Context : WHO has issued new guidelines recommending low-sodium salt substitutes (LSSS).
Relevance : GS 2(Health)
Key Recommendations by WHO
- These substitutes reduce sodium chloride (NaCl) content and incorporate potassium chloride (KCl).
- Aim: To bring daily sodium intake below 2g per person, reducing risks of hypertension and cardiovascular diseases (CVDs).
- Recommendations target household salt consumption but do not apply to packaged foods or restaurant-cooked meals.
- Excludes pregnant women, children, and individuals with kidney disease, as high potassium levels (hyperkalemia) may be harmful.
Why Salt is Again a Public Health Focus
- Salt Fortification Success in India:
- Iodized salt (introduced in the 1950s) successfully tackled iodine deficiency and related diseases like hypothyroidism.
- Salt’s Role in the Human Body:
- Sodium increases water retention in blood vessels, raising blood volume and blood pressure.
- High sodium intake is linked to hypertension, stroke, and cardiovascular diseases.
- Potassium helps improve vascular function, countering some of sodium’s negative effects.
Health Risks of Excessive Sodium Consumption
- Hypertension and Cardiovascular Diseases (CVDs):
- Major risk factor for atherosclerosis, leading to blocked arteries, heart attacks, and strokes.
- Vascular stiffness: Excess sodium makes blood vessels less flexible, increasing the burden on the heart.
- Chronic Kidney Disease (CKD):
- High salt intake strains kidney function.
- Excess sodium also increases protein leakage in urine, worsening kidney disease.
- Other Health Impacts:
- Gastric cancer risk is linked to excessive salt intake.
- Bone health deterioration due to calcium loss caused by excess sodium.
- WHO states 1.9 million deaths annually are attributed to high sodium intake.
Indian Context: High Salt Consumption & Public Health Concerns
- Cultural dietary habits in India promote high salt consumption (added to cooked food, pickles, snacks).
- Studies show Indians consume far more sodium than WHO’s recommended 2g/day.
- 2013 British Medical Journal study:
- Cutting sodium intake by 4.4g/day for 4 weeks reduced systolic BP by 4mmHg and diastolic BP by 2mmHg.
Challenges in Implementing Low-Sodium Salt Substitutes (LSSS)
- Affordability & Market Access:
- Low-sodium salt substitutes are costlier than regular table salt.
- Prof. Vivekanand Jha (George Institute for Global Health) suggests government intervention to reduce prices and increase availability.
- Consumer Awareness & Behavioral Change:
- Majority of Indian households lack awareness of salt-related health risks.
- The Sapiens Health Foundation has launched initiatives to train 300 physicians nationwide to spread awareness.
- Policy & Regulation Issues:
- Signal labeling on food products could help consumers make healthier choices.
- WHO recommends government-led initiatives to promote LSSS usage.
- Health Risks of Potassium Intake:
- Potassium-rich salt substitutes are not suitable for people with kidney disease.
- Large sections of the population remain undiagnosed for kidney ailments, increasing the risk of hyperkalemia.
Potential Solutions & Policy Recommendations
Substituting salt with herbs and spices to maintain flavor.
Subsidizing Low-Sodium Salt:
Government intervention can lower costs and increase adoption.
Public Awareness Campaigns:
Similar to iodized salt campaigns, public messaging can educate consumers on the dangers of excess sodium.
Stronger Food Labeling Laws:
Mandatory “high sodium” warning labels on packaged foods.
Promoting Home-Based Salt Reduction Strategies:
Encouraging gradual reduction of table salt usage.
