Massive anti-sodium campaign needed to fight hypertension epidemic

Today is World Hypertension Day (WHD). It is a day designated by The World Hypertension League (WHL), which is made up of 85 national hypertension societies. Since 2006, the WHL has been dedicating May 17 of every year as WHD. It was initiated to increase awareness on hypertension which is the biggest single risk factor for cardiovascular diseases (CVDs).

CVDs are the number one cause of death globally where 1.55 million deaths every year are attributed to hypertension. By 2030, 23.3 million people would die from CVDs mainly from heart disease and stroke. This is a disturbing 34% increase from 17.3 million in 2008.

Malaysia is not spared from this global epidemic. Every day an average of 110 people are dying of heart disease and related diseases of the circulation. It is now the principal cause of death in the country, accounting for 16.5% of all deaths in Ministry of Health Hospitals in 2008.

Every year there are 38,000 new cases of heart disease in Malaysia. Six new cases of stroke occur every hour and stroke has become Malaysia’s number-three killer after heart disease and cancer. One in 3 or about 32.7% of Malaysians aged 18years and above are suffering from hypertension.

In Malaysia, the prevalence of high blood pressure has increased in the past decade. In 1996, it was indicated that 33% of adults aged 30 years and above had hypertension. Ten years later, the figure has increased to 43%.

The exact causes of high blood pressure are not known, but several factors and conditions may play a role in its development. These include being obese, lack of physical activity, consuming too much salt in our diet, stress, smoking and alcohol consumption.

Essentially hypertension is also influenced by diet and lifestyle. The link between salt and high blood pressure is especially compelling.

A report published in the journal Hypertension projects that 280,000 to 500,000 lives would be saved by a 40% reduction in sodium intake to about 2,200 milligrams a day over 10 years.

According to The New England Journal of Medicine, since the early 1970s, Finland began a campaign to reduce salt intake. Since then, the daily consumption of salt dropped by 3000 milligrams a day with a corresponding decline in death rates from stroke and coronary heart disease of 75-80%.

In a recent study it was found that the consumption of salt among Malaysians was 8.7 grams (3,419mg of sodium) daily which is 1.7 times higher than the World Health Organisation’s recommendation of 5 grams of salt (2,000mg of sodium) a day.

Excessive sodium intake, besides raising blood pressure, also increases the risk of stomach cancer and kidney disease and may aggravate asthma and osteoporosis.

Table salt (sodium chloride) is the major source of sodium in the Malaysian diet. One teaspoon or 5g of salt provides 2,000 mg of sodium. However, sodium may also be present in food as food additives. It may be present as monosodium glutamate (MSG) (flavour enhancer), sodium bicarbonate (leavening agent), sodium nitrate and sodium benzoate (preservatives) and in many other commonly used sodium-based additives.

Salt acts not only as a flavour enhancer, but is used to also increase the shelf lives of food products, control fermentation and improve the functionality of foods.

According to the USFDA, about 75% of our salt intake comes from salt added to processed foods and salt added at food establishments. Eating processed foods and eating out is unhealthy.

CAP research found also over 40 sodium-containing additives used in processed foods.

The WHO Codex Alimentarius food standards allow 136 additives to be used in instant noodles out of which 24 are sodium salts. A packet of instant noodles alone contains over 1,000 mg of sodium, more than half the allowable daily intake of sodium.

Studies has shown that if one lowers the consumption of sodium in the diet the body starts to expect food to taste less salty, and that becomes the normal flavour of food. Lower sodium diets will regulate the salt taste receptors in about six weeks.

In view of the escalating number of hypertension cases among Malaysians, the Consumers Association of Penang calls on the government to:

• Make it compulsory for manufacturers to show the amount of sodium on the labels of food products.
• Stop the advertisements of food products that contain high levels of sodium, such as instant noodles and fast foods, during children’s television viewing hours.
• Launch a massive campaign to encourage consumers to be aware of the dangers of high sodium intake, to use less salt and to avoid high- sodium foods.

Meanwhile consumers are advised to:

• Avoid processed foods with high sodium content.
• Use less salt and seasonings in cooking at home, instead use various natural herbs and condiments to add flavour to the food.
• Choose food with less salt and sauces when purchasing foods away from home, either as takeaways or when dining out.
• Read the nutrition information panel (NIP) and find out the amount of sodium in foods intended to be purchase.

Press release, 17 May 2013