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According to WHO, about 9.8 million people die every year due to hypertension-related complications. Hypertension is considered a silent killer producing heart disease, kidney failure and strokes. About 35 percent of world population above the age of 25 suffers from hypertension. One of the important strategies to lower hypertension in the population and its complications is reducing salt intake. Developed countries like Finland, United Kingdom, Australia and Canada have been actively campaigning for the reduction of salt intake in the population. In these countries, there has been a close association between government and NGO’s for this purpose. Finland was the first country to show an enormous health benefit by reducing salt in the diet. Not only the population’s health improves, there is also a great benefit in saving health expenditure related to heart revascularization and dialysis.

How does eating salt lead to or cause hypertension?

Eating salt increases the amount of salt in your blood, which ruins the balance of electrolytes and other vitamins and minerals in your body. This imbalance reduces your kidney's ability to filter out toxins from your body. It also reduces your kidney's ability to get rid of excess fluid from your body. This results in high blood pressure due to excess fluid in your body that exerts pressure on the blood vessels leading to the kidneys. 

How much is too much?

Dr Umesh Khanna, Senior Nephrologist and Secretary of Amar Gandhi Foundation said, “The WHO’s recommendation of salt intake from all sources is less than 5 grams per day. Salt or sodium is present in natural food, it is added while cooking and also used as a preservative for processed food. Considering the rapid economic growth that is happening in our country with urbanization and increased demand for processed food, it is imperative that we act at the earliest to control the salt intake of the Indian population.”

What happens when you reduce your salt intake?
“Salt or Sodium in various forms has been used as a preservative for several thousand years. It enhances the taste, prevents the growth of harmful microorganisms and can improve the texture of food, Taste is often a habit and high salt intake can saturate the taste buds. If you lower salt intake for 2 weeks you can start appreciating low salt intake and other tastes,” says Dr Umesh Khanna

What are the most common hidden sources of salt one should keep an eye out for?

Dr Umesh Khanna said, “Sodium in various forms is used as a flavouring, buffering, anticaking, leavening, thickening and stabilizing agent. The biggest culprit is in baked goods especially bread and instant noodles.”

How can a person start to reduce their salt intake?

Here are a few tips by Dr Umesh Khanna

Get used to low salt to allow the taste buds to recover: Not only does reducing your salt intake affect your blood pressure and other health parameters, it also helps you taste foods better.

Eat fresh food when possible: Since processed foods are packed with high levels of salt, switching to fresh and natural foods is the best way to reduce your daily salt intake.

Add less salt in cooking: With high amounts of salt added to food, your taste buds become immune to the level of salt and you will eventually need more salt in your food to bring out the taste you are looking for. Gradually reducing this amount will help you give up the high salt habit one step at a time. And since your taste buds will eventually become more sensitive to salt content in food, dishes made with low salt will start to taste as delicious as one with high salt content.

Do not add extra salt while at the table: A common practice in India is to provide a little bit of salt on the side of one’s plate while eating and to provide a salt shaker for one to spice up their soups. By stopping this practice, you can reduce your salt intake.

Use herbs and spices as flavouring agents: Ditch the salt and use herbs and other natural flavouring agents to your dishes that will help enhance the flavour while reducing your salt intake.

Dr Umesh Khanna, MD, DNB Nephrology, Lancelot Kidney & GI Center, Karuna Hospital & Asian Heart Institute. He is the Chairman, Mumbai Kidney Foundation, Trustee, Sapiens Health Foundation, Secretary, Mumbai Nephrology Group and the Secretary, Amar Gandhi Foundation

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Regulating salt consumption is key to prevent hypertension, which is associated with an increased risk of heart disease, heart attack, stroke and heart failure, say experts. According to World Health Organization (WHO), adults should reduce consumption of sodium to less than 2 grams a day, or the equivalent of about one teaspoon of table salt to reduce the risk of heart disease. 

Hypertension is a condition in which the blood vessels have persistently raised pressure. Hypertension is also referred to as high or raised blood pressure. Hypertension can also affect fertility in both males and females, says Rajalaxmi Walavalkar of Cocoon Fertility. Hypertension not only affects fertility but also is also known to cause trouble sleeping. Trouble sleeping leads to signs of premature ageing, like fine lines, uneven pigmentation and reduced elasticity.

