Salt is essential but in the quantities it’s being consumed across India, it’s also becoming lethal. Scientists from the Indian Council of Medical Research’s National Institute of Epidemiology (ICMR-NIE) are sounding the alarm: excessive salt intake is quietly fuelling a rise in hypertension, stroke, kidney damage, and cardiovascular disease.The numbers speak for themselves. The World Health Organization (WHO) recommends less than 5 grams of salt per person per day. Urban Indians are consuming nearly double that—around 9.2 grams daily. Even in rural communities, where processed food intake is relatively lower, the average is about 5.6 grams/day. This isn’t just a matter of preference; it’s a looming public health crisis.To tackle this issue, ICMR-NIE has launched a three-year community-based salt reduction project in Punjab and Telangana. The goal is simple but ambitious: bring salt consumption closer to the WHO threshold by working directly with local communities. What sets this apart is the model—they’re not pushing health education top-down. Instead, they’re co-creating solutions with health workers, residents, and local authorities.Dr Sharan Murali, senior scientist and principal investigator of the study, says this approach is intentional. “We’re not just distributing pamphlets. We’re listening first. Health interventions work best when they’re built with the people who will use them.”This model of collaborative design is being trialled through India’s network of Health and Wellness Centres (HWCs), where trained health workers will deliver personalised salt-reduction counselling. The focus is particularly sharp on people already living with hypertension.Why the Focus on Salt?There’s a reason salt is getting so much attention from epidemiologists and public health experts. It’s directly linked to raised blood pressure—one of the strongest risk factors for heart attacks, strokes, and kidney failure.Dr Murali explains that even modest reductions in sodium intake can lead to noticeable health improvements. “Just switching to low-sodium salt can lower blood pressure by an average of 7/4 mmHg. That’s a small change with big potential, especially when scaled across millions of people.”These low-sodium salts, often made by replacing part of the sodium chloride with potassium or magnesium salts, are already available in some markets. But the real problem? Access and affordability.Can Low-Sodium Salt Help?Before launching the intervention, researchers from NIE conducted a market survey across 300 retail stores in Chennai to assess the availability and pricing of low-sodium salt substitutes (LSS). The findings were discouraging. While 52 percent of supermarkets stocked LSS, just 4 percent of small grocery shops carried them. On average, LSS was more than twice the cost of standard iodised salt—Rs 5.6 per 100g compared to Rs 2.7 per 100g.“The supply-demand mismatch is glaring,” says Dr Murali. “Low availability is often a proxy for low awareness. People don’t ask for what they don’t know exists. That’s where public education plays a critical role.”To amplify the conversation, ICMR-NIE launched a digital campaign called #PinchForAChange on social media. The campaign uses bite-sized messages, infographics, and quick facts to raise awareness around the hidden salt in common Indian foods, advocate for healthier choices, and make low-sodium salt feel like a tangible option—not a medical compromise.Dr Ganesh Kumar, a senior scientist at NIE and part of the intervention team, says the goal is to normalize lower salt use without inducing fear. “This isn’t about villainizing Indian cuisine. It’s about finding ways to retain the flavor while dialing down the danger.”The NIE’s program is more than just a research trial—it’s a blueprint for future policy. If the intervention works, it could integrate a salt-reduction module into India’s national health framework, particularly in chronic disease programs. It could also trigger price regulations, improve retail distribution, and increase demand for heart-healthy salt alternatives.“It’s time to stop treating salt as an invisible ingredient,” Dr Murali says. “This study is about making the invisible, visible—on labels, in stores, and in conversations around health.”The intervention’s first year is focused on groundwork—baseline surveys, stakeholder mapping, and training community health workers. The second and third years will roll out the intervention in phases, with rigorous data collection to track shifts in sodium intake and blood pressure levels.Though this is an India-specific project, its implications are global. The problem of excess sodium isn’t limited to India. Across the globe, people are unknowingly consuming dangerous amounts of salt, mostly hidden in processed food, sauces, snacks, and bread. What ICMR-NIE is attempting—pairing science with community-led implementation—could serve as a model for other developing nations grappling with similar public health challenges.The WHO has identified salt reduction as one of the five priority actions to reduce noncommunicable diseases. Yet progress has been patchy. What sets this project apart is its bottom-up model—one that could potentially offer more sustainable, community-supported outcomes.One Pinch at a TimeIn a country where food is deeply cultural, where flavors are layered and bold, telling people to “eat less salt” isn’t enough. But offering affordable, accessible alternatives? Partnering with communities? Making salt reduction a collective effort, not just an individual choice?That might just work. As Dr Murali puts it, “This is not just about salt. It’s about balance—on our plates, in our bodies, and in public health. Change doesn’t need to be overwhelming. Sometimes, it begins with just a pinch.”