More salt intake a reason for high prevalence of hypertension, chronic renal diseases
Keralites consume about six to seven times more than the recommended daily intake of dietary salt per person, making excessive salt intake one of the potential reasons for the high prevalence of hypertension and chronic renal diseases in the community.
The WHO-recommended level of daily intake of salt is about 5 gm (which works out to about 2 gm of sodium). In Kerala, on an average, a person consumes about 25 to 35 gm of salt through the diet daily.
Excessive intake of dietary salt is a well-established risk factor for hypertension, which seems to be the gateway for all other non-communicable diseases. As 30.5 per cent of all deaths in Kerala have been found to be due to coronary heart disease and stroke, uncontrolled hypertension is a significant contributor to the mortality and morbidity burden here.
With an estimated 33 to 40 per cent of those above 30 years in the State already suffering from high blood pressure, a mass movement for dietary salt restriction will have to be the most strategic and urgent public health intervention required in Kerala to stem the glut of lifestyle diseases, says S. Sivasankaran, Professor of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology.
The WHO has chosen to focus on high blood pressure as a major public health problem on the occasion of World Health Day (April 7) and has drawn attention to the fact that excessive salt consumption is the seventh leading cause of mortality in the South East Asian Region (SEAR).
“Packed convenience foods and processed meats have become a staple in most homes but these contain high amounts of sodium. One serving of the noodles (pre-cooked packet noodles) that you give your children has sodium content which is more than an adult’s normal daily requirement. Excessive salt intake coupled with low consumption of fruits and vegetables – which are rich in potassium and can counteract the effect of sodium – is setting our future generation too on a destructive path,” he points out.
Sodium is vital for the body and excess sodium is flushed out by the kidneys into the urine. But when salt intake becomes excessive, the kidneys are unable to remove all sodium. The excess sodium in the bloodstream leads to water retention and an increased blood volume, thus raising the blood pressure.
Sailesh Mohan, senior research scientist and associate professor, Public Health Foundation of India, points out that population-based strategies to reduce dietary salt intake is one of the most cost-effective and potential ways to reduce the incidence of CVDs.
Many studies have proven that even modest salt reduction can lead to a decrease of 2 mm hg diastolic pressure and an estimated reduction in the prevalence of hypertension by 17 per cent.
In Kerala, even a good percentage of children and adolescents too have been found to be having high blood pressure. A study among 19,000 schoolchildren by the Amrita Institute of Medical Sciences in 2005-06 had found that the study population had significantly higher blood pressure values than the international reference population.
A study in 2007-08 among students of classes I to VII in select government schools in Thiruvananthapuram by SAT Hospital found that 2.8 per cent of the children had high blood pressure.
The Achutha Menon Centre for Health Science Studies followed up 297 individuals aged 15 to 64 years in rural Kerala, who were free of hypertension at the time of study enrolment, from 2003 to 2010. Nearly one-quarter of this population developed hypertension during this period, underscoring the need for primary prevention of hypertension.
Apart from restricting the consumption of salt-laden foods such as chips, pickles, papads, cheese and processed meat like sausages, simple measure like shaking the salt-shaker habit can go a long way in reducing blood pressure, public health experts point out. Increasing the consumption of fruits and vegetables, which are rich in potassium, is one good way of balancing the high intake of sodium.