The following is my personal experience working in Klinik Kesihatan Pengkalan Hulu. I noticed that some of my patients were consuming foods high in sugar and salt. One example is a fish product called Ikan Pekasam, which can be found in the northern half of the peninsula in states such as Perak. It is often served with hot rice after being deep-fried. 

Ikan Pekasam is a Malaysian term for fermented fish that has been fermented using ground roasted (uncooked) rice and salt. Ikan Pekasam is traditionally made from freshwater fish like black tilapia and Javanese carp, boiled for 3 to 14 days at ambient temperatures in a brine solution of approximately 30% salt (30 grams of salt in every 100mlof water). Then, the fish is rinsed and mixed with roasted rice and left to ferment at ambient temperature for up to two weeks in a closed container. In this process, 300 grams of salt is used for every piece of fermented fish.

Sounds delicious! But bear in mind, the Ministry of Health recommended that we consume only 5g of salt (equivalent to one teaspoon of salt) or 2g of sodium every day. A small slice of salted fish such as ikan pekasam, or approximately half of the small fish contains 400 mg of sodium. Thus, if we were to eat one of the delicious-looking fish shown in the following image (100 grams), we would be consuming almost 1700 mg of sodium, which is almost the whole day’s recommendation of sodium. With an additional tablespoon of sambal (300 mg of sodium), we would have reached our recommended daily limit of sodium in just one meal (or for some people, half a meal)!

Of course, this does not mean we can no longer consume ikan pekasam. As a general rule, we should be conscious of how much sodium we consume every day and limit that intake. A study in Selangor urban and rural areas showed that our mean dietary sodium intake was 3.6 grams/day, 1.6 grams higher than current WHO recommendations. This is extremely worrying as it puts many people at higher risk of high blood pressure, stroke, and heart disease. Together, let us remind each other to be aware of our daily salt intake.

"Iwak Pakasam Basanga" © Ezagren 2018. From Wikimedia Commons. Copyleft: This is a free work, you can copy, distribute, and modify it under the terms of the Free Art License