New Delhi: With the availability of food delivery services at our fingertips, the consumption of processed food has increased exponentially. Despite the convenience and accessibility offered by food delivery platforms, no one can deny the flip side of it that is hugely contributing to unhealthy eating habits and a sedentary lifestyle.
While these fast food choices could be practical and alluring, they are also heavy in saturated fats, added sugars, and sodium with little or no nutritional value.
Consuming these meals on a regular basis results in an increased prevalence of hypertension. Due to this changing lifestyle, the prevalence of hypertension in the young adult population is rising in India. Studies have suggested that hypertension is one of India’s most common CVD risk factors, affecting approximately 30 per cent of adults.
On the occasion of World Hypertension Day, ETHealthworld spoke to medical practitioners with diverse experience bases to understand the devastating impact of regular consumption of processed foods that are loaded with high sugar and salt content and how they act as a catalyst behind the rise in blood pressure-related conditions amongst people belonging to all walks of life.
Speaking about the impact of consuming excessive salt and sugar, Dr Soumita Biswas, Chief Nutritionist, Aster RV Hospital, said, “Increasing evidence suggests that small increases in plasma sodium may have a direct effect on BP, independent of extracellular volume. A high-salt diet disrupts the natural sodium balance in the body. This causes fluid retention, which increases the pressure exerted by the blood against the blood vessel walls. There are several other factors that also increase BP, one of which is added sugars.”
Underscoring that high sodium intake can negatively affect the control of hypertension. Dr Dayanand Balappa Yaligar, General Physician, Apollo Clinic, Electronic City, said, “Salt restriction is believed to be a cost-effective measure to reduce population morbidity and mortality.” Dr Yaligar adds that most individuals consume almost double the recommended daily dose. High sodium content is found in pickles, salty fish, carbonated beverages, and processed and canned food.
The World Health Organisation (WHO) recommends that individuals with hypertension limit their sodium intake to 2 g/d (5 g of salt per day). Notably, the daily sodium intake is between 3.5 and 5.5 g (9 to 12 g of salt). WHO is also raising awareness about salt restriction, aiming to reduce global sodium intake by a relative 30 per cent by 2025.
Almost 50 to 60 per cent patients diagnosed with hypertension are salt sensitive individuals. ‘Salt sensitivity’ refers to an individual’s blood pressure susceptibility to dietary salt intake. In salt-sensitive people, the kidney will not be able to excrete excess sodium in response to high salt intake.
Experts suggest that hypertension has always been traditionally linked to excessive salt intake. However, sugar intake can also play a major role in increasing blood pressure. Studies have pointed out that salt and sugar are the “notorious white killers.” In fact, both of them are integral parts of every household.
The intake of sugar-sweetened beverages (SSBs) has been one of the leading factors postulated for increasing blood pressure levels. Dr Kavita V, AVP and Chief of Lab Operations, Metropolis Healthcare Limited, elaborated on this further. She said, “Nitric oxide is a substance present in the blood that helps maintain the pressure in blood vessels. Nitric oxide is a vasodilator, which helps reduce blood pressure. Fructose, a simple sugar that is present in SSBs and processed foods containing added sugars, inhibits the production of nitric oxide, thereby elevating blood pressure. In addition, excessive consumption of added sugar leads to obesity, which is also a contributor to hypertension. In addition, it has been observed that young adults and adolescents with hypertension have a significant history of taking sugar sweetened beverages.”
Emphasising that increased intake of any ultra processed, sugary products and all industrially processed foods does lead to hypertension. Dr Arun Gupta, Paediatrician and Conveyor, Nutrition Advocacy in the Public Interest (NAPI), explained that there is no clear definition of healthy food. And perhaps that is why several FMCG companies continue to claim their food products as healthy, or at least near healthy foods. Furthermore, there is no established threshold for labelling.
Several studies have indicated that the country has seen a significant increase in the consumption of added sugars over the past few decades. This rise is attributed to changing dietary patterns, increased availability of processed and sugary foods, urbanisation, and the influence of mass media. The increase in sugar consumption has contributed to the rising prevalence of diabetes in India. According to the International Diabetes Federation (IDF), India has one of the highest numbers of people with diabetes in the world.
Diabetes is a metabolic syndrome that comes in tandem with an increase in bad cholesterol, which further complicates hypertension. Explaining it further, Dr Bindumathi P. L., Sr. Consultant, Internal Medicine, Aster CMI Hospital, said, “One of the complications of diabetes is its impact on the kidneys, which can produce hypertension. It is also associated with thyroid abnormalities, which can produce hypertension. Blood sugar increases calories, thereby increasing the stimulation of insulin, which increases lipids, producing atherogenic, vascular resistance, and sympathetic activity leading to hypertension.”
Terming sugar and salt as the biggest enemies and excessive consumption of them for longer periods could potentially invite hypertension, Dr Balbir Singh, Chairman, Cardiology, Max Healthcare, suggested a reduction in quantity of consumption as the way out. He asked people to come forward and get their blood pressure checked at regular intervals. Blood pressure guidelines are periodically updated based on the latest scientific evidence and research findings.” Now we understand normal blood pressure is less than 130/80. Even though the target to treat is 140/90,” for anybody above 130/80, the red line is already there. Thereafter, an individual has to undergo lifestyle modification, i.e., reduce salt intake and exercise.
The mass media has often been accused of featuring advertisements for foods and beverages that are high in sugar, salt, unhealthy fats, and calories. Research has shown that the portrayal showcased by advertisements can normalise and reinforce poor dietary choices among viewers. Not only FMCG giants but also online food delivery platforms heavily rely on digital and television media to cater to their target audience. Experts believe that the impact of such advertisements on health is widely understated.
Existing regulations are very weak and allow misleading advertisements. Apparently, food content is not the only issue; the problem of celebrities endorsing unhealthy foods can have a bad influence on society, said Dr Gupta while raising a pertinent point and urged that “Misleading advertisements that cross a particular benchmark of salt, sugar, or fat ideally should be prohibited from advertising.” He went on to say that people should start reading labels until the government comes up with regulations to ban such advertisements.
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