According to scientific studies conducted and published in India and abroad, Salt consumption in India is around 10 grams which is twice the recommendation by WHO(5 GM). Salt is consumed majorly in home cooked in rural India with cultural usage of pickles, chutneys ,papads, farsans etc. Some communities keep extra salt in thalis in villages or keep salt shakers on tables. Cities have access to fast food snacking, high energy food intake especially bakery products and noodles, soy sauce and ketchups, soups and processed foods. Salt rich food need not always be salty.
How to measure salt intake by a common man?
In our clinic, we give a small spoon of 5 grams which is used to measure the salt to be used for the whole day by the cook of the house and thereby it is easy to find the average consumption of salt if the family does not eat out. Add to it the salt consumed in the form of food or snacks eaten out. This is a rough way of calculating. The most accurate way to calculate when we do a scientific study is to collect urine for 24 hours and measure the sodium intake in urine sample. This is cumbersome and can be only done if the patient’s BP is not coming down and you want to check whether patient is compliant with your instructions of salt reduction or not.
How high levels of sodium damage kidneys.
High Bp is 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 him into the stage of dialysis because of extra salt consumption and uncontrolled blood pressure. Further, kidney patients are 100 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.
Who should do 24 hour urine sodium test?
This test of 24 hour urine sodium need not be done for all but for only those who have Difficult to control bp and difficult to control swelling in the body.
As a Nephrologist we at the Amar Gandhi foundation carried out a survey and found that majority are not aware of the importance of salt control, the hazards of salt.
Tips to consume less salt
- Do not add salt during the preparation of food. The measured quantity of salt should be added to the food cooked.
- Do not have a salt shaker on the table.
- Limit the consumption of Processed foods like bakery products, ketchups , namkeens , chips, soya sauce, noodles, pastas etc
- Check labels for sodium in all its forms.Table salt is mainly sodium chloride, but canned or packaged foods can contain other forms of sodium.: Sodium glutamate is used as a food additive in many products.
- Use fresh fruits, rather than packaged fruits.
- Use herbs and spices like imli, kokum, ginger, garlic, lemon, spices to increase the palatability.
- Use fresh meats, rather than packaged meats.
- Remember that high salt product need not always taste salty Eg cottage cheese, biscuits.
Remember Amar Gandhi foundation’s slogan “ek chammach kaam” salt will save u from heart disease, paralytic stroke and kidney failure.
By Dr. Umesh Khanna
Chairman, Mumbai Kidney Foundation
Trustee, Sapiens Health Foundation
Secondary, Amar Gandhi Foundation