Salt is a big part of South African meals and culture, but eating too much of it can quietly harm the heart, kidneys, and overall health. Most salt isn’t just what people add—it hides in processed foods, making it easy to eat too much without realizing. High salt intake raises blood pressure, leading to serious illnesses like heart disease and stroke. Campaigns like “5 Ways to 5 Grams” are helping people use less salt, choose healthier foods, and cook fresh meals to protect their health while honoring traditional flavors. Small changes in salt habits can make a big difference for South Africa’s future.
Excessive salt intake in South Africa leads to high blood pressure, increasing risks of hypertension, heart disease, stroke, kidney failure, and certain cancers. Most sodium comes from processed foods, making awareness and reducing salt consumption essential for improving national health outcomes.
Morning sunlight fills South African kitchens, illuminating the age-old ritual of seasoning family meals. For countless households, salt is more than just a flavor enhancer—it’s a symbol of hospitality and tradition, woven into recipes passed down through generations. The salt shaker stands as a familiar fixture, its presence comforting and almost automatic as meals are prepared and shared.
However, the cultural embrace of salt hides a far more intricate narrative. Beyond its role in taste and preservation, salt—specifically its sodium content—has quietly shaped the health of South Africans in profound ways. The connection between sodium and well-being is not just a scientific detail but a storyline that touches every home, influencing daily life and the future of public health.
This overlooked relationship prompts a critical question: How does something so ordinary become a driver of disease? Understanding this requires a closer look at salt’s dual nature—as both a fundamental nutrient and a potential catalyst for some of South Africa’s most serious health problems.
Salt’s allure stretches back to ancient civilizations, where it was valued as highly as gold and even used to pay Roman soldiers. Today, its legacy continues in the kitchens of South Africa and around the globe. Yet inside each crystal lies sodium, a mineral essential for health but dangerous when consumed in large quantities.
Within our bodies, sodium performs essential tasks. It helps regulate fluid balance, supports muscle contraction, and ensures that nerves transmit signals accurately. Shonisani Nephalama, who leads the Nutrition Science team at the Heart and Stroke Foundation South Africa (HSFSA), explains that sodium draws water into the bloodstream. This process increases blood volume, demanding more work from the heart and raising blood pressure over time.
The kidneys, tasked with filtering excess sodium, can only handle so much. Persistent overconsumption of salt can burden these organs, leading to fluid retention and sustained high blood pressure. As this pressure mounts, the risk of developing hypertension—long dubbed the “silent killer”—rises sharply. Hypertension doesn’t just harm the heart; it paves the way for cardiovascular disease and stroke, threatening almost every organ as it quietly progresses.
The consequences of prolonged high salt intake reach beyond the heart and kidneys. Medical research links excessive sodium to bone density loss, stomach cancers, and even an increased likelihood of becoming overweight. These interconnected health risks mean that the impact of salt touches every stage of life, from childhood to old age.
South Africa faces a particularly urgent salt problem. The World Health Organization (WHO) recommends that adults consume no more than 2,300 milligrams of sodium per day, equivalent to a single teaspoon (about 5 grams) of salt. Yet, most South Africans regularly surpass this amount, often unknowingly.
According to data from the HSFSA, cardiovascular diseases accounted for about one in seven deaths in the country during 2021. This staggering figure highlights the pervasive reach of salt-related illnesses. Once considered disorders of affluent Western societies, heart attacks and strokes now occur with alarming frequency across South Africa, affecting young and old alike.
But the dangers of salt do not stop there. Researchers have also found strong connections between high sodium intake and chronic diseases such as kidney failure, osteoporosis, and certain gastrointestinal cancers. Obesity, another growing concern, has joined the list of conditions fuelled in part by high-sodium diets. This intricate web of health effects demonstrates that salt’s influence is both broad and deeply embedded in the nation’s health landscape.
For most people, the true threat of salt comes not from what they add themselves, but from what is already present in their food. Ultra-processed products—such as bread, processed meats, tinned soups, breakfast cereals, and ready-made meals—contain large amounts of hidden sodium. Many restaurant dishes and popular takeaways are also packed with salt, adding to the problem.
This pattern is part of a global shift. As historian Rachel Laudan observes, the spread of industrially processed foods has changed diets worldwide, introducing high levels of sodium into everyday eating habits. In South Africa, as in many places, traditional meals centered on fresh produce and whole grains have gradually given way to more processed alternatives. This shift has produced serious health consequences, with sodium becoming an ever-present but invisible part of daily meals.
The result is a situation where consumers, often unaware of how much sodium they’re ingesting, routinely exceed recommended guidelines. Even with government regulations setting sodium limits for certain foods since 2012, many products still require careful scrutiny. This means that the battle against excess salt is fought not only at home but also in supermarkets and restaurants.
Recognizing the urgency of the situation, the Heart and Stroke Foundation South Africa has partnered with World Action on Salt, Sugar and Health (WASSH) to launch the “5 Ways to 5 Grams” campaign. Timed to coincide with Salt Awareness Week (12–18 May 2025), this initiative aims to empower people to take control of their sodium intake and protect their health.
The campaign offers a practical framework for change:
Choose Flavourful Alternatives: Instead of relying solely on salt, home cooks are encouraged to experiment with herbs, spices, garlic, ginger, chili, and citrus. According to Cari Erasmus, a registered dietitian at the HSFSA, reducing salt need not mean sacrificing taste—palates can be retrained to enjoy the complex flavors that these alternatives provide.
