Consuming too much salt? It's harming your health, say experts

Do you like extra salt in your food while cooking? Do you consume a lot of packaged food? All these practices are leading to an excessive consumption of sodium, the primary ingredient of salt. While sodium is an essential nutrient, its unbalanced use can lead to various health complications.

A recent modelling study conducted by researchers from multiple institutes and published in The Lancet Public Health found that complying with the World Health Organisation's sodium benchmarks could avert almost 3 lakh deaths from cardiovascular and chronic kidney disease in the first 10 years in India. Bringing the sodium intake down is also estimated to avert 17 lakh cardiovascular disease events and 7 lakh new chronic disease cases in the first 10 years of compliance.

WHO's sodium benchmarks
WHO had released global sodium benchmarks for different food categories in 2021 and a revised version in 2024, also specifying recommended levels of sodium in some packaged foods.

Here are global benchmarks of sodium for some common packaged food categories:
• Crackers/savoury biscuits: 580 mg/100 g
• Nuts, seeds and kernels: 280 mg/100 g
• Potato, vegetable and grain chips, popcorn and extruded snacks: 470 mg/100 g
• Minimally processed breakfast cereals: 120 mg/100 g
• Highly processed breakfast cereals: 280 mg/100 g
• Canned foods: 225 mg/100 g
• Leavened bread: 370 mg/100 g
• Flatbreads: 320 mg/100 g
• Pickles, sweet and sour: 560 mg/100 g

It becomes important to read nutritional labels to ensure daily sodium consumption is well within the recommended standard.

⁠Sharvari Umesh Gude, Senior Dietician, Manipal Hospital, Goa, informs, "Recommended intake of sodium is less than 5 g per day. While cooking, the best way to measure is 1 pinch of salt is equivalent to 1 g."

Stressing on how packaged foods often lead to excessive sodium intake, she says, "High sodium intake can be due to packaged food items as a high amount of salt is used to ensure food is kept fresh or edible for a longer period of time, which enables the food items to adsorb more sodium compared to freshly cooked food. Cooked food has less salt added in it as it's freshly cooked and is not stored for more than two or three days."

How does excessive sodium intake impact health?
Excessive intake of sodium, primarily through salt, can cause a range of health issues related to blood pressure, heart and kidney.

Dr. Vivek Mahajan, Consultant, Interventional Cardiology, Fortis Hospital, Kalyan, informs, "Kidneys can excrete only a certain amount of sodium a day. If you consume excessive sodium, it gets retained in the body and stored in blood vessels. Now, sodium has the property of attracting water. When it pulls a lot of water, the volume of the blood in the blood vessels increases. This leads to a rise in blood pressure."

"Sodium can cause approximately a 5-10 mm Hg rise in blood pressure. This can significantly increase the risk of cardiovascular disorders like stroke, myocardial infarction (heart attack), brain bleeding, etc. In the long run, it can impact kidney function also. It's a cycle. Every 10 mm Hg rise in blood pressure increases the risk of cardiovascular diseases by two times," he further explains.

Excessive sodium intake can have visible effects on the body. Gude elaborates, "High intake of sodium can lead to bloating due to water retention in the body, swelling of feet and ankles, headaches due to high blood pressure, frequent urination and adding load on the kidneys for excretion of the waste products from the body. One might also experience palpitations due to high blood pressure."

Is too little sodium also harmful?
Excessive sodium intake has considerable health implications, consuming less than recommended levels of sodium can also cause issues since sodium is an essential nutrient.

"Absolutely no sodium can also cause disorders like hyponatraemia, which can give rise to neurological emergencies like drowsiness. This condition can also be life-threatening," informs Dr. Mahajan.

"The recommended level is 2.4 to 6 g on a daily basis. It should not be less or more," he adds.

Managing sodium consumption
Some foods are rich in sodium, while others act as a healthy alternative. Cutting back on sodium is essential to manage the health complications that arise out of its excessive consumption.

Dr. Mahajan recommends the following steps:
• We put salt in the food according to taste. If you put 5 per cent less salt than what is needed to give you the required taste, i.e., if you can stay a little deprived of the perfect taste, you can significantly cut down sodium levels in your diet.
• Do not add extra salt to your food, i.e., add more salt after the food is prepared. If the salt is too deficient in the food, use a sprinkler instead of a spoon to add it. This will ensure a controlled amount goes into the dish.

What to eat and what not to eat
Packaged foods are a major source of sodium intake in a large population. To control sodium levels in the body, Dr. Mahajan advises, "Avoid packed foods like chips, namkeen, sev, chivda, etc. All these items are extremely rich in salt content because you need it to preserve what is inside. Food prepared in restaurants also usually doesn't have low salt. It is always made according to taste, so avoiding that can also help. Bakery items like breads, cakes, and biscuits contain soda, which is also sodium. So cutting down on that is also important."

Stating other food items that are rich in sodium content, Gude says, "Foods high in sodium are red meats, shellfish, sauces and pickles, preserved food items like papad, dried fish, sausage and salami, frozen non-veg food items, frozen green peas, etc."

One can opt for healthier alternatives to manage dietary sodium levels.
"Some people advocate for alternatives like black salt, rock salt, etc. These are fine. But the aim should be to not use excess of any kind of salt," suggests Dr. Mahajan.

Additionally, to counterbalance the salt intake, potassium is an essential nutrient. "Food rich in potassium like green leafy vegetables, sprouts, fruits, etc., can help mitigate sodium's harmful effects," he adds.

Gude suggests the following:
• Foods like herbs, lemon juice, or fresh coriander leaves, curry leaves, and spices like crushed chilli flakes and black pepper powder can be used.
• Opt for freshly cooked food rather than precooked or preserved food items.
• Cook food without adding salt, and one pinch of salt can be added while dishing out the food for the meals.

She also suggests the following dishes that can be prepared with minimal sodium.
• Soya beans pulav (no added preserved food items)
• Fresh fish curry (add lemon juice instead of kokum or tamarind)