Context: Indians are consuming more than the WHO-recommended amount of salt every day, 8 gm instead of 5 grams across all categories of people, according to a recent survey by the Indian Council of Medical Research (ICMR). The study is based on a sample survey carried out as part of the National NCD Monitoring Survey (NNMS) in India
About salt intake in India
- Salt intake was higher in men (8.9 gm), employed people (8.6 gm), and current tobacco users (8.3 gm).
- The consumption was also higher than the mean among obese persons (9.2 gms) and those with high blood pressure (8.5 gms).
Need for limiting salt intake
- Salt reduction is a cost-effective and practical approach to preventing cardiovascular disease (the foremost cause of mortality worldwide).
- Cardiovascular diseases account for an estimated 28.1 % of total deaths in India. In 2016, 1.63 million deaths were attributable to hypertension compared to 0.78 million deaths in 1990. Reducing salt intake to 5 grams can reduce high blood pressure by 25 percent.
- The Indian economy faces losses surpassing $2 trillion between 2012 and 2030 due to cardiovascular diseases according to the World Economic Forum.
- India has got a score of 2 which signifies the presence of at least one voluntary policy, emphasising the need for more rigorous efforts to address this health concern.
WHO Guidelines on Sodium Intake recommends
- A reduction in sodium intake to reduce blood pressure and risk of cardiovascular disease, stroke and coronary heart disease in adults. WHO recommends a maximum intake of <2000 mg/day sodium (<5g/day salt) in adults.
- Implementing front-of-pack labelling to help consumers select food products with lower sodium content.
- All 194 Member States of WHO have committed to reducing population sodium intake by 30% by 2025 in 2013. However, as no country in the world is on track to attain this target. WHO has proposed 30% reduction target for 2030.
- WHO has documented progress to date on policies through Sodium Country Score Card. It assesses country implementation of sodium reduction policies and other measures, allocating a score from 1 (for lowest level of implementation) to 4 (for highest level of implementation).
Suggestions for reducing Sodium Intake
- Maximum sodium content limits in foods: Setting of global sodium benchmarks is critical to facilitate reformulation of food products, which contributes to driving progress in sodium reduction.
- Healthy public food procurement & service policies: Government should lead by example through the implementation of mandatory policies of sodium reduction that cover food and beverages purchased, subsidised, prepared, served in public agencies.
- Marketing restrictions: Implementing mandatory marketing restrictions is needed to limit exposure to unhealthy foods and beverages, to decrease demand for these products and to provide industry incentive to reformulate and market healthier products.
- Fiscal policies: Fiscal policies to reduce population sodium intake include taxes on unhealthy foods and beverages or removing tax benefits for development and marketing of foods high in sodium. They can be strengthened by earmarking revenue for subsidies for fresh fruits and vegetables, or for implementation of other sodium reduction strategies.
- Use natural salt substitutes: Like lemon and its zest, which give a tangy effect and also help bring down blood pressure. Crushed garlic, oregano, black pepper and seasoning make for good coverage in salads.
- Reducing salt cravings: Drinking water infused with lime, orange and mint to reduce craving. Salt cravings make you thirsty and indicate magnesium and calcium deficiencies, which need to be corrected.
- The Food Safety and Standards Authority of India (FSSAI) has implemented the ‘Eat Right India’ movement to transform the nation’s food system to ensure secure, healthy, and sustainable nutrition for all citizens.
- FSSAI launched a social media campaign called ‘Aaj Se Thoda Kam.’ However, the average Indian’s sodium intake remains alarmingly high (approximately 11 grams).
About National NCD Monitoring Survey (NNMS)
- It is the largest comprehensive national Survey on risk factors and health systems preparedness of non-communicable disease (NCD) conducted by the Indian Council of Medical Research (ICMR) – National Centre for Disease Informatics & Research (NCDIR), Bengaluru, Government of India with the support of Ministry of Health and Family Welfare.
- It also provides framework on the use of telemedicine for cancer, heart diseases, diabetes, and stroke.
- The survey was conducted with the purpose of collecting the reliable baseline data on key indicators such as select NCDs, risk factors, and health systems response related to the National NCD monitoring framework and its Action Plan.
- The year 2010 will serve as a baseline for assessing the progress made for achieving the NCD targets in 2015, 2020 and 2025.