"Hypertension can lead to cardiovascular diseases. The rise in blood pressure caused by eating too much salt may damage the arteries leading to the heart," Vijay D'Silva, Director at the Asian Heart Institute, said in statement.

According to a recent study, published in the journal Hypertension, about half of adults living in Asia are suffering from the high blood pressure.

While lifestyle factors, including diet and stress, are behind the high hypertension rates in Asia, one common problem is high salt intake, the study showed.

Asians not only tend to have diets high in sodium, but they are genetically more sensitive to sodium, the researchers said.

"Raised blood pressure due to high salt consumption is the biggest single contributing risk factor for non-communicable diseases and damage to your kidney," explained Bhupendra Gandhi of the NGO Amar Gandhi Foundation.

Previously, it was believed that eating high amounts of fruit and vegetables might help counteract the effect of high salt on blood pressure.

However, another study led by researchers from the Imperial College London and Northwestern University, showed that people eating higher amounts of salt had higher blood pressure -- no matter how healthy a person's overall diet.

"Anyone with hypertension is at an increased risk of infertility. A high salt diet leading to high blood pressure can result in delayed puberty and even impact reproductive health," Walavalkar noted.

Besides affecting the heart and fertility, hypertension can affect the skin too, the health experts said.

"High blood pressure can harden your arteries, which decreases the flow of blood and oxygen. An impairment of the flow of oxygen, to an organ such as your face, can cause your skin to dry and wrinkles faster which can make one look less youthful," said Amit Karkhanis - Medical Cosmetologist and founder of Dr Tvacha clinic.

Reducing salt consumption in everyday life, cutting down on fried foods and processed foods, can not only curb the problem of hypertension but also save multiple organs from damage and pave way for a healthy life.

Also read: Mumbai Health: These 7 Lifestyle Changes May Help Lower Heart Disease Risk

(Edited by mid-day online desk, with inputs from IANS)

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50 percent of people between the age of 60 to 69 years suffer from hypertension. This statistic only worsens as a person grows older reaching about 75 percent in those over the age of 70. In fact, the lifetime risk of developing hypertension is approximately 90 percent for men and women who were non-hypertensive at 55 or 65 years respectively – making hypertension a condition that requires our immediate attention.

While the condition affects one’s whole body, your heart is one organ that takes the worst beating. Dr Santosh Kumar Dora, Senior Cardiologist, Asian Heart Institute tells you how hypertension affects your heart and what you can do to deal with the condition.

How does hypertension affect your heart?

• It can result in hardening and thickening of the heart arteries, leading to their narrowing and causing the heart to receive less blood supply.
• It can also cause a heart attack. In fact, persons who present with an acute heart attack often have preexisting hypertension that evaded detection and treatment.
• It can cause abnormal thickening of heart muscle, the presence of which is a strong predictor of future cardiovascular death.
• High blood pressure puts more load on the heart and increases the amount of work that the heart has to do.

Eating right

Eating a heart-healthy diet is important for managing your blood pressure and reducing your risk of heart attack, heart disease, stroke and other diseases. Aim to eat a diet that's rich in fruits, vegetables, whole grain and high fibre foods, fat-free and low fat or 1 % dairy products etc. Avoid saturated and trans fats, excess salt and added sugar in your diet. DASH (Dietary approach to stop hypertension) diet pattern which contains low sodium, high potassium and rich in fruits and vegetables reduces by an average of 5.5 mm Hg for systolic and 3 mm Hg for diastolic blood pressure. For hypertensive patients, the reduction is 11.4 mm Hg for systolic and 5.5 for diastolic blood pressure. Low salt (< 1500 mg/day) further potentiates the reduction of blood pressure.

Maintain a healthy weight:

As your body weight increases, your blood pressure can rise. In fact, being overweight can make you more likely to develop high blood pressure than if you are at your desirable weight. You can reduce your risk of high blood pressure by losing weight. Even small amounts of weight loss can make a big difference in helping to prevent and treat high blood pressure. Studies conducted in obese hypertensive patients show a decrease in body weight by 1 kg resulted in a reduction of systolic and diastolic pressure by 1.2 and 1.0 mmHg, respectively.

Be physically active:

Physical activity not only helps control your blood pressure, it also helps you manage your weight, strengthen your heart and manage your stress level.