Scrutinize Labels: Grocery shopping becomes an opportunity for health-conscious choices when individuals check nutrition labels for sodium content. The Heart Mark logo, a trusted sign of healthier options, helps shoppers navigate the aisles. Although regulations exist, vigilance remains essential, as not all products comply or meet the strictest standards.
Keep the Salt Shaker Out of Sight: Breaking the habit of reaching for the salt shaker, both at home and when dining out, can make a significant difference. Families who model this change for their children help establish new social norms around mealtime.
Embrace Home Cooking: Preparing meals from scratch gives control over not only salt but the overall quality of ingredients. Home-cooked meals encourage mindfulness and creativity in the kitchen, echoing the “slow food” movement’s emphasis on nutritional value and enjoyment.
Opt for Potassium-Rich Foods: Increasing intake of fruits, vegetables, legumes, whole grains, and low-fat dairy naturally boosts potassium while keeping sodium low. Potassium helps counteract sodium’s negative effects, aiding the body in eliminating excess sodium and relaxing blood vessels. Research from Mediterranean and East Asian regions demonstrates that such dietary patterns contribute to lower rates of hypertension and heart disease.
Across South Africa, stories of change are taking root. In one Cape Town neighborhood, a community health worker describes how a church group, inspired by the Foundation’s campaign, began swapping recipes and recalling old traditions. Elders shared memories of meals built on fresh vegetables and legumes, reigniting appreciation for flavors that don’t rely on salt. This journey back to wholesome cooking reshaped not just diets, but the very fabric of communal gatherings.
Nonetheless, challenges remain. Salt is not just a seasoning—it is entwined with heritage, taste memory, and social rituals. Anthropologist Sidney Mintz, in his exploration of food’s role in society, points out that changing dietary habits involves much more than facts and advice; it demands empathy, collaboration, and sensitivity to cultural meaning.
Shifting a nation’s food habits takes time, creativity, and sustained public engagement. But the momentum is building, as more South Africans begin to embrace new patterns of eating that honor both health and tradition.
South Africa’s relationship with salt is at a crossroads. While the dangers are real and immediate, the potential for positive change is equally powerful. Each small decision to use less salt, read a label, cook a wholesome meal, or choose potassium-rich foods can ripple through families and communities, strengthening collective health.
Public education campaigns like “5 Ways to 5 Grams,” along with grassroots initiatives and renewed respect for traditional foods, are laying the groundwork for a healthier future. The aim is not to strip meals of pleasure, but to rediscover the rich, varied flavors that fresh ingredients can offer.
As Salt Awareness Week approaches, South Africans are encouraged to pause before they reach for the salt, to appreciate the vibrant complexity of their food, and to remember that every meal is a chance to invest in lasting health. Every decision about salt—whether in the kitchen or at the table—helps shape the nation’s well-being, one choice at a time.
Excessive salt intake significantly raises blood pressure, leading to hypertension, which is a major risk factor for heart disease, stroke, and kidney failure. Additionally, high sodium consumption is linked to other health problems such as bone density loss, certain stomach cancers, obesity, and an increased risk of chronic diseases. In South Africa, cardiovascular diseases related to high salt intake accounted for about one in seven deaths in 2021, highlighting the severe impact on public health.
Salt is deeply embedded in South African culture and cuisine, often symbolizing hospitality and tradition. Beyond the salt added during cooking or at the table, most sodium intake comes from processed and ultra-processed foods like bread, processed meats, breakfast cereals, tinned soups, and ready-made meals. The rise of industrially processed foods has introduced hidden sodium into everyday diets, making it easy for people to consume excessive amounts without realizing it.
Sodium is essential for the body as it regulates fluid balance, aids muscle contractions, and helps nerves transmit signals. However, excessive sodium intake increases blood volume by drawing more water into the bloodstream, making the heart work harder and raising blood pressure. Over time, this strain can lead to hypertension, kidney damage, and cardiovascular disease. The kidneys can only filter a limited amount of excess sodium, so persistent high intake causes fluid retention and increases risks to overall health.
The “5 Ways to 5 Grams” campaign, led by the Heart and Stroke Foundation South Africa in partnership with WASSH, aims to help South Africans reduce their daily salt intake to the recommended 5 grams (about one teaspoon). The campaign suggests practical strategies such as using herbs and spices as flavor alternatives, reading food labels carefully for sodium content, avoiding adding salt at the table, cooking fresh meals at home, and increasing intake of potassium-rich foods like fruits and vegetables which help counterbalance sodium’s effects.
Most of the hidden salt in South African diets comes from processed and ultra-processed foods, including commonly consumed items like bread, processed meats, tinned soups, breakfast cereals, ready meals, and many restaurant or takeaway dishes. These foods often contain sodium levels that far exceed recommended limits, contributing to unintentional overconsumption of salt.
Reducing salt does not mean sacrificing traditional flavors or cultural heritage. Many communities are revisiting older cooking practices that rely on fresh vegetables, legumes, and spices rather than excessive salt. Campaigns encourage using herbs, garlic, chili, ginger, and citrus to enhance flavor naturally. Changing habits requires empathy and collaboration, respecting the social and cultural meanings of salt while promoting healthier alternatives. Embracing home cooking and fresh ingredients helps preserve heritage and improve health simultaneously.
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