Dr Kher indicated the medical community’s role in overlooking salt reduction as a prevention for disease, during a panel discussion in Delhi Tuesday on ‘Focus on Salt in HFSS Diets to Bolster India’s Fight Against NCDs: Hidden in Plain Sight’, alongside Dr Chandrakant Lahariya, Founder-Director of Foundation for People-Centric Health Systems, and Dr Ritika Sammadar, chief clinical nutritionist at Max Healthcare, Saket. HFSS diets are high in fat, sugar and salt.
The discussion was organised by Partnerships for Impact, a social enterprise dedicated to improving the lives of vulnerable populations, and non-profit Resolve to Save Lives.
According to the doctors, the lack of attention to salt intake is alarming, given that non-communicable diseases account for over 60 percent deaths in India with cardiovascular diseases being the leading cause—a trend they attribute to excessive salt consumption.
The World Health Organisation (WHO) and the National Institute of Nutrition (India) advise adults to limit their daily salt intake to under 5g, equivalent to about one teaspoon.
Unfortunately, Indians are estimated to consume an average of 8-11 g of salt per day, roughly double the recommended amount, thereby elevating their risk of developing hypertension and other health problems. Nearly 80 percent of salt consumption comes from home-cooked food and added salt.
This excessive salt consumption is a significant contributor to high blood pressure, which in turn increases the likelihood of heart disease, stroke and kidney disease, resulting in approximately 1,75,000 deaths in India each year, according to the doctors.
“Remove that salt shaker from the table,” Dr Kher remarked at the discussion.
Salt is composed of sodium chloride. One gram of sodium chloride contains about 400 milligrams of sodium.
The doctors highlighted that salt and sodium are often misunderstood as interchangeable terms, but are not the same.
Dr Sammadar shared her experience with patients who think switching to alternatives like pink salt or reduces salt intake. She pointed out that the sodium content in these salts is essentially the same as regular salt.
“The only difference is probably the presence of certain minerals in these salts, but we’re not consuming salt for those minerals; it’s for the iodised content,” she explained.
Dr Kher clarified: “When we consume 5g of salt, we’re consuming roughly 2g of sodium”, pointing out that the body ultimately processes salt as sodium and chloride, and the kidneys handle these components. The daily requirement for salt remains less than 5g.
Doctors also underlined a concerning trend where patients using alternative salts like pink salt often end up increasing their sodium intake by adding it to their salads, fruits and other foods, thinking it’s healthier.
“In the long run, they’ve actually increased their sodium content rather than reducing it,” Dr Sammadar said.
India has committed to reducing average salt intake by 30 percent by 2030 as part of WHO’s global non-communicable disease prevention plan.
As part of India’s commitment to control obesity, the latest economic survey suggests imposing a health tax on ultra-processed foods and salty snacks to deter consumption.
However, Dr Lahariya noted that this approach comes with challenges, particularly in India, where a significant portion of production comes from the informal sector.
“If we put a very high tax, it will go to the informal sector economy, and the government won’t earn tax, but the product will still be in circulation,” he explained, while suggesting the need to subsidise healthier options.
The experts also advocated for clear warning labels rather than star ratings on products. According to them, warning labels, such as “high in salt” or “high in sugar”, are more effective than ratings.
“This is because star ratings can be misleading, giving a weighted average that might not accurately reflect a product’s nutritional value,” Dr Lahariya said.
For example, a biscuit high in sugar but with some fibre might receive a three-star rating, causing confusion among consumers. In contrast, warning labels provide clear and direct information, making it easier for people to make informed choices.
Food products high in sugar, salt, fat or energy calories should have multiple warning labels.
“This approach, backed by evidence from Latin American countries, could be an effective way to promote healthier eating habits in India,” he added.
A suggestion to establish a “salt board” similar to the “sugar board” introduced by the Central Board of Secondary Education (CBSE) in schools—an initiative aimed to educate children about the dangers of excess sugar, promote healthier habits, and ultimately reduce the burden of lifestyle diseases on the next generation—was also put to the table by Dr Sammadar.
She emphasised the importance of targeting schools, noting that children retain information well and often share what they learn with their families.
(Edited by Nida Fatima Siddiqui)
