International researchers are studying the salt intake of Indian adults to provide vital new data to aid the development of a national salt reduction strategy.

Scientists from the Public Health Foundation of India (PHFI), the University of Birmingham, Imperial College London and the University of Sydney are carrying out an assessment of dietary salt intake among 1,400 adults over 24 years in urban Delhi and rural Haryana.

India has a diverse dietary culture where salt and spices are used extensively but up-to-date figures on population salt consumption are very limited. Public health studies worldwide have found excess salt intake to be associated with increased risk of high blood pressure (hypertension), an important risk factor for cardiovascular disease.  Projections indicate that from 2000 to 2025 the number of Indians suffering with hypertension will almost double from 118 million to 213 million.

The existing available data indicates that population salt intake is very high across different regions of India with the average daily intake ranging between 9 and 12 grams daily. This is extremely high compared to the World Health Organization (WHO) recommended intake level of 5 grams daily.  The intake is reported to be higher in urban settings compared to rural settings. 

The cross-sectional survey will determine the mean daily salt consumption and determine the main sources of salt in diets through the collection of 24-hour urinary sodium excretion samples among a representative sample. It will also assess the knowledge, attitudes and behaviours with regard to salt consumption and its impact on health through a questionnaire.

Dr Sailesh Mohan, the study’s Principal Investigator and Associate Professor at PHFI, said: “Population-based strategies are necessary given the high prevalence and growing burden of hypertension and its inadequate management in India.  Therefore, it’s imperative to determine current consumption levels so that appropriate evidence-based preventative public health action can be initiated. Such data is critical in facilitating the development and implementation of an India-specific salt reduction programme, to translate the existing scientific evidence into population health gains, and also to subsequently monitor and evaluate such a programme.” 

Dr Paramjit Gill, Reader in Primary Care Research at the University of Birmingham, added: “There is strong evidence that cutting the amount of dietary salt consumed will reduce population blood pressure and associated risk of cardiovascular events in both hypertensive as well as normotensive individuals. 

“Evidence points to dietary salt programmes being extremely cost effective and they offer great potential to prevent cardiovascular disease-related deaths. Regrettably much of the current data available has been derived from dietary surveys alone and not estimated from 24-hour urinary sodium excretion, which is considered to be the gold standard for determining population salt intake levels. The data obtained from this current survey can be used to facilitate the initial development and subsequent evaluation of a national population-wide salt reduction strategy.”

The results of the study are due in 2014.

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