What is the extent of the problem of high salt intake in developing countries particularly SSA and South Asia?
Are there particular sources of the salt in South Asia or SSA e.g. like soya sauce in China or processed food in the West.
What strategies have been used to reduce salt intake and lessons learnt. Where possible please give examples from SSA or South Asia, if not, from elsewhere.
There is mixed evidence of the extent of the problem of high salt intake in South Asia and sub-Saharan Africa (SSA). Different reports and different unit measurements make it hard to compare and assess data.
Data suggests:
- a significant problem in India
- a moderate problem in South Africa and Zimbabwe
- a potential problem in Nigeria
- not a problem in Kenya, Uganda and Tanzania.
In many sub-Saharan African countries, particularly in less urbanised settings, the main source of dietary sodium is predominantly from salt added to food for preservation, for taste and added in the cooking process.
Strategies that have been used to reduce salt intake include:
- A health education programme carried out by community health workers in Ghana. Advice was given not to add salt to food, to limit the amount of salted fish, and to soak salted items overnight before eating them. Results from this intervention did not show significant change in sodium excretion.
- An earlier pilot study in Ghana found vigorous nutrition education sessions did reduce sodium excretion rates.
- Observance of ‘World Salt Awareness Week’. In Bangladesh this has included a press conference, stake holder meetings, posters and talks.
- A study in Nepal found that extremely high physical activity and very low % fat could serve to mute the influence of high sodium intake.
- One report recommends reducing the sodium content in margarines.