“I eat pickled vegetables almost every day, and in winter I add pickled kohlrabi and cabbage that can last a week,” the Hanoian says.

“If there are leftovers, I cook them with meat or fish and add fermented bean paste to make the dish richer.”

He adds that salt has been a staple ingredient in his family’s diet for generations.

Ten years ago Minh was diagnosed with diabetes and high blood pressure. Doctors warned of stroke risks and told him to cut back on salt.

He reduced his intake for a while but returned to salty foods when medication improved his health indicators.

In September, Minh experienced prolonged fatigue and poor appetite. Tests at the Hanoi Medical University Hospital showed kidney failure and he was prescribed regular dialysis.

His doctor said years of eating foods with high sodium content such as dried fish, fish sauce and pickled vegetables had overworked his kidneys. High salt levels raised his blood pressure and damaged the kidneys’ filtration units over time.

“Many people do not realize their traditional meals are silently destroying their health until it is too late.”

A 30-year-old man was diagnosed with end-stage kidney failure at Bach Mai Hospital’s nephrology and dialysis center in Hanoi five years ago. The result surprised him because he had always felt healthy.

He admits he often rushed through his meals and relied on processed foods, which use large amounts of salt to enhance flavor and for preservation.

Chronic kidney disease affects nearly 850 million people worldwide and is the third fastest-growing cause of death.

In Vietnam, over 10 million people have the disease, 10.1% of the population, and it ranks eighth in the list of leading causes of death.

The disease has been increasingly affecting young people in recent years.

At the artificial kidney department in HCMC’s Cho Ray Hospital, 450 patients underwent regular dialysis in the first three months of 2024. Nearly 60 were under 35 and most were diagnosed as being in the final stage.

At Binh Dan Hospital in HCMC, a third of kidney outpatients are under 40.

At Duc Giang General Hospital in Hanoi, doctors say the rate of young patients with end-stage kidney failure requiring regular dialysis has risen by 5-10% in the last five years.

Dr Ngo Thi Kim Oanh of the HCMC University Medical Center said a long-term high-sodium diet is a major risk factor for kidney damage.

When sodium intake exceeds safe levels, the kidneys must work harder to flush it out. This raises filtration pressure, triggers hormonal changes, and causes high blood pressure and scarring that gradually destroys kidney function.

Many people are unaware of the “hidden” sodium in processed foods like instant noodles, dipping sauces, canned goods, and fast food.

Regularly consuming too much sodium raises blood pressure and increases protein levels in urine, an early sign of kidney damage.

Salt affects more than just the kidneys, Dr. Tran Duc Canh, deputy head of endoscopy and functional exploration at K Hospital in Hanoi, warned.

A high-salt diet makes the body retain water to balance sodium levels, increasing blood volume and straining the heart and raising the risk of heart failure, heart attack and stroke.

Excess salt also increases calcium excretion, which can cause kidney stones, reduces blood flow to the brain, harms cognitive function, and contributes to osteoporosis and stomach damage.

Vietnamese prefer strong flavors in their food and a variety of dipping sauces with high sodium content to go with it. Photo by Read/Bui Thuy

Salt consumption in Vietnam remains at alarming levels despite efforts to change eating habits.

A survey by the Ministry of Health and the World Health Organization showed the daily sodium intake in 2021 was 3,360 mg, or 8.4 grams of salt. This is nearly 70% higher than WHO’s recommended limit of 2,000 mg of sodium, or five grams of salt.

In response to the survey, the ministry warns: “Fast foods and packaged processed foods contain high levels of sugar, fat and sodium. They increase the risk of hypertension, heart disease, diabetes, cancer and other non-communicable diseases.”

The 2020 National Nutrition Census found people eat only about 70% of the recommended amount of fruits and vegetables while consuming large quantities of instant noodles and high-sodium seasonings. Rising fast food consumption, especially among young people, has exacerbated the problem.

A recent ministry study of people aged 19-39 in HCMC found 47% regularly ate fast foods.

The rate was highest among men and people in the 16-24 age group. Nearly half stayed at fast food restaurants for over an hour.

Canh advises cutting back on fish sauce, soy sauce and seasoning powder.

He recommends cooking with less salt, using lemon or vinegar for flavor, and avoiding processed foods such as instant noodles, sausages, canned goods, and snacks. He also urges consumers to read labels and choose low-sodium products.

*Names of some characters have been changed.