The emerging need to manage diet, and more specifically sugars, salt and processed foods, is a challenge in India. Sources like these remain hidden and we must be aware and informed prior to making our dietary choices
A recent study by the George Institute for Global Health has made some startling revelations about an innocuous, yet insidious, enemy we find and use in our daily lives. The study indicates that as against the World Health Organisation’s daily consumption recommendation of five gms per day for a healthy adult, Indians are consuming over 10gms of salt per day. This great penchant for salt comes from the Indian diet that uses it in greater amounts than the West, the manifold increase in the use of packaged and processed foods and general unawareness of the sources of salt from various seen and unseen sources.
Salt, as we know, has been intrinsically linked to heart disease and more specifically hypertension. The sodium that constitutes one half of salt contributes to the regulation and physiological dynamism of blood pressure. Increase intake in salt has aninvariable effect on blood pressure.
Hypertension prevalence in India, as per the Indian Council for Medical Research, is in the range of 25 per cent, while pre-hypertension, a sub-clinical condition that can lead to eventual hypertension, is by some estimates and equivalent amount. Therefore, nearly 50 per cent of Indians, are either predisposed to or suffer from hypertension. Hypertension is one of the leading risk factors for deaths worldwide and accounts for seven per cent of the disease burden.
Hypertension is the leading cause of cardiovascular disease and stroke, which attributes to amongst the leading causes of mortality in India. A recent article by Prabhakaran in the journal circulation highlight that cardiovascular diseases (CVDs) have become the leading cause of mortality in India. A quarter of all mortality is attributable to CVD’s. India specifically is a cause of concern, as researchers point out, “that the early onset of disease, including accelerated buildup and high fatality rates” make us an exceptionally bleak case in global health.
While contributory factors and their link, direct and indirect, to chronic diseases remain complex, the need to fast-track changes in modifiable risk factors and causes is essential. These modifiable risk factors include diet and exercise, restriction of alcohol intake, curb on tobacco exposure and stress and lifestyle management.
Within this cohort, the emerging need to manage diet and more specifically sugars, salt and processed foods high in fats is a challenge and needs our collective attention. Salt consumption in India has been linked to our traditional diets and also the globalisation of cultures that have given us foods with higher salt content.
The conventional wisdom, that given the tropical weather and resulting higher perspiration rates, Indians must consume more salt, is also being chipped away at its edifice. With increased urbanisation, climate controlled environments at home and work and more sedentary lifestyles, the need for additional salts in our diets may be overstated.
Similarly, hidden sources of salt from processed foods to restaurant food and the myriad range of preservatives and ready of eat delights that make their way to our dining tables is a cause for concern. There have been collective calls from doctors, activists and researchers to increase front-of-label information on food items to make them more actionable and intelligible for the consumer.
Specifically mentioning salt and sugar content has been a clarion call and there has been much progress on this front. Additionally, the doctor community would need to ensure that their fraternity as a whole and not just cardiologists, offersound advice on consumption patterns to every patient, irrespective of whether they are predisposed to chronic diseases.
On the supply side of the issue, industry constituents must offer alternatives that include low-salt varieties in their product range for consumers to make an informed choice. Restaurants, street food vendors and manufacturers must work towards a considerable reduction in salt in their products.
The Ministry of Consumer Affairs, Food and Public Distribution and the Ministry of Food Processing Industries along with the FSSAI must create consumer awareness on the dangers of a high salt diet and the availability of alternatives.
On the demand side, we must ensure that we keep a check on the amount of salt we consume. Small changes like keeping the salt-shaker in the cabinet rather than on the table or avoiding adding salt to fruits and salads or to cooked foods are all small yet significant steps.
Schools, colleges and educational institutions must partner with like-minded institutions to raise awareness on the sources of and dangers of high-salt diets. We must also become more mindful of the sources of salt. How many us know that bread can contain as much 230 milligrams of sodiumIJ Or as the Cleveland Clinic points out, fizzy drinks long associated with excessive sugar, contains sodium. These and others sources remain hidden and we all must become more aware and informed, prior to making our dietary choices.
(The writer is general manager, Operation &Public Affairs, Indraprastha Apollo Hospitals)