Halt the extra salt

The food -- however nutritious or favourite -- can turn bland without salt, at least in this part of the world where taste matters more than anything else when it comes to dining.

The same salt, nonetheless, can be extremely harmful when consumed at levels higher than permissible one as it is linked to hypertension or high blood pressure, a major risk factor for coronary artery disease, stroke, heart failure, vision loss and kidney diseases.

Alarming though, findings of two new studies indicate higher level of salt consumption by the city dwellers.

At least 70 percent of the white bread of various brands marketed in Dhaka city has higher sodium (salt is primarily composed of sodium chloride) concentration than the maximum allowable level recommended by the World Health Organization (WHO), according to a study.

It says 450-milligram (mg) sodium in 100 grams of bread is permissible, but seven out of 10 brands of the white bread marketed in the capital were found having higher level of sodium.

The highest concentration of sodium found in a brand was 625.9mg, followed by 609.9mg, 594.2mg and 584.6mg in 100 grams of bread, according to the study conducted by Dr Mohammad Rashidul Alam of the Department of Public Health and Informatics (DPHI) at Bangabandhu Sheikh Mujib Medical University (BSMMU).

The average salt level was 503.1mg in 100 grams of bread, says the study conducted between January and December 2016 based on three bread samples from each of the 10 selected brands.

Laboratory tests of breads were conducted at the Bangladesh Council for Scientific and Industrial Research (BCSIR).

"People in urban areas are increasingly consuming bread. Besides, bread is used in many of the processed food, but there is no regulation on the usage of salt. Bakeries also don't write the measurement of salt they use on the labels," Dr Rashidul Alam told this correspondent.

Another study found 90 percent people in Bauniabadh slum of the city consume higher dietary salt than the WHO-recommended level of less than 5 grams a day.

"The dietary salt intake of the study population was 7.8 grams a day, which is significantly higher than the WHO-recommended level," said Dr Fahmida Afroz Khan, research officer at the DPHI of BSMMU, who conducted the study on 100 adults aged between 20 and 59 years from January to December in 2016. The dietary salt intake was measured by urinary sodium.

The study found that 54 percent of the respondents took additional salt during their meals, while 19 percent of them recognised the importance of lowering the salt intake.

These findings are significant given the fact that a large number of people in the country suffer from hypertension and cardiovascular diseases, which are a rising health concern.

In Bangladesh, hypertension prevalence was 26.4 percent -- 32.4 percent among women and 20.3 percent among men, says a research published by the UK-based health journal BioMed Central in 2016.

And, of the 8.86 lakh deaths that occurred in Bangladesh in 2012, 17 percent were caused by cardiovascular diseases, says the WHO.

Health experts say though there is awareness among people that high intake of salt is unhealthy, they often ignore it in practice.

"However, they have nothing to do when higher than permissible level of salt is used in processed food items that are becoming popular in urban areas," said Dr Rashidul.

Given sodium's link to hypertension and cardiovascular diseases, it is high time that the policymakers have proper regulations on use of salt in the processed food and monitor labelling compliance to reduce its intake, he said.

Prof Harisul Hoque of cardiology department at the BSMMU said doctors can also help to create public awareness.

"The advice should be -- don't have additional salt on the table and mix moderate amount of salt while cooking food," he said.