Salt A common culprit, be aware and act

Reducing the impact of Kidney disease and its associated health problems is the need of the hour. A very apt topic to understand and act upon is SALT (Sodium Chloride) intake, given its significant impact on health.

Humans are genetically programmed to need 0.25 grams per day, but the median intake in most countries has risen to nearly 8 – 12 grams per day presently. This phenomenon is profound in South Asia, which accounts for 80% of Kidney diseases in the World. Excessive salt intake is linked to higher blood pressure, heart attack, heart failure, and Kidney disease. However, the silent and steady uptrend of salt intake and its negative health impact has not received its due recognition especially compared to sugar.

The increase in salt intake has been rather exponential with socio-economic development due to the shift in the type of constituents in our food plate. Amore significant proportion of the food we consume is not cooked at home, semi-processed, or processed. As a result, there is a simultaneous decrease in the intake of fruits and vegetables. Urbanisation, mass production of meat, lower cost of packaged food are drivers of this transition. In addition, our food is more energy-dense high in saturated fats, trans-fats, sugars, which also raises the risk of heart disease, stroke, renal disease, and hypertension.

But to achieve significant change in behavior for most of us, individual knowledge, motivation, and action will be woefully inadequate. Therefore public health advocacy, interventions, and regulation are an absolute necessity. For example, The World Health Organization (WHO) is a global campaign '#LessSalt' that has mandated a salt-controlled diet for a healthy lifestyle. The campaign has called out the excessive consumption pattern of Salt. It has been recommended that a salt intake of less than 5g/day is the most cost-effective measure countries can take to improve population health outcomes, which ultimately can prevent 2.5 million deaths every year.

All member states under WHO have agreed to reduce the global population's salt intake by a relative 30% by 2025. Many countries have adopted policies on the individual and community level to reduce Salt consumption. While developed countries have initiated policy interventions targeting the source, emerging economies like India have significant ground to cover. A notable example is mandating the food industry to label food products by marking food products with sodium to help consumers make an informed choice.

The link between Salt and Kidney Disease (CKD) is growing in importance; with chronic kidney disease becoming the eighth leading cause of death in India as per the Global disease burden study in 2015 .CKD in the Indian population has shown an upward trend over the last two decades. Studies from Urban India have also demonstrated a high prevalence of CKD in the background of the high prevalence of Diabetes and high blood pressure influenced by the urban lifestyle of less physical activity and intake of energy-dense and high salt food.

Now that we all have understood the impact of Salt on our health, it is imperative to sensitise individuals, communities, the food industry, policymakers, advocacy groups, and politicians to the harmfulness of excessive salt intake. Furthermore, a targeted and calibrated action is the need of the hour.

(Dr. Suresh Sankar, Senior Vice President, Clinical Affairs, NephroPlus)