Avoiding salt totally isn't a solution to better health, but quite the opposite.

Everytime I flip the newspaper or watch TV, the gahmen is always telling us to reduce the amount of salt we eat. Headlines constantly talk about how heart diseases and strokes are big killers in Singapore and how they are commonly linked to hypertension, high blood pressure and excessive sodium intake. Then when Umommy started nagging me not to makan salty food, aiyah, I got more and more scared of eating salt.

So when I went for a medical checkup, I asked the doctor, “We should all stop eating salt completely, right? That was when he told me about hyponatremia or low blood sodium. Wah, something I’ve never heard of before. Maybe you haven’t too.

But first, what is sodium?

Not only does sodium make our food taste shiok, it’s an essential electrolyte. It helps to transmit nerve impulses, keep our muscles working properly and maintain the balance of our body’s fluids. 

In short: No sodium, no life! 

Salt is one of the main sources of sodium. Too much salt can lead to high blood pressure or hypertension. Too little salt, on the other hand, can lead to hyponatremia.

Hypo-, what?

Don’t worry, I’m not trying to smoke you. Hyponatremia is not a disease. It’s simply a condition that occurs when sodium levels in the blood are too low.

A normal blood sodium level is between 135 and 145 milliequivalents per litre (mEq/L). When our blood sodium level falls below 135 mEqL, hyponatremia occurs. 

In severe cases, the brain may swell, leading to headaches, seizures, coma and even death. Other symptoms include nausea and vomiting, muscle weakness or spasms, low energy and fatigue, confusion and irritability. If you experience any of these symptoms, faster see a doctor!

How to jaga ourselves from getting hyponatremia

These are some common causes:

1. Drinking far too much water

Our body constantly loses water from urine, sweat, breathing, and other regular body functions. To prevent dehydration, we need to get plenty of water from our food and drinks. 

However, overhydration makes it difficult for our kidneys to eliminate the excess liquid. When the sodium content in our blood gets diluted, the effects of hyponatremia can set in. 

The rule of thumb is two litres of water per day. Adjust the amount according to your environment, exercise regimen, overall health, and conditions like pregnancy or breastfeeding.

2. Loss of sodium during long and siong exercises

I’m not telling you to forgo exercise altogether hor. Highly demanding activities like ultramarathons, endurance events, and backpacking in challenging terrains, especially under the blazing sun, can tempt anyone to gulp down water like a camel. 

We have to watch out! Prolonged overhydration during exercise is the primary cause of all forms of exercise-associated hyponatremia. Even though we lose both salt and water in our sweat, we often only replace it with water. This dilutes the remaining sodium in our body. The trick is to drink just enough to satisfy our thirst. 

But for hard-core sportsmen or sportswomen out there, think about getting salt tablets. They’ve been used for donkey years to treat heat cramps and restore electrolytes lost through sweating. Sports drinks also work!

3. Fluid level regulation from underlying conditions

Brain, lung, heart, liver and kidney conditions can affect how our body regulates fluid levels and our sodium levels may become diluted. Severe diarrhea, vomiting and other causes of dehydration can also lead to hyponatremia. Proper medical treatment of these associated conditions can lower our risk.

4. Side effects from medication

Some medications can interfere with normal hormonal and kidney functions. These include diuretics (water pills), antidepressants and pain medications. If you’re worried about getting hyponatremia from taking these medications, speak to your doctor.   

Too much salt jialat, too little salt jialat. How?

Moderation is the answer. About 90% of Singaporeans consumed an average of 9g of salt a day in 2018, a level far exceeding the World Health Organisation’s recommended limit of 5g or 0.83 teaspoon. So monitor your own intake and be aware that a lot of salt is hidden in the food we buy. If you have specific needs, consult a doctor or dietitian. Health is wealth, so don’t anyhow play, play!