We can all live with a little less saltiness


A DASH, a sprinkle or a pinch, these crystalline granules are sure to enhance the taste of any food or drink. Being of Teochew descent, I know this too well because Teochew dishes are delicious no less in part flavoured by this not-so-secret ingredient.

My late father was proud of his heritage, especially the cuisine. He took every available opportunity to introduce to me a variety of Teochew condiments and dishes that are either pickled, salted, or marinated in copious amounts of soy sauce.

From salted fish to preserved vegetables and tau yew bak (braised pork in soy sauce), Teochew food and salt are inseparable. I grew up eating all these and consequently developed a high tolerance for salty food. I did not realise the level of salt in the food I have been ingesting until I had to go on a low-salt diet due to kidney disease.

Salt is a mineral composed of sodium chloride. Sodium is also found naturally in a lot of food, which may also contain sodium in other forms. Sodium helps in regulating blood pressure, maintaining proper fluid balance, transmitting nerve impulses, and contracting and relaxing muscle fibres.

Salt has been used for thousands of years to enhance the taste of food and also to preserve it. There is evidence of salt processing that dates to as far back as 6,000 BC. It was prized by ancient civilisations and an important commodity during those times. Wars have been fought over it.

Sodium in the body is regulated. Low levels of sodium in the blood can trigger muscle cramps, nausea and vomiting, seizures, and even coma. On the other hand, high sodium intake is associated with higher risk of hypertension, which in turn, has been linked to stroke, heart disease, and kidney failure.

Nevertheless, my kidney disease is not caused by high dietary salt. Backflow of urine into the kidneys, the effect of a neurogenic bladder associated with cervical spinal cord injury, and bouts of chronic urinary tract infections were the probable contributing factors.

My Salt 2015, a study by the Ministry of Health to determine dietary sodium intake among the ministry’s staff, showed we are taking too much salt. The study found Malaysian adults consumed an average of 7,150mg of salt daily (equivalent to 2,700mg sodium) as opposed to the 5,000mg daily (equivalent to 2,000mg sodium) recommended by the World Health Organisation (WHO). Ideally, the ministry recommends the daily limit recommended by WHO but the target is to reduce the salt intake to at least 6,000mg by 2050.

Excess salt in the body is removed largely by the kidneys and the skin through sweating. Because my kidneys can no longer filter out water and waste efficiently, excess sodium, other electrolytes, fluid and wastes accumulate in my body. I was advised to reduce as much dietary salt as possible, apart from limiting water and food high in phosphorous and potassium.

I will know when I have taken too much salty food. The unmistakeable symptoms are an unquenchable thirst, elevated blood pressure, swollen feet, and the water drawn out from my body by dialysis is vastly reduced. Sodium causes fluid retention and is the cause of those issues which could lead to high blood pressure and build-up of fluid in the lungs. There was a time when my feet were so swollen that I could not wear shoes at all.

Since observing this low-salt and other corresponding restrictions in my diet, the swelling has gone down and I no longer suffer from hypertension. As such, I always make a conscious effort to watch what I eat.

My taste buds have since become sensitive to salt in food. What most people find acceptable has become too salty for me. While salt makes food more delicious, I also noticed it masks the natural tastes of the food. I do enjoy my food more now in some ways because of this. In reality, food does not taste less delicious with less salt.

I have to forgo some of my favourite food like condiments for Teochew porridge, kuey chap, bak kut teh, nasi kandar, and a myriad of mouth-watering hawker food. I also try to avoid fast food and eating out as much as possible.

I do miss the days when I could feast on them with impunity. Admittedly, I do succumb to the temptation occasionally and suffer the consequences right after. Unless the food is extremely delicious and I have been hankering for it, I would usually give it a pass.

Grocery shopping has become a more meticulous affair now. I read the nutrition labels and look for food lower in sodium content. No-nos on the list are salted, smoked, cured, and canned meat. These include salted fish, salted eggs, luncheon meat, ham, sardines, anchovies, dried shrimp, budu, cincalok, and pekasam. Mayonnaise, sauce, ketchup, marinates and belacan are major culprits too. Where possible, I go for fresh food. But then again, I have to be mindful that some fresh food are naturally high in sodium as well.

Seeing the negative effects excessive salt intake can do to our health, cutting down on it is not such a bad idea for everyone. For one who used to enjoy salty food, I now cringe at the taste of it. Life will not be less enjoyable with less salt but it definitely will be less enjoyable should we be struck with diseases related to excessive salt intake.