May 2, 2017
Indian are now alert to dangers of high salt intake and are modifying their diet
According to a new study, Indians are actively trying to reduce their daily salt consumption, far more than Australians and others.
Cutting down involves adding less salt during cooking and on the table.
Indians, aware of the dangers of excessive salt intake, are modifying their diets unlike other international communities like Australians who are sticking to high-salt foods though they are aware of its effects, according to a new study.
Populations in 181 of 187 nations consume more than the WHO-recommended daily upper limit of 5 gm of salt. Indians consume nine % more salt than the global average -- 10.06 gm.
Claire Johnson, a research fellow with The George Institute for Global Health, Australia, led an India-centric study on salt intake in February this year. It included a cross-section of 1,395 respondents across India -- educated and uneducated, urban and rural, male and female, and of different ages averaging 40 years.
Nine of 10 respondents said they were aware that a diet high in salt is bad for their health. When asked the question: ‘How important to you is lowering salt in your diet?’ as many answered affirmatively. Not just that, participants actually acted upon this knowledge, lowering their salt intake.
Every measure to cut down on salt will benefit Indians.
For instance, 98% participants reported using spices other than salt, 61% said they avoided eating out and 52% maintained that they avoided processed foods.
This implies that greater awareness about the health risks of excessive salt intake could benefit Indians significantly because they are open to lifestyle changes.
Every measure to cut down on salt will benefit Indians, said Johnson. ‘By lowering your salt consumption by 1 gm, you lower your heart attack and stroke risk by 4.8%. And the more you cut down, the more you gain.’
One in four Indians living in villages and one in three in its cities suffers from hypertension, or high blood pressure. The control of hypertension requires a reduction in salt intake because too much sodium constricts arteries, thus raising blood pressure, and impairs kidney function, leading to extra fluid and extra strain on the associated blood vessels.
The average Indian consumes 10.98 gm salt a day.
Hypertension is a leading cause of cardiovascular disease. Thus the impact of excessive salt intake on the health of the average Indian is clear: One in four Indians succumbed to cardiovascular disease in 2012.
India’s health gains could be ‘enormous’, Johnson told IndiaSpend, if we could cut our average salt/sodium intake by 30%. This would meet one of nine WHO targets to cut premature deaths caused by four major non-communicable diseases. It would also cut the risk of Indians dying by heart attack or stroke by about 15%.
The average Indian consumes 10.98 gm salt a day, according to an earlier Johnson-led study. This is over twice the WHO-recommended upper limit per day, 5 gm, which is just under a teaspoon, and seven times what the body actually needs.
There is a widespread belief in India that in warm weather when the body sweats and loses salt it is imperative to consume more salt. Johnson refutes it. ‘Irrespective of the weather, physiologically, humans need just one-quarter teaspoon of salt: 1-2 grams which equals 500 mg of sodium daily,’ said Johnson.
Indians are eating less pulses, fruits and vegetables and lots more processed and fast foods.
About 10% of the daily salt intake of an Indian occurs naturally in fruit, vegetables, cereal and other raw ingredients, said Johnson. The rest is added during cooking or at the table.
So, cutting down involves adding less salt during cooking and on the table. Both are more doable than making the major dietary changes implicated in controlling salt-intake in the West, where the excess consumption generally comes from salt added to processed foods such as pasta sauces.
India has seen great dietary changes in the last 30 years, noted Johnson. ‘Indians are eating less pulses, fruits and vegetables and lots more processed and fast foods, and as a result, their diets now include excess salt, sugars and harmful fats,’ she said. ‘These are driving up rates of high blood pressure, obesity and cardiovascular diseases, such as heart attack and stroke.’
Currently it is impossible to reckon how much salt you are getting from packaged foods in India. Consider:
(a). 1 in 4 products fail to meet the (so far, voluntary) nutrition information labelling guidelines of the Food Safety and Standards Authority of India, and
(b). 2 in 3 products do not list salt on the nutrition information panel and fail International Codex Alimentarius requirements, a collection of standards, guidelines and codes of practice aiming at protecting consumer health and promoting fair practices in the food business.
This may change soon. New Food Safety and Standards Authority of India (FSAI) labelling regulations for all packaged foods are on the anvil.
‘Our new guidelines, which should come into effect in a few months, will make it mandatory for packaged food labels to list their salt/sodium (and other nutrients) content, in total and against the recommended daily value,’ Pawan Kumar Agarwal, CEO of Food Safety and Standards Authority of India, told IndiaSpend.
In the mid-1950s, urban India reported a hypertension prevalence of 1.2 to 4.0% based on the WHO blood pressure diagnosis guidelines then in vogue -- diastolic blood pressure exceeding 95 mmHg, a systolic reading exceeding 160 mmHg.
