Context: The WHO has recommended reducing sodium intake by promoting low-sodium salt substitutes (LSSS) to combat hypertension and cardiovascular diseases.

About Sodium

• It is essential for maintaining plasma volume, acid-base balance, nerve transmission, and cell function.

• Sodium deficiency is rare in healthy individuals.

• Excess sodium is linked to health issues like high blood pressure.

• Primary sources of dietary sodium depend on cultural and dietary habits.

• Naturally found in foods like milk, meat, and shellfish, but high in processed foods (e.g., breads, processed meats, snacks) and condiments (e.g., soy and fish sauces).

• Sodium glutamate is a common additive in many foods.

Historical Role of Salt in Public Health

• Salt was introduced in India in the 1950s with iodine fortification, successfully combating iodine deficiency.

• This helped prevent hypothyroidism and other health issues, improving public health over generations.

WHO recommends

• Adults: Less than 2000 mg of sodium/day (less than 5 g of salt/day, just under a teaspoon).

• Children (2–15 years): Adjust the adult dose based on their energy needs (excluding exclusive breastfeeding or complementary feeding periods).

• LSSS contain less sodium than regular salt by replacing sodium chloride with potassium chloride (KCl) or other minerals.

• All salt consumed should be iodized to support healthy brain development in fetuses and young children and optimize mental function in general.

WHO’s New Guidelines on Low-Sodium Salt Substitutes (LSSS)

• The WHO has recommended replacing sodium chloride in table salt with potassium chloride.

• The goal is to reduce sodium intake to below 2 grams per day to prevent hypertension and cardiovascular diseases.

• The guidelines target households but exclude packaged and restaurant foods.

• These recommendations apply to adults, excluding pregnant women, children, and individuals with kidney impairments.

Impact of Salt on the Human Body

• Sodium retains water in the body, increasing blood volume and pressure.

• Reducing salt lowers blood pressure, reducing the risk of heart disease and strokes.

• Hypertension contributes to atherosclerosis, vascular stiffness, and cardiovascular diseases.

• Potassium helps improve vascular function, reducing arterial stiffness.

Global and Indian Health Concerns

• High sodium intake is responsible for 1.9 million deaths globally each year.

• Studies show that reducing salt intake by 4.4g/day lowers systolic blood pressure by 4mmHg and diastolic pressure by 2mmHg.

Initiatives to Reduce Salt Intake

• Sapiens Health Foundation has launched the ‘Losalter Group’ to raise awareness and train physicians.

• Experts suggest that reducing salt intake requires action from individuals, the government, and the food industry.

Challenges in Implementing Low-Sodium Salt Alternatives

• Low-sodium salt options are costlier than regular salt, making them less accessible.

• Experts suggest government intervention to regulate pricing and ensure proper display of these alternatives in stores.

Concerns About Potassium-Based Substitutes

• Potassium-enriched salts are beneficial but may be harmful to people with kidney diseases.

• Experts warn about the risk of hyperkalemia (high potassium levels) due to undiagnosed kidney issues in India.

Conclusion

• Reducing sodium intake is essential for combating hypertension, heart disease, and stroke in India.

• Government policies, industry cooperation, and public awareness are key to promoting low-sodium salt alternatives while ensuring safety for all.