Central Idea

• The WHO recently published the ‘Global Report on Sodium Intake Reduction’ which sheds light on the progress of its 194 member states towards reducing population sodium intake by 30% by 2025. Regrettably, progress has been lethargic, with only a few countries making considerable headway towards the objective. Consequently, there is a proposal to extend the deadline to 2030.

The target of reducing population sodium intake

• The target of reducing population sodium intake by 30% by 2025 was set by the World Health Organization (WHO) in its Global Action Plan for the Prevention and Control of Noncommunicable Diseases in 2013.
• The plan aims to reduce premature deaths from non-communicable diseases, including cardiovascular diseases, by 25% by 2025, and to achieve a 30% reduction in the mean population intake of salt/sodium.
• The target of reducing population sodium intake is aimed at reducing the burden of hypertension, which is a major risk factor for cardiovascular disease.

Why reducing sodium intake is essential for India?

• Reduced sodium intake and decreased blood pressure: There is a strong correlation between reduced sodium intake and decreased blood pressure, leading to a decrease in stroke and myocardial infarction incidence. Lowering sodium intake by 1 gram per day leads to a 5 mm Hg reduction in systolic blood pressure, as per a study in The BMJ.
• Cardiovascular disease: Elevated BP is a critical risk factor for cardiovascular disease, which is the leading cause of mortality worldwide. It contributed to 54% of strokes and 47% of coronary heart diseases globally in 2001.
• Economic impact of cardiovascular disease on LMICs: Cardiovascular disease has a staggering economic impact on LMICs, estimated at $3.7 trillion between 2011 and 2025 due to premature mortality and disability. This represents 2% of the GDP of LMICs. The Indian economy alone faces losses surpassing $2 trillion between 2012 and 2030 due to cardiovascular disease, highlighting the need for effective interventions to mitigate the economic and health consequences of the disease in LMICs.

How cardiovascular disease and hypertension pose significant challenges in India?

1. Cardiovascular diseases as primary cause of mortality and morbidity:

• As per data from the Registrar General of India, WHO, and the Global Burden of Disease Study, cardiovascular diseases have emerged as the primary cause of mortality and morbidity. Data from the Registrar General of India, WHO, and the Global Burden of Disease Study
• Age-adjusted cardiovascular disease mortality rate increased by 31% in the last 25 years
• Hypertension as leading risk factor for such diseases in India

2. Prevalence of hypertension in India:

• More prevalent among men aged 15 and above compared to women
• More common in southern states, particularly Kerala, while Punjab and Uttarakhand in the north also report high incidence rates

3. Pre-hypertensive population in India

• Defined by systolic blood pressure levels of 120-139 mmHg or diastolic blood pressure levels of 80-89 mmHg
• 5% of women and 49.2% of men at the national level
• Significant risks of cardiovascular disease, stroke, and premature mortality for Indians with BP readings between 130 and 139/80-89 mmHg
• Many Indians classified as pre-hypertensive are now included in the newly defined stage-I hypertension by the American guidelines.

4. Circulatory system diseases: The 2020 Report on Medical Certification of the Cause of Death shows that circulatory system diseases account for 32.1% of all documented deaths, with hypertension being a major risk factor.

Global Efforts to Reduce Sodium Intake

• The WHO aims to reduce population sodium intake by 30% by 2025
• Only a few countries have made considerable progress towards the objective
• India’s score of 2 on the WHO sodium score signifies the need for more rigorous efforts to address the health concern

Government Initiatives

• Voluntary programmes: The Union government has initiated several voluntary programmes aimed at encouraging Indians to decrease their sodium consumption
• Eat Right India: The FSSAI has implemented the Eat Right India movement, which strives to transform the nation’s food system to ensure secure, healthy, and sustainable nutrition for all citizens
• Aaj Se Thoda Kam: FSSAI launched a social media campaign called Aaj Se Thoda Kam.

Urgent Need for a Comprehensive National Strategy

• Despite of awareness efforts, the average Indian’s sodium intake remains alarmingly high. Evidence shows an average daily consumption of approximately 11 grams.
• India needs a comprehensive national strategy to curb salt consumption
• Collaboration between State and Union governments is essential to combat hypertension, often caused by excessive sodium intake

Conclusion

• The excessive consumption of salt can lead to severe health consequences, and India has a pressing need to reduce its sodium intake. While the government has initiated several voluntary programs, these have fallen short of the goal. India needs a comprehensive national strategy, engaging consumers, industry, and the government, to curb salt consumption. Collaboration between State and Union governments is essential to combat hypertension, often caused by excessive sodium intake.

Mains Question

Q. Reducing population sodium intake is a critical step towards preventing and controlling non- cardiovascular diseases and hypertension. Comment.

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