Context

In India’s evolving discourse on nutrition and public health, sugar and excessive oil consumption have taken centre stage. This focus is understandable, given the increasing prevalence of non-communicable diseases (NCDs), particularly obesity, among individuals of all age groups. However, amid this heightened awareness, a critical dietary risk factor continues to be overlooked: the excessive intake of salt. Deeply rooted in Indian culinary traditions, salt is often considered indispensable, yet its overconsumption poses severe health risks. As such, it is essential that salt consumption receives the same policy attention and public awareness as the dangers of sugar and fat.

The Extent of the Problem

·       Scientific studies indicate that Indian adults consume between eight to eleven grams of salt per day—almost twice the World Health Organization’s (WHO) recommended limit of five to six grams. While concerns over sugar and fat typically focus on processed foods, the majority of India’s salt consumption—nearly three-fourths—originates from meals prepared at home. Traditional foods such as pickles, papads, and various condiments are major contributors. Cultural practices like placing salt shakers on dining tables and the increasing frequency of dining out, where restaurants liberally use salt, butter, and oil to enhance taste, further aggravate the issue.

·       What makes salt particularly insidious is its hidden presence in everyday items like bread, biscuits, sauces, and even sweet foods like cakes. The surge in packaged and ultra-processed foods—classified as high in fat, salt, and sugar (HFSS)—has saturated Indian markets. Although public health campaigns often highlight the dangers of sugar and oil, salt remains under-discussed, despite being equally detrimental. This neglect persists even as hypertension—strongly linked to high salt intake—affects 28.1% of Indian adults and significantly elevates the risk of cardiovascular disease, a leading cause of mortality in the country.

Myths and Misconceptions

Public perception around salt is also clouded by several misconceptions. Many people believe that rock salt, black salt, or Himalayan pink salt are healthier alternatives to regular table salt. However, these variants still contain sodium, the harmful component in salt. In fact, their milder taste often results in larger quantities being consumed, thereby intensifying the health risks. Another overlooked issue is the lack of iodine in many of these alternative salts, which can lead to iodine deficiency—a condition India has historically battled through widespread iodisation initiatives.

A Multi-Pronged Approach

·       To meaningfully address India’s salt crisis, a comprehensive and multi-layered strategy is essential.

·       One important step is expanding the mandate of current nutrition-focused bodies. Instead of having separate boards for sugar and oil, integrated HFSS boards should be established to include salt. These would raise awareness of the combined risks associated with ultra-processed foods that are high in sugar, fat, and salt.

·       Public education campaigns should aim to foster behavioural changes around salt use. These campaigns must promote a gradual reduction in the quantity of salt used in cooking, encourage the use of herbs and spices to enhance flavour, and introduce low-sodium substitutes where medically appropriate. However, caution must be exercised with such substitutes, particularly those high in potassium, as they may be unsuitable for individuals with kidney-related conditions and should only be used under medical supervision.

·       Instilling healthy eating habits must begin in early childhood. Since salt preference is an acquired taste, children should be introduced to low-salt diets from infancy. Infants and toddlers should not be given added salt, while older children should consume food that is only minimally salted, similar to that consumed by health-conscious adults. Establishing such taste preferences early can substantially reduce long-term dependence on high salt intake.

·       Reforms are also needed in large-scale public food programmes. Millions of Indians, including schoolchildren, pregnant women in Anganwadi centres, and patients in government hospitals, rely on meals provided by state-run schemes. These programmes must integrate salt regulations, train cooks in healthy preparation methods, and enforce procurement standards that prioritise nutritional safety.

·       Mandatory front-of-pack labelling should be introduced to clearly indicate high-salt foods. Countries like Chile have already demonstrated the success of such measures in curbing unhealthy consumption patterns. Alongside labelling, implementing salt content ceilings for processed foods and limiting the marketing of HFSS products to children are critical regulatory steps.

·       At the household and community level, several practical interventions can make a difference. Removing salt shakers from restaurant tables, encouraging families to monitor and reduce their weekly purchases of HFSS foods, and discouraging repeat consumption are effective starting points. Local innovations tailored to community needs can also play a vital role in shifting dietary habits.

·       While salt reduction is already included in India’s National Multisectoral Action Plan (2017–22) for NCD prevention, current efforts remain fragmented. Stronger cross-sectoral collaboration and integration with broader health initiatives are urgently required. As the government drafts its next multisectoral strategy, salt reduction must be recognised not as an optional add-on but as a core objective.

The Case for Stronger Regulation

According to the WHO, salt reduction is one of the most cost-effective public health interventions available, offering a return of twelve dollars for every dollar invested. Yet, despite this compelling evidence, awareness efforts alone will not suffice. A successful strategy must combine regulatory frameworks—such as mandatory labelling, procurement guidelines, and marketing controls—with grassroots-level action to produce sustainable outcomes.

Conclusion

·       Salt is a largely invisible but equally harmful component of both modern and traditional diets. Its excessive intake is silently fuelling the growth of hypertension and cardiovascular diseases, which place immense pressure on both families and the national healthcare system. By dismantling misconceptions, reforming food systems, and encouraging behavioural shifts at every level—from policymaking to household kitchens—India has the opportunity to lead a transformative public health movement.

·       Ultimately, reducing salt consumption will require an integrated, multi-pronged approach that balances regulation, awareness, and community engagement. Only through such coordinated efforts can the country hope to safeguard public health and reduce the burden of NCDs for future generations.