Indians Continue To Eat More Salt Than WHO Recommendation

Relevance: GS2 - Issues relating to development and management of Social Sector/Services relating to Health,

(Source: The Hindu, 09/27/2023)

Why in the news?

• Recently, a survey conducted by the ICMR as part of the National NCD Monitoring Survey (NNMS) found that Indians are consuming more salt than recommended by the WHO.
• According to the study, 1.63 million deaths were attributed to hypertension in 2016.

What has the ICMR survey said about salt intake by Indians?

• Daily salt intake: The average salt intake in India is 8.0g/day in India.
• The daily salt consumption by men is 8.9 g/day for men and for women is 7.1 g/day.
• The WHO has recommended a threshold of 5g of salt per day or 2000mg of sodium.
• In March, the WHO claimed that the global average sodium intake is around 4,310 mg/day i.e. 10.78 g of salt/day.
• Urban-rural difference: Salt intake was significantly higher in rural areas.
• Among those with NCDs: Salt intake was higher in people suffering from obesity (9.2 g/day) and high blood pressure (8.5g/day).
• Other categories: The daily salt intake was also high among employed people (8.6) and tobacco users(8.3g/day)
• Dietary control: Less than half of the participants in the survey were found to have practiced measures to control dietary salt intake
• The most commonly adopted step to reduce salt consumption among participants was to avoid meals outside of the home.
• Hypertension-related deaths: According to the study, the number of deaths caused by hypertension in India increased from 0.78 million in 1990 to 1.63 million in 2016.
• Recommendation: Reducing consumption of processed goods and foods cooked outside the home.
• Planning and controlling dietary salt consumption measures as mean dietary salt intake is high in the Indian population.
• Advocates a 30% reduction in mean population salt intake by 2025.
• Benefit: Reduced salt intake is a beneficial and cost-effective method to reduce elevated blood pressure by around 25%.

Survey Methodology

• Dietary sodium intake was estimated from spot urine samples and the population mean was calculated using sampling weights.
• The findings of the study can be used to generalize salt intake across the population.
• The authors of the study have suggested that the findings could be used to plan and implement control measures.
• Limitation: Information on awareness and behavior was self-reported and could be affected by information bias.
  • The study did not capture data on the actual dietary sources of salt in food items and condiments.

Concerns associated with higher salt intake

• Salt is a major risk factor for cardiac health as the body retains more water in the presence of excess salt.
• As a result, blood volume increases increasing stress on the heart causing blood pressure levels to elevate.
• Over time, the high blood pressure causes the walls of the blood vessels to overstretch and quickens the formation of sticky plaque, which blocks blood flow.
• An estimated sodium intake between 3 g per day and 6 g per day was associated with a lower risk of death and cardiovascular events than higher or lower intakes.
• Higher potassium excretion was associated with a lower risk of death and cardiovascular events.
• Generally, high-sodium diets are high in total fat and calories and may lead to obesity and associated complications.
• Some studies have suggested that there could be a link between sodium intake and osteoporosis and stomach cancer.

Cardiovascular diseas

• Cardiovascular diseases (CVDs) refer to a group of disorders of the heart and blood vessels, including coronary heart disease, cerebrovascular disease, rheumatic heart disease, and other conditions.
• Global impact: CVDs are the leading cause of death globally, accounting for around 17.9 million lives every year.
• Indian impact: CVDs accounted for nearly 28.1 % of total deaths in India.
• Risk factors: Unhealthy diets, physical inactivity, tobacco use, and alcohol consumption.
• Intermediate risk factors include raised blood pressure, raised blood glucose, raised blood lipids, and obesity.

Initiatives

• WHO’s “Global Report on Sodium Intake Reduction”: Set a target of reducing sodium intake by 30% by 2025.
• However, countries have not made significant progress on the target, so they have proposed to extend the deadline from 2025 to 2030.
• Eat Right India’s movement: It has been introduced by the FSSAI to transform the nation’s food system and ensure secure, healthy, and sustainable nutrition for all citizens.
• Aaj Se Thoda Kam: It is a social campaign launched by FSSAI to promote healthier diets.
• People are encouraged to reduce their uptake of salt, sugar, and fats as excess consumption could lead to CVDs.
• National Programme for Prevention & Control of Non-Communicable Diseases (NP-NCD):
• It was launched in 2010 under the National Health Mission (NHM) to strengthen infrastructure, human resource development, health promotion, early diagnosis, management, and referral.
• NCD Cells have been established at national, state, and district levels for program management.
• NCD Clinics have been set up at District and Community Health Centres (CHC) levels, to provide early diagnosis, treatment, and follow-up services for common NCDs.
• It was earlier known as the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS).
• Affordable medicines:
  • Affordable Medicines and Reliable Implants for Treatment (AMRIT) Deendayal outlets have been opened to make drugs and implants to treat cancer and cardiovascular disease drugs available at discounts.
  • The Department of Pharmaceuticals has established Jan Aushadhi stores to provide generic medicines at affordable prices.
  • STEMI Project: In 2021, the Maharashtra government launched the ST-Elevation Myocardial Infarction programme to enable rapid diagnosis of heart disease.
  • It has been recognized by the National Health Mission.

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Question: Regular intake of fresh fruits and vegetables is recommended in the diet since they are a good source of antioxidants. How do antioxidants help a person maintain health and promote longevity? (UPSC CSE 2011)

(a) They activate the enzymes necessary for vitamin synthesis in the body and help prevent vitamin deficiency

(b) They prevent excessive oxidation of carbohydrates, fats, and proteins in the body and help avoid unnecessary wastage of energy

(c) They neutralize the free radicals produced in the body during metabolism

(d) They activate certain genes in the cells of the body and help delay the aging process

Question: Consider the following.

Assertion (A): Fatty acids should be a part of the balanced human diet.

Reason (R): The cells of the human body cannot synthesize any fatty acids.

Which of the following is/are correct? (UPSC CSE 2004)

(a) Both A and R are individually true and R is the correct explanation of A.

(b) Both A and Rare are individually true but R is not the correct explanation of A.

(c) A is true but R is false

(d) A is false but R is true