Excessive salt consumption linked to rising cases of hypertension in Kenya

Sodium has long been a crucial component of many people’s diets, including in Kenya, where its use in food preservation and flavouring is deeply rooted in cultural practices.

However, the increasing consumption of ultra-processed foods, which often contain excessive salt additives, is worsening the risk of hypertension across the country.

In East Africa, the combination of traditional dietary habits and the rising popularity of ultra-processed foods is fuelling a silent hypertension crisis.

Sodium-rich spices, seasonings, and processed snacks are now common, especially in urban areas, further compounding health risks. The use of salt to preserve foods such as meat and fish is embedded in cultural practices. Yet, the high sodium content found in modern processed foods far exceeds the World Health Organisation's (WHO) recommended intake, contributing to the growing prevalence of hypertension.

The WHO recommends that adults limit their sodium intake to less than 2000 mg per day, which is equivalent to just under 5 grams of salt (about a teaspoon). For children aged 2-15 years, sodium intake should be adjusted based on their energy needs.

While sodium naturally occurs in foods such as milk, meat, and shellfish, it is also found in higher concentrations in processed foods like bread, processed meats, snacks, and condiments such as soy and fish sauces. Additionally, monosodium glutamate, a widely used food additive, is another major source of sodium.

Globally, hypertension affects 1.2 billion people, with two-thirds of them residing in low- and middle-income countries, including East Africa. Alarmingly, 46 per cent of individuals with hypertension are unaware of their condition, leaving them vulnerable to severe complications.

A 2019 study conducted by researchers from the University of Nairobi, published in the East African Medical Journal examined the relationship between salt consumption and hypertension in urban Kenyan populations, particularly in Nairobi.

Salt in processed foods

The study found that the average sodium intake in urban diets exceeded the WHO's recommended levels, primarily due to the high consumption of processed foods and salty snacks.

The study found that many urban Kenyans, particularly in Nairobi, were consuming more than 3,000 mg of sodium daily, far surpassing the WHO's recommended limit of 2,000 mg. This was largely attributed to the growing consumption of processed and fast foods.

There was a strong correlation between high sodium intake and elevated blood pressure. Hypertension rates were significantly higher in urban populations compared to rural areas, where sodium intake was lower.

It also found that middle-aged and older adults were particularly vulnerable. The study found that this group had a higher prevalence of hypertension, directly linked to their higher sodium intake.

The study highlighted a growing health disparity between urban and rural populations, with urban residents consuming more processed foods and salt, leading to higher hypertension rates. In contrast, rural populations had lower sodium intake and consequently lower hypertension rates.

Public health campaigns

It stressed the urgent need for public health campaigns to raise awareness about the risks of excessive salt consumption and promote healthier food choices, especially in urban areas.

According to pathologists from The Lancet Kenya, excessive salt (sodium chloride) intake significantly increases the risk of non-communicable diseases (NCDs), including hypertension, which is a major risk factor for stroke, cardiovascular diseases, and kidney problems.

High salt consumption is linked to 30 per cent of hypertension cases and related diseases, contributing to 1.65 million deaths annually due to cardiovascular events. Additionally, research suggests a positive association between high salt intake and an increased risk of gastric cancer.

Health experts recommend several strategies to reduce salt consumption and mitigate the risks associated with high sodium intake.

Preparing meals using fresh ingredients gives you control over the amount of salt added. The WHO emphasises this approach to reduce reliance on processed foods, which are often high in sodium.

While cooking, it is recommended that you flavour your meals with herbs, spices, garlic, onions, and salt-free seasoning blends instead of using salt. The American Heart Association (AHA) suggests this as an effective way to reduce sodium intake.

Slowly cutting back on salt allows your taste buds to adjust to a lower-sodium diet. The Centres for Disease Control and Prevention (CDC) recommends this gradual approach to help people adapt to lower salt consumption.

Opt for fresh or frozen vegetables instead of canned ones, which often contain added salt.

Check the sodium content on food labels, especially in packaged foods. The US Food and Drug Administration (FDA) encourages consumers to select low-sodium or no-salt-added options.

Limit processed and fast foods as they are often loaded with sodium. WHO recommends limiting processed foods to reduce the risk of hypertension and related diseases.

When using canned foods like beans or tuna, rinse them under cold water to reduce sodium content.

Avoid placing the salt shaker on the table to prevent adding extra salt to meals. This simple step can help reduce unnecessary sodium consumption.

Reducing global salt intake from the current average of 9-12 grams per day to below 5 grams could significantly lower blood pressure and reduce the risk of cardiovascular diseases, potentially preventing up to 2.5 million deaths annually from heart attacks and strokes worldwide.

In Kenya, undiagnosed high blood pressure remains a significant concern.

The Ministry of Health reports that about 24 per cent of the adult population is affected, yet nearly half of these individuals are unaware of their condition. Alarmingly, only 21 per cent manage to control their blood pressure.

Hypertension is a leading cause of premature deaths globally, and one of the WHO’s targets for non-communicable diseases is to reduce its prevalence by 33 per cent between 2010 and 2030.