Opinion
Cardiac health calls for a collective salt rollback
Summary
High blood pressure haunts Indians overdosed on salt. To fend off this silent killer, nutrition labelling seems too blunt a tool. To reduce our sodium intake, we need a collective pullbackThis week, a report on hypertension published by the World Health Organization (WHO) said that over 188 million Indians were living with high blood pressure, but only 37% of them were aware of their status. It can lead to a cardiac attack, stroke or other illnesses, but the condition stalks us stealthily, often without symptoms. By the WHO’s estimate, intervention can potentially prevent 4.6 million deaths in India by 2040. The study’s eye-popper was its finding on our intake of salt, the sustained over-dosage of which bears a clear link with the pressure of what flows through our arteries. On average, Indians consume about 10gm of salt everyday (2019 data), which is twice the WHO’s recommended limit of 5gm for adults. For the health of our hearts, this needs sharp reduction. The problem, it seems, is that our palates have been conditioned to savour extra salinity. Indeed, the role of packaged foods in raising our tolerance of salt in their chase of taste-buds cannot be over-estimated. Get used to excessive sodium-chloride (its chemical name), and we end up over-salting all our meals without even realizing it.
It’s a global worry, with most of the world on a sodium binge. The standard way to intervene against the health risks of any food ingredient is via pack labelling, designed for us to watch what we eat. Label rules issued by the Food Safety and Standards Authority of India were revised in 2021-22 to tighten our norms of disclosure. Yet, the efficacy of this approach remains in doubt. At one level, it is unclear how widely the data tables of these labels are understood. To some, they’re a maze of numbers. For cross-pack comparison, they list the nutritional content in every 100gm of the product. Then, confusingly, another column alongside shows nutrient percentages. This is meant to tell us what portion of our ‘RDA’—recommended dietary allowance—is made up by a single serving, but how each of these is defined varies; it’s usually modest (like “two biscuits"), depending on what the pack contains. Even the language used seems more lab-derived than market-friendly. Indian snack packs list ‘sodium’ instead of ‘salt,’ for example, without adding that 1gm of sodium is 2.5gm of salt, half the day’s quota. While the health conscious can use such data to monitor their intake (online aids exist), the numeracy demanded by this exercise would surely deter millions of us. It’s plausible that a vast chunk of any salty snack’s consumer base pays nutrition labels little attention, if any. To push demand down, friendlier labels deserve a try.
At another level, we should ask if the efficacy of these labels can be improved with better insights from behavioural economics. Broadly, the idea of food labelling is to ‘nudge’ us into healthier habits. But, as studies show, data often needs an alert level clearly marked out for it to spur action. Percentages tend to alarm us only if we see an outsized share. Typically, a serving of even a heavily salted snack won’t make up more than, say, a tenth of our RDA. If that doesn’t sound scary, it may explain why labels are such blunt tools. In any case, it’s an overall salt habit that needs a rollback. As marketers of salty snacks jostle for our taste-buds in a thriving game of volumes out there, maybe the best way out would be to frame it as a “tragedy of commons": Each marketer risks a loss of business to rivals if it cuts back on salt. Tragic as that is, game theory offers a solution. If all food sellers across India take salt seriously enough to forge a pact, a collective pullback may be possible.
