As World Kidney Day draws near, Thailand's Ministry of Public Health is marking the occasion by encouraging Thais to eat less salt.
Starting from Tuesday, Low Salt Week is aimed at putting proper salt intake into the spotlight.
Public health campaigns promoting the importance of controlling levels of dietary salt have been carried out for quite some time, not just in Thailand, but around the globe, said nutritionist Somsri Tachavarakul. Despite this, people are still consuming too much salt, especially when dining out.
"We have been speaking about how excessive salt intake affects the health for so many years. But it seems like the attempt to reduce salt in diets is easier said than done," Somsri commented.
Salt — or sodium chloride to be more precise — has a direct effect on blood pressure, the certified dietitian continued. Basically salt makes the body hold on to more water. And the extra water raises the volume of blood and, in turn, the body's blood pressure. Too much salt therefore is likely to bring about hypertension.
When blood does not flow properly as a result of abnormal blood pressure, cells in several organ systems begin to die because they do not receive sufficient blood.
"Each kidney contains up to a million functioning cells," Somsri added. "When they die, it is not that all of them die at the same time. The cells gradually malfunction until they finally cease working. Meanwhile, the remaining cells are still functioning. Also, because the cells are damaged little by little, you will not realise there is something wrong with the kidneys until symptoms of kidney diseases develop, and it is probably too late. Some people almost lose most of their kidney cells."
According to statistics from the Department of Health, there are approximately 8 million people currently in Thailand that have fallen victim to chronic kidney diseases. Of this number, about 200,000 people are in the terminal stage. Around 40,000 cases are now waiting for kidney transplants, at a cost of 200,000 baht per procedure. Unfortunately, in Thailand, only 400 patients undergo kidney transplants every year owing to insufficient number of organ donors.
One way of preventing kidney diseases, therefore, is to lower the amount of salt intake from diets. But salt, according to Somsri, does not just mean table salt and other salty seasonings such as fish sauce, soy sauce and shrimp paste.
"When medical personnel speak of salt, they refer to sodium chloride," she explained. "This means anything, any ingredients that contain the word 'sodium' you see on product labels. They are common flavour enhancers like monosodium glutamate or MSG as well as baking powder [sodium bicarbonate]. Food preservatives can also contain sodium compounds too."
A large number of food products available in supermarkets also contain sodium components, with canned food, frozen food, instant noodles, processed food and juice drinks all things that consumers should be extra cautious about. According to Somsri, even natural foods, like fresh fruit and vegetables, contain sodium. Therefore, when further seasoned or processed, such items will without a doubt contain an additional amount of sodium, which is way beyond what the body needs.
Then the next question is how much is too much?
Somsri suggested that people consume no more than 2,400mg of sodium per day, which is in line with the recommendation from the US Food and Drug Administration (FDA).
"The recommended amount is equal to approximately one teaspoon per day," she advised. "But if you suffer from kidney diseases, the number has to go down to half-a-teaspoon per day."
The amount of salt intake among Thais is one ongoing public health concern, admits Somsri, with an average Thai person consuming around four teaspoons of salt per day.
"In this modern age people are too busy to cook at home, and prefer to eat out in restaurants or buy ready-to-eat food rather than spending time shopping for fresh ingredients and cooking by themselves. When we eat outside, it is almost impossible to control the amount of salt being added during the preparation process. So, what we can do when we eat outside is to not put additional salt or seasoning into your dish. If you eat at a noodle vendor, for instance, be aware that the soup already contains salt. So if you add more fish sauce, that may well be too much," the nutritionist noted.
Avoiding strong-flavoured food is also key in reducing salt intake. "Salt is usually hidden in food with strong flavours. Take som tum, for example. It's spicy and sour and you probably cannot spot the salty taste in the dish. But in fact, som tum is one of the dishes that contains a lot of fish sauce just to create that favourable taste — not to mention the saltiness from dried shrimp."
The dietitian said that it is paramount for consumers to read product labels carefully before purchase. Avoid things that contain a lot of sodium. Also, regular medical check-ups are vital as it can be a strong shield against kidney diseases.
"Signs of kidney diseases can range from body swelling, rapid weight gain, bubbles in urine and high blood pressure," Somsri explained. "But in many cases, when these symptoms start to develop, it is too late for the kidneys to recover. So routine medical check-ups will enable physicians to detect the abnormality in your kidneys before it is too late."
