Salt consumption in India: the need for data to initiate population-based prevention efforts

Scientists from the Public Health Foundation of India (PHFI), the University of Birmingham, Imperial College London and the University of Sydney are carrying out an assessment of dietary salt intake among 1,400 adults over 24 years in urban Delhi and rural Haryana.

India has a diverse dietary culture where salt and spices are used extensively but up-to-date figures on population salt consumption are very limited. Public health studies worldwide have found excess salt intake to be associated with increased risk of high blood pressure (hypertension), an important risk factor for cardiovascular disease.  Projections indicate that from 2000 to 2025 the number of Indians suffering with hypertension will almost double from 118 million to 213 million.

The existing available data indicates that population salt intake is very high across different regions of India with the average daily intake ranging between 9 and 12 grams daily. This is extremely high compared to the World Health Organization (WHO) recommended intake level of 5 grams daily.  The intake is reported to be higher in urban settings compared to rural settings.

The cross-sectional survey will determine the mean daily salt consumption and determine the main sources of salt in diets through the collection of 24-hour urinary sodium excretion samples among a representative sample. It will also assess the knowledge, attitudes and behaviours with regard to salt consumption and its impact on health through a questionnaire.

Dr Sailesh Mohan, the study’s Principal Investigator and Associate Professor at PHFI, said: “Population-based strategies are necessary given the high prevalence and growing burden of hypertension and its inadequate management in India.  Therefore, it’s imperative to determine current consumption levels so that appropriate evidence-based preventative public health action can be initiated. Such data is critical in facilitating the development and implementation of an India-specific salt reduction programme, to translate the existing scientific evidence into population health gains, and also to subsequently monitor and evaluate such a programme.”

Dr Paramjit Gill, Reader in Primary Care Research at the University of Birmingham, added: “There is strong evidence that cutting the amount of dietary salt consumed will reduce population blood pressure and associated risk of cardiovascular events in both hypertensive as well as normotensive individuals.

“Evidence points to dietary salt programmes being extremely cost effective and they offer great potential to prevent cardiovascular disease-related deaths. Regrettably much of the current data available has been derived from dietary surveys alone and not estimated from 24-hour urinary sodium excretion, which is considered to be the gold standard for determining population salt intake levels. The data obtained from this current survey can be used to facilitate the initial development and subsequent evaluation of a national population-wide salt reduction strategy.”

The results of the study are due in 2014.


Notes to Editors

· The Public Health Foundation of India (PHFI) is a public private initiative that has collaboratively evolved through consultations with multiple constituencies including Indian and international academia, state and central governments, multi & bi-lateral agencies and civil society groups. PHFI is a response to redress the limited institutional capacity in India for strengthening training, research and policy development in the area of Public Health.

Structured as an independent foundation, PHFI adopts a broad, integrative approach to public health, tailoring its endeavours to Indian conditions and bearing relevance to countries facing similar challenges and concerns. The PHFI focuses on broad dimensions of public health that encompass promotive, preventive and therapeutic services, many of which are frequently lost sight of in policy planning as well as in popular understanding.

·  A leading UK research-intensive university, the University of Birmingham is a vibrant, global community and an internationally-renowned institution, in the top 100 globally. With approximately 28,000 students and 6,000 members of staff, its work brings people from more than 150 countries to Birmingham.  The University has a bold strategy to develop its global reputation by enhancing its international presence and collaborations.


The University of Birmingham’s engagement with India spans over 100 years.  The first Indian students came to Birmingham in 1909 to study degrees in Mining and Commerce and there are now more than 1000 Indian alumni.  The University currently has over 180 students from India studying a wide range of subjects – at all levels from foundation to doctoral research. The University’s India Office opened in New Delhi in 2009 to maintain partnerships with local providers, support alumni in India, further consolidate research collaborations and provide local services to those students who wish to study at the University.  For further information please visit:


·         For further information about Imperial College London and the University of Sydney please visit: and  


·         For media enquiries, please contact: Catherine Byerley, International Media Relations Manager, University of Birmingham, Tel: +44 (0) 121 414 8254 or +44 (0) 121 414 6029