The dark side of white salt
Special report: Thailand's favourite snacks harbour a secret killer
TV host and actress Deejai Dedede recalled her "happy" childhood when her grandma allowed her to eat as many snacks as she wanted.
Because her family ran a grocery store, she was free to plough through as many as 20 brightly coloured bags of crispy snacks each day.
It wasn't unusual to see her hands covered in oil and smelling of salt, sugar and other artificial flavourings throughout the day.
"I knew that eating brought me joy," said Deejai, also widely known by her nickname, Padthai. "But I didn't know that I was putting toxins into my mouth."
At the age of 52, Deejai is seriously ill. Her kidneys are functioning at only 16%. Medically speaking, she has reached the dreaded end -- the final stage of chronic kidney failure.
Her condition is a result of the excessive consumption of salt, one of the staple additives in Thai snacks and food.
The sad thing is, thousands of Thais -- both children and adults -- are unaware that they, too, are facing the same risk.
"The incidence of kidney problems among Thais is rising by 15% each year," said Wiwat Rojanapithayakorn, the director of the Centre for Health Policy and Management at Ramathibodi Hospital's Faculty of Medicine.
In fact, he said, kidney disorders are quickly becoming a major cause of death in Thailand, before adding that the non-communicable disease (NCD) is costing the country up to 99 billion baht annually.
"Up to 37 people die every hour as a result of non-communicable diseases," said Dr Wiwat, who said Thailand is currently ranked first in Asia in terms of NCDs-related problems.
The excessive consumption of salt claims the lives of over 20,000 Thais each year through kidney failure, heart attack, strokes and high-blood pressure, said paediatrician Renu Garg, who works for World Health Organisation's (WHO) NCDs division.
Dr Renu also said that while the WHO recommends capping one's salt intake at 2,000 milligrammes (mg) per day, most Thais regularly go beyond the safe limit on a daily basis.
Eating culture in question
Recent research on Thai food preparation suggests that most Thais have been unknowingly conditioned to associate saltiness with pleasure.
"Popular Thai condiments such as kapi (shrimp paste), pla ra (fermented fish), and budu (anchovy sauce) contain high amounts of salt," said the chairman of the Thai Low Salt Network, Surasak Kantachuvesiri, who cited a study by Mahidol University's Institute of Nutrition.
Thai cooks have been using salt to preserve food for centuries. But in the past, the over-consumption of salt was not an issue because most people mainly ate vegetables and engaged in lines of work that require physical exertion, which causes the body to secrete the excess sodium through sweat and other bodily excretions.
In the modern age, however, most people work indoors. The advent of technology meant most people are spared from physically-taxing work.
While some do exercise, the frequency is simply isn't enough to counter the increased input of sodium, which now comes from basic staples as well as newly-invented snacks.
"Instant noodles, rice porridge, and other prepackaged snacks may contain more than three times the daily recommended sodium intake," said Dr Surasak.
He said the increased intake is almost inevitable as the modern age requires people to pack in more activities in a day.
"Think of working parents who have no time to prepare breakfast," said Dr Surasak. "They are likely to buy their children instant rice porridge just to make sure they go to school in time."
The search for a solution
Health experts have been touting several means to raise public awareness about sodium over-consumption, which ranges from public campaigns to salt taxes.
Deejai believes more effort needs to be made to educate people.
"Children are especially in danger," she said. "Parents and teachers must educate them on the health risks they face to protect them."
The Health Promotion Foundation is doing its part by advising people to reduce their salt intake by avoiding processed, prepackaged foods -- including sausages and prik kaeng, or red curry paste, said Pairoj Saonuam, chief of the foundation's Healthy Lifestyle Promotion division.
Other means to get Thailand's sodium consumption to drop by 30% by 2025 have been faced with stiff resistance.
Health experts have tried to get three major instant noodle producers to decrease the sodium content in their most popular flavours without success, said Dr Surasak.
However, the proposal that faced the stiffest resistance from businesses, is the plan to introduce salt taxes.
Salt tax unwelcome
The government committee on sodium reduction policy announced earlier this month that it will push ahead with the plan to collect salt tax for three types of food -- instant noodles, crispy snacks and monosodium glutamate.
The move drew opposition from the Federation of Thai Industries (FTI) which said the tax will increase production costs and deal a blow to producers' competitiveness.
At present, the market value of instant noodles stands at 16 billion baht.
Snacks and monosodium glutamate businesses are worth 36 billion and 11 billion baht, respectively.
"Eating salty food is a personal choice," Wisit Limluecha, chief of FTI's food industry section, argued.
"Salt tax won't change their decision."