Reduce high sodium levels

We often hear of warnings to reduce salt intake. But why wait till we get diagnosed with hypertension to do so? Most of us are unaware of how much we consume and assume we don’t need to worry about it unless we have high blood pressure (BP). They say prevention is better than cure, and rightly so. Read on to know why...  

WHAT RESEARCH SAYS

Recent studies published by Brigham and Women’s Hospital in the UK have confirmed that higher salt intake through food can be a cause of death. The researchers analysed results for subjects in the Trials of Hypertension Prevention, which included nearly 3,000 individuals with pre-hypertension. The method showed a direct linear relationship between increased sodium intake and increased risk of death.

Nancy Cook, a researcher said that sodium is notoriously hard to measure. “Sodium is hidden — you often don’t know how much of it you’re eating, which makes it hard to estimate how much a person has consumed from a dietary questionnaire. Sodium excretions are the best measure, but there are many ways of collecting those,” she says.

BEST WAY TO CHECK SODIUM LEVEL ACCURATELY

Generally, people are unaware of their sodium intake. “Sodium level fluctuates in blood and urine as per the dietary salt intake. The best way to check is to do the 24-hour Urinary Sodium test. It gives a more appropriate level of sodium consumption per day,” advises Dr Santosh Kumar Dora, senior cardiologist, Asian Heart Institute. He advises everyone should be very careful about their salt intake. 

INDIAN DIET IS VERY SALTY

Internationally, daily salt intake shouldn’t exceed 3 to 5 mg per day. However, Indians on an average consume about 10 mg per day, informs Dr Hemal Shah, senior nephrologist and secretary, Amar Gandhi Foundation. The Amar Gandhi Foundation (AGF), supported by the Mumbai Kidney Foundation (MKF), has over 150 nephrologists in the city who raised a clarion call, Ek chammach kam i.e. one spoon less, to highlight the high salt intake among Indian population.

“The Indian diet is very salty in general. People eat farsaan, namkeen, sauces, pickles, chutneys, bhajiyas with excessively salty dry chutney, Chinese food,  which has a lot of soy sauce, Chaat items like Paani puri, etc. containing a lot of salt. Junk foods like pastas, pizzas, burgers, fries, etc, have excess salt. Even when people have a fruit plate, they ask for chaat masala to be sprinkled on it. Chaas too, contains a lot of added salt,” he explains. 

DAMAGE CAUSED BY HIGH SALT INTAKE

High BP is the second commonest cause of kidney disease in the world. Also, poorly controlled BP in any other kidney patient, such as diabetic kidney disease can worsen the existing kidney disease into advance kidney failure much faster, pushing one into the stage of dialysis because of extra salt consumption and uncontrolled blood pressure, informs Dr Umesh Khanna, senior nephrologist and secretary, Amar Gandhi Foundation. Further, kidney patients are hundred times more prone to heart disease or lead to paralytic stroke. Kidney patients have a lot of water retention manifest as swelling over face and legs and high sodium intake can worsen it, making them severely breathless and pushing water to go into lungs leading to hospitalisation or need for emergency dialysis.

DON’T WAIT TILL YOU’RE DIAGNOSED WITH HYPERTENSION

“High BP is preceded by a decade of consumption of high salt intake. Therefore, don’t wait till you’re diagnosed with hypertension in your 40s and then as a result, try to lessen your salt intake. Know your sodium levels beforehand, in your 30s itself, and reduce your salt intake to avoid getting high BP later. If one has a family history of high BP, know your sodium levels and cut down salt intake immediately. Remember, prevention is better than cure,” cautions Dr Shah. Besides the 24-hour Urine Sodium test, another alternative is the Urine Sodium Creatinine Ratio test.

TIPS TO REDUCE SALT INTAKE

Dr Hemal Shah shares some useful guidelines:

• Begin by reducing salt consumption by 20 per cent and then by 50 per cent. 
• Avoid eating pre-packaged food like chips, chivda, fried snacks. Also, avoid eating outside food. Eat fresh fruits, vegetables and home cooked food.
• Don’t get swayed with marketing gimmicks used to promote pink salt or Himalayan salt. They may contain certain minerals however, the sodium content is the same whether it’s rock salt, iodised salt, black salt, pink salt or Himalyan salt. 

Dr Umesh Khanna shares some tips:

• Do not add salt while cooking food. A measured quantity of salt (not more than 5 mg in a day) should be added to the food cooked.
• Don’t keep a salt shaker on the table.
• Read labels for sodium in all its forms. Table salt is mainly sodium chloride, but canned or packaged foods can contain other forms of sodium. For eg, sodium glutamate is used as a food additive in many products.
• Use herbs and spices like imli, kokum, ginger, garlic, lemon, spices to increase food palatability
• Remember, salt-rich foods need not always taste salty. For eg, cottage cheese, biscuits, etc. Watchout for them.