Nepali Times
Life Times
Salt shakers

DHANVANTARI by BUDDHA BASNYAT, MD


Salt restriction lowers blood pressure. And lowering blood pressure should reduce rates of heart attacks and strokes. Unfortunately there are no clinical trials to convincingly show that just sodium (salt) restriction lowers the risk of myocardial infarctions, strokes and deaths. The latter three are the usual, well-known end points that are examined when figuring out the benefits in cardiovascular illness.

Normal kidneys which play an important part in regulating blood pressure can deal differently with vast increases in sodium intake. If we go to a Nepali wedding and eat plenty of salty dishes with a generous helping of 'achar', individual blood pressure response will be heterogeneous, that is, all over the place. Some people's blood pressure will show no effect, even though they feasted on salty food, but others will show an increase. And guess what, some will even have a lowered blood pressure. These are acute or short-term changes. Then there are also differences between how normal people react to excessive salt intake versus people with common diseases like diabetes, high blood pressure and kidney diseases. As often happens regarding general health recommendations these days, it is hard to find a 'take home' message about salt restriction in all this confusion.

Turning to the internet and googling key words like salt intake, blood pressure, salted potato chips and so forth is one option. But the internet may lead to more mind-boggling, controversial recommendations. Following suggestions from Ayurvedic or Tibetan medicine is perhaps another option, but if you want conclusions from some kind of randomised clinical trials, you can bet Ayurvedic and Tibetan medicine will not deliver on these counts.

Another possible alternative is to look for dietary guidelines by well-established institutions like the World Health Organisation. Keeping in mind race and ethnicity, factors which influence blood pressure, it would be wonderful to have home-grown guidelines from South Asia, but we South Asians are too preoccupied with political problems to give priority to such guidelines.

Western dietary guidelines recommend reducing salt intake to generally less than 2,300 mg per day in normal individuals and to less than 1,500 mg per day for people with high blood pressure, diabetes or chronic renal failure. But if figuring all this out is too complicated, a simple rule of thumb is not adding that extra table salt and cutting down on packaged instant noodles, crispy, salted potatoes, 'achar' and 'titaura'.

More importantly, make sure to check your blood pressure, and if you are on blood pressure medicines, don't stop taking them based just on Ram Dev Baba's pronouncements.



LATEST ISSUE
638
(11 JAN 2013 - 17 JAN 2013)


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