There is renewed attention in India on the harmful effects of high sugar food items and the use of fats or oils in cooking. The context is the rising burden of non-communicable diseases (NCD), more so obesity, in all age groups including in children and adolescents. However, there is one component which is of equal if not bigger concern and an issue that is not receiving adequate attention. It is the subject of the high consumption of salt by India’s population.
There is scientific data that Indian adults consume nearly eight to 11 grams of salt every day. This is double the World Health Organization (WHO) recommended daily salt intake of five to six grams per day. Salt is very much a part of the Indian diet. Much of the salt intake — nearly three-fourth — in India is from home-made food items. Pickles, papad/papadam and many other items that are rich in salt are part of home-made food.
Visible and invisible forms
There is also the cultural practice of having a salt shaker on the dining table or the surfaces around it which also helps increase salt intake. Eating out is becoming common — nearly one-fifth of adults eat outside, three times a week on average. Essentially, restaurants are an extension of an individual’s food habits. Therefore, in an attempt to make the food served tastier, these eating places add more oils and butter, which require more salt to be added to suit the taste buds. In addition to visible salt, there is also invisible salt present in many items — bread, cookies, ketchups and even sweet items such6980741069807410 as cakes and pastries. All packaged food items have salt as a preservative or as a taste enhancer. What is available in the market is often a variety of high fat, salt and sugar (HFSS) and ultra processed food items.
It is not that excess salt consumption is harmless. The adverse health impacts of excess salt intake are well documented. The high intake of salt is a key factor in India’s growing burden of hypertension, which affects 28.1% of adults and significantly increases the risk of cardiovascular diseases. Yet, salt does not get sufficient public health attention. The current discourse is about sugar boards or the need for attention on oil boards (visual information panels in public places to highlight high sugar and fat content in foods) but there is limited advocacy for reducing one’s salt intake.
Moving beyond awareness campaigns
Salt reduction is a public health imperative. The WHO calls salt reduction a “best buy” intervention, with research suggesting that for every dollar invested in scaling up salt reduction interventions, there will be a return of at least $12. While current efforts promote awareness measures, these alone do not solve the problem.
Salt consumption is also linked to widely prevalent myths in India. For example, there are many who believe that salts such as rock salt, black salt and Himalayan pink salt, are better and have health benefits, which is not true. All types of salt contain sodium with minor range variations.
Excess sodium, regardless of the source, contributes to high blood pressure and linked harmful effects. Some of these salt formulations have a less than salty taste and thus are consumed more. Further, these types of salt are usually not iodised, and their use could lead to iodine deficiency.
In such a situation, it is time that we start paying attention to reduced salt intake in a multi-pronged approach. First, the isolated approaches of a focus on a ‘sugar board’ and ‘oil board’, need to be expanded into a more comprehensive strategy of HFSS boards, where equal attention is given to ensure salt reduction. We need to be mindful that ultra processed food or anything which requires packaging often has excess salt (and possibly sugar and fat as well).
Second, there is a need for public awareness campaigns to change behaviour which includes gradual salt reduction while cooking, flavouring with herbs and spices, and replacing regular salt with low-sodium salt substitutes. Here, a word of caution, replacing sodium based salt with high potassium salt should be done with medical advice as higher potassium salt could be risky for some people such as those with kidney diseases.
Third, a salty taste is an acquired taste. If a person is exposed to high salt food, the person is likely to consume more salt to get a similar taste. Therefore, salt reduction should start with children. In fact, babies (up to one year) should not be given any added salt. Even toddlers and pre-school children should not be given added salt. Of course, they can have the same food items which adults eat, made from the common kitchen.
Fourth, every day, millions of vulnerable Indians including children in schools, pregnant women in Anganwadi centres, and patients in hospitals rely on government-provided meals. These programmes are critical touchpoints for public health. Yet, mechanisms to regulate or monitor salt content in these meals are still evolving. Reforming public food procurement norms to mandate salt limits, train cooks, and set standards can improve health outcomes in the most at-risk populations.
Fifth, there is a need for more proactive front-of-pack nutritional labels which inform readers about warnings regarding high salt content of specific items, as it has been done in Latin American countries. In this, Chile is a front leader. India must adopt mandatory warning labels, salt ceilings in processed foods, and restrict marketing of unhealthy foods to children.
Sixth, community and family-level initiatives such as restaurants removing salt shakers from tables (providing them only on demand) and families doing weekly reviews of high salt and fat and sugar items in the kitchen (and dispose of and not purchase more) will help in reducing salt intake. More such innovations would be needed.
An integration with health programmes
Seventh, India’s own National Multisectoral Action Plan (NMAP) for prevention and control of NCDs (2017-22) includes salt reduction as a priority. While several steps have been taken, a more integrated, cross-ministerial approach could further strengthen the impact. As the Union Ministry of Health and Family Welfare is working on a new multi-sectoral plan for NCDs, it is time for additional bold steps. To effectively reduce salt intake at the population level, it is essential to have and implement a combination of regulatory measures and community-based interventions.
Integrating salt reduction strategies into existing national health programmes can facilitate this process.
Dr. Chandrakant Lahariya is a practising physician and Founder-Director, Foundation for People-Centric Health Systems, New Delhi. He has worked for nearly 18 years with the World Health Organization and UNICEF. C.K. Mishra is a former Union Health Secretary, Government of India
Published – September 25, 2025 12:08 am IST