Friday, June 19, 2009


At the recently concluded European Meeting on Hypertension 2009, held at Milan, DrLuis Martin from Porto, a member of the Portuguese Society of hypertension, reported their success story. They managed to get the Portuguese government to restrict the amount of salt in process foods, and also for foods to carry a salt label. At Milan, Dr Martin was given the oppoortunity to share the Portuguese experience in trying to restrict salt intake, thereby reducing hypertension, CAD and strokes. It is important to note that Portugal, a country of 10 million, has the highest stroke rate in Europe, many cases attributed to hypertension.
In his experience, it was important to use the mass media, with involvement of celebraties ( footballers, comedians etc ) to highlight the issues and lobby the politicians. They formed the Portuguese Action Against Salt and Hypertension ( PAASH ) society, to bring awareness of the dangers of salt. They found that Portugal bread had the highest salt content in Europe and that Portuguese were consuming about 12 gms of salt a day, when it should be one third that. PAASH then successfully lobbied the Portuguese Bakers association to reduce the amount of salt in Portuguese bread. Their mass media approach then bought the attention of the politicians, who subsequently drafted laws to limit salt in process foods.
The Milan meeting, in agreement with the Portuguese Society of Hypertension, concluded that " if you can reduce the salt intake for the whole population and shift their blood-pressure distribution, it has a major impact on the incidence of stroke and also coronary heart disease. The same thing should be tried in all countries."
Certainly we in Malaysia have a long way to go. I suppose one of the best ways to limit healthcare expenditure for the country is to prevent diseases, especially thos ethat can be prevented. The lifestyle diseases can certainly be prevented, including obesity, hypertension, diabetes and heart disease ( CAD ). I tell my patient no added salt or sauce in their food and warn them of a taste adjustment period of about 1 week. Can we do these on a nation wide scale. Perhaps we should start with some form of food labelling so that at least we know which are the heavy salt items and where to target our initiative.
Maybe we should follow the Portuguese example, but then we are Malaysians. Can we ever form a Malaysian Action Against Salt and Hypertension Society?

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