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Pickles, papads, junk food raise risk of hypertension: Experts -Malathy Iyer
-The Times of India


MUMBAI: The urban Indian's diet, pickled with takeaways from fast-food joints and instant foods that are ready in a jiffy at the end of a long working day, could worsen the present epidemic of hypertension due to its high proportion of salt. In a city where every fourth adult is believed to have hypertension, experts said the focus should be on reducing salt intake in the daily diet.

Around 21% of Indians are generally believed to have hypertension, while studies have shown that Mumbai's figure is higher at 25%.

Hypertension means increased blood pressure in the body's blood vessels. This increased pressure can, over the years, weaken organs, precipitate heart attacks and kidney failure and trigger a brain stroke. Increased levels of sodium, a key element of the body, can play a great role in causing hypertension. The World Health Organization (WHO), in fact, has chosen to focus on hypertension as its theme for World Health Day on Sunday.

"There is hidden salt in the Indian plate, right from papads to pickle," said endocrinologist Shashank Joshi. The hidden salt, along with salt we liberally add to food, worsens the plight for Indians as far as blood pressure is concerned. A study he worked on in 2009-10, of 16,000 patients visiting doctors' clinics, showed that 56% of those in Maharashtra had hypertension as compared to the all-India figure of 46%.

Experts say that Indians consume up to 6 to 8 grams of salt daily, while the Indian health ministry hypertension guidelines say that only 2.4 grams is recommended.

It isn't excess salt intake alone that heightens an Indian's chances of getting hypertension, it's also the Indian build. "Indians have thinner blood vessels than Caucasians, leading to different salt sensitivity among the two groups. Hence, the Indian blood vessel's ability to handle salt is lower than others," said Joshi, who practises at Lilavati Hospital in Bandra.

A study done in Chennai in 2007 found that an increased intake of 1.5 to 2 grams of salt was associated with an increase in high and low blood-pressure by approximately 1mm Hg (the unit to measure blood pressure).

"The risk of cardiovascular disease rises with blood pressure throughout the normotensive (normal) blood-pressure range and almost 60% of coronary heart disease events and 45 to 50% of strokes occur in those with high normal blood-pressure," said the study conducted by Dr V Mohan of Chennai.

Any reduction in salt intake brings about a healthy change as far as hypertension is concerned. The Chennai study, which was published in JAPI (Journal of Association of Physicians of India), found that a reduction in intake of sodium by 1.2 grams daily would lead to a 50% reduction in the number of people requiring anti-hypertensive therapy. The lower intake could also mean a 22% reduction in the number of deaths due to stroke and a 16% reduction in the number of deaths due to coronary artery disease.

Incidentally, if one sticks to the traditional Indian diet, hypertension wouldn't be such a problem. Dr Jagmeet Madan, principal of the SNDT College for Nutrition, Juhu, said, "If you stick to the traditional Indian diet, you will never go higher on salt." The problem creeps in when additions creep in to the Indian thali. "Adding chutneys, pickles and papads sends the salt balance haywire," she said.

So, processed foods should be kept as "sometime foods" instead of everyday foods.