India has made tremendous progress on key health indicators such as maternal mortality ratio and infant mortality rate—demonstrating a clear commitment to public well-being, but non-communicable diseases are now becoming a significant public health concern. For example, the country bears a staggering burden of hypertension, which is often a precursor to heart disease. An estimated 200 million people in the country have high blood pressure—and more than a quarter of all deaths in the country are caused by heart disease.
While the government has made concerted efforts to address non-communicable diseases such as hypertension, challenges remain. It’s critical to address this looming public health crisis through actionable pathways.
In an exclusive conversation Onlymyhealth, Mr. Pawan Agarwal, Founder-CEO, Food Future Foundation & former CEO, FSSAI shared some tips on strengthening heart health by making some nominal shifts in your diet and lifestyle.
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Making sodium reduction a priority
While sodium is an essential nutrient required for various bodily functions, its excessive intake can increase the risk of hypertension and heart ailments. The World Health Organisation (WHO) recommends no more than 2g of sodium intake daily but Indian consumption is twice that threshold. WHO had set a 30% sodium reduction target by 2025— but most member countries have failed to hit the benchmark. That’s because preventative measures like sodium reduction face significant barriers to large-scale adoption.
For its part, the Indian government has made remarkable strides in promoting sodium reduction in food by adopting a multi-sectoral intervention strategy comprising public awareness campaigns and policy frameworks. Reducing salt, sugar, and fats is one of the key focus areas of the Eat Right India movement, which was launched by the Food Safety and Standards Authority of India (FSSAI) in 2018. Aaj Se Thoda Kam, FSSAI’s signature mass media campaign, promotes the reduction of sodium, sugar, and fat in dietary intake. It also launched a low-salt cooking challenge to raise consumer awareness.
While these impactful initiatives have resonated with Indian households, behaviour change needs long-term sustained investments. After all, Indian culinary traditions have historically relied heavily on salt for food palatability. Integrating nutrition education across schools, offices, and other public institutions can help drive long-term behaviour change. Nutrition education should not be confined to responding to public health crises; it should be a core element of a comprehensive mass media strategy addressing health-related topics.
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Bringing manufacturers and producers into the fold
In the meantime, policy interventions aimed at the food and beverage sector can accelerate progress towards our sodium reduction targets. In the developed world, processed foods, such as bread, sauces, snacks, soups, and processed meat, contribute significantly to sodium consumption. The Household Consumptions Expenditure Survey 2023-2024 indicates a rising tendency towards processed food consumption among Indians too. In urban parts of the country, monthly spending on beverages and processed foods on a per capita basis jumped from 8.98% in 2011-12 to 11.09% in 2023-24. Similar trends were noticed in rural areas.
FSSAI, for its part, has made commendable efforts to promote sodium reduction. The body has urged companies to reformulate salt, sugar, and fats in their packaged food products. Consequently, many companies have voluntarily reformulated their products to reduce salt, sugar, and fats.
Many countries have adopted mandatory regulations to meet sodium reduction targets. South Africa set mandatory sodium thresholds for packaged foods such as bread and processed meats. The country implemented a phased approach for mandatory compulsory limits across 13 food categories, including bread, in 2013, with the manufacturers required to meet two sets of targets over a six-year timescale. Post-implementation evidence points towards positive impact. Similarly, mandatory reformulation regulations could nudge companies in India into action.
Last year, in a pivotal move, move, the FSSAI also proposed an amendment to current labelling legislation mandating companies to highlight salt, sugar, and fat information on their packaging in large and bold lettering.
Paving the way for low-sodium alternatives
Low-sodium food ingredients that can substitute some salt in food can be another tool to achieve sodium reduction targets. Recently, WHO issued guidelines for the use of low-sodium salts, such as potassium chloride (KCl).
Another effective tool is MSG, or monosodium glutamate--a widely used umami seasoning that has been shown to reduce sodium content in food by 31-61%. Using low-sodium alternatives, such as MSG, has been recognized as a key pillar supporting sodium reduction efforts in Singapore by Singapore Nutrition and Dietetics Association (SNDA), Singapore Heart Foundation (SHF), and The National Kidney Foundation (NKF). FSSAI permits MSG use under Good Manufacturing Practices.
Evidence-backed policy frameworks that factor in the health impacts of low-sodium alternatives and their acceptance among Indians are needed to support their large-scale integration into Indian gastronomical culture. Regulatory approaches to sodium reduction can be part of a scalable and effective national response to the public health crisis posed by hypertension and heart disease.