Even moderately intense physical activity, such as brisk walking, is beneficial when done regularly for a total of 30 minutes or longer at least 5 days a week. Hiking or stair-climbing, jogging, running, bicycling, swimming, fitness classes, team sports, dance classes are some of the activities which can help you stay fit. Studies say that regular dynamic physical exercise for at least 30 minutes daily for most days of a week leads to 5 to 9 mm Hg reduction of systolic blood pressure.

Say no to tobacco:

While smoking has not been conclusively proven to cause high blood pressure, each cigarette you smoke temporarily increases your blood pressure for many minutes after you finish. For your overall health and to reduce your risk of heart attack and stroke, avoid all forms of tobacco as well as secondhand smoke. A study has shown that smoking cessation leads to a reduction of systolic blood pressure by 3.5 mm Hg and diastolic blood pressure by 1.9 mm Hg.

Avoid drinking:

Drinking too much alcohol can raise blood pressure to unhealthy levels. Having more than three drinks in one sitting temporarily increases your blood pressure, but repeated binge drinking can lead to long-term increases. If you have high blood pressure, avoid alcohol or drink alcohol only in moderation.

Also read: World Hypertension Day: Why And How You Should Reduce Your Salt Intake

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Avengers: Endgame
U/A: Action, Adventure, Fantasy
Director: Anthony Russo, Joe Russo
Cast: Robert Downey Jr, Chris Evans, Mark Ruffalo, Chris Hemsworth, Scarlett Johansson
Rating: 

How does one put together words about a film that, for all practical purposes, anything and everything you write, is likely to be misconstrued/diagnosed as a spoiler?

Suffice it to know that this expectedly dramatic conclusion of Marvel's three-part Infinity Saga is a relatively internalised, deep and sober film, concerned more with the motivations of super-heroes, the choices before them, and what they should pick, in order to take on super-villain Thanos—of course.

For one, the earth is a much quieter place, since as you're aware, its species have been annihilated, decimated by Devil Thanos, ever since he got his hands on the infinity stones, and went on to execute the bizarre plan of supposedly ethical ethnic cleansing—randomly ridding planets of half its populations, to make them more sustainable, by restoring balance of sorts, as it were.

Of course, there will be survivors. And Iron Man or Tony Stark (Robert Downey Jr), to start with, is thankfully rescued or reunited with the human family back home. So is Hawkeye (Jeremy Renner). Both of them, like all the others, seem to be somberly dealing with the aftermath of a universal tragedy.

Surely, you have your own favourites from this cinematic universe (and how can Iron Man not top that list?). But there's something about the inherent cuteness of Hulk (Mark Ruffalo) that saves this franchise's final installment from turning into a complete depresso—left to be downed over rounds of espresso, what with the screen-time running three hours plus.

Also Read: Box Office report: Avengers: Endgame sells 1 million advance tickets in India

Indians might thank their theatres for the usually hated interval. I caught it without one, but didn't miss it either. There's enough material here to keep you engaged, even if to wonder, on occasion, if some of it makes any sense. You may or may not be impressed with the long drawn explanations, but you're only too happy to go with it.

Frankly, I'm no Marvel fanboy/fanatic—if the movie-world is indeed divided into two types, then more the DC demographic. That said, there is an infectious verve and energy that multiple super-heroes bring to this cinematic universe that is hard to not be swayed by, even if an individual or sub-set, Guardians Of Galaxy in particular, may be difficult to appreciate on their own.

Check out the Avengers: Endgame trailer here:

Avengers: Endgame does a fine job of navigating a reasonably cogent script without over-populating the screen. Avengers: Infinity War seemed more overwrought in comparison. I re-watched portions of the 2018 prequel on my phone (for quick revision), which of course means I didn't watch it at all.

For, at the end of the day, battle sequences and pyrotechnics is the point of it all, isn't it? Endgame, despite all the philosophy, is not an exception. It shines gloriously as 3D spectacle on the IMAX screen, ideally viewed from the third-row, from the back—and if you're not on IMAX, then the third row from the front—for a stunningly immersive experience, with such depth of field that the points where the camera focuses on a river, the ripples flowing towards you, you almost feel like you can wade through the frickin' water!

I know, don't need to put in a word (spoilers be damned). Suffice it to know that seldom has the excitement of audiences entering a theatre, matched by those exiting, after a hugely hyped pic. Endgame equals its astounding anticipation. And that's saying a whole lot!

Also read: Avengers: Endgame Box Office Prediction: Will the film open at Rs 50 crore in India?

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