The prevalence increased to 5% in the 1960s, then to 12 to 15% in the 1990s. Today, about 33% of urban Indians are hypertensive based on revised WHO guidelines-diastolic blood pressure exceeding 90 mmHg, and a systolic reading exceeding 140 mmHg.
Hypertension is a silent killer with few symptoms such as headaches, shortness of breath or nosebleeds, according to Mayo Clinic. In general, hypertension causes so few symptoms that by the time it becomes obvious, the body could have suffered irreparable damage.
Physicians quoted the rule of 50 to explain poor hypertension control, which means: 50% of the hypertensive population is unaware of their condition. Of those who know, only 50% are on appropriate treatment and 50% of those have their hypertension in check.
Low awareness about hypertension is a bigger problem in rural India than in urban settlements,’ according to Jugal Kishore, Director, professor and head, Community Medicine at Vardhman Mahavir Medical College, New Delhi, based on the findings of his 2016 study Prevalence of Hypertension and Determination of Its Risk Factors in Rural Delhi.
Cost of treatment is also an issue, said Kishore, as only about 30% Indians avail free health services from the public sector. ‘Also, the less privileged are intimidated by big hospitals, and the investigations involved in diagnosing a chronic problem, so they tend to ignore symptoms.’
lso, blood pressure medication is typically prescribed for a lifetime, which can be hard to accept.
Fortified foods to tackle malnutrition
Targeting children, the Rajasthan, Madhya Pradesh, Haryana and Himachal Pradesh governments have begun using fortified oil for their mid-day meal schemes.
MNCs, co-ops, other manufacturers will add premixes of micronutrients to products
Malnutrition isn’t just about acute starvation. Often, healthy-looking people are malnourished too, because their diet does not include the right micronutrients. In severe forms, such deficiencies can have serious effects. For instance, iron deficiency leads to critical problems during pregnancy, and not enough Vitamin A can lead to poor vision, infections, and skin problems.
To tackle the issue, the Food Safety and Standards Authority of India (FSSAI) released a set of standards and a logo last year. Since then, it has focussed on awareness- and consensus-building. Now, a number of enterprises will begin adding premixes of micronutrients to launch fortified foods. Smita Mankad, head of the FSSAI’s Food Fortification Resource Centre, told The Hindu that in the next few months, General Mills India, ITC, Hindustan Unilever and Patanjali will launch wheat flour, Adani Wilmar, Marico, Borges India, and Kaleesuwari Refineries are working on oil, LT Foods, DCP Food, and KKR Food are launching rices, and in salt, other brands will join Tata, which already has a double fortified brand in the market.
Milk cooperatives in Haryana, Punjab, Rajasthan, Assam and Maharashtra will fortify their products too. Targeting children, the Rajasthan, Madhya Pradesh, Haryana and Himachal Pradesh governments have begun using fortified oil for their mid-day meal schemes. West Bengal and Andaman and Nicobar Islands are now distributing fortified wheat flour through the public distribution system, and the Maharashtra government has started a pilot project.
The FSSAI is also working with small local suppliers, for instance local flour grinding mills, to get them to add premixed micronutrients. “The next level of awarenesses will be among consumers to opt for fortified staples,” Ms. Mankad said. The FSSAI has decided not to interfere in pricing.
Govt imposes heavy penalty on companies for substandard milk, spices
Srinagar: State government Monday imposed a penalty of Rs 2.1 lakh on 10 food operators for manufacturing and selling adulterated and substandard products to consumers.
According to officials, a fine was imposed by the Court of Adjudicating Officer on these 10 food business units including milk processing firm for selling and manufacturing substandard food items.
“The Additional Deputy Commissioner, Srinagar, Vikas Kundal imposed a fine of Rs 2.1 lakh on 10 Food Business Operators for manufacturing and selling substandard food items which include one milk processing and two spices manufacturing units besides some mobile milk vendors,” they said.
Official sources told Rising Kashmir that the products which were found impure and adulterated include a famous milk brand 'Snow and two spice brands, Kesar and Shafat Spices manufactured at Khunmoh Industrial Estate beside some mobile milk vendors.
A penalty of Rs 80000 was levied on the manufacturers of Snow Cap milk brand, which is a popular milk brand in J&K is run by a government supported cooperative, Jammu and Kashmir Milk Producers Cooperative Limited (JKMPCL) situated at Cheshma Shahi. “The Snow Cap's milk processing unit was levied with a fine of Rs 80000 for selling impure milk to consumers while the each spice manufacturing units was fined with Rs 25000,” officials said.
The Food Safety Department also warned the food business operators to desist from the malpractice of food adulteration
“Stern action under food safety and standards act shall be initiated against them,” they said.
The samples of milk and spices were taken from these business establishments and sent for the testing following which they were found to be adulterated, an official said.
A fine has been imposed on the ten business units the Food Safety and Standard Act. (muhassan@risingkashmir.com)
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