spices to flavour food, rather than salt, replace regular table salt with lower-sodium salt substitutes that contain potassium, limit the consumption of processed foods.
“Just switching to low-sodium salt can lower blood pressure by 7/4 mmHg on an average, a small change with a big impact,” Dr Murali added.
