Many people wonder if salt or fish sauce is healthier, particularly those managing blood pressure or heart conditions. According to doctor Chau Thi Anh, head of the Nutrition Department at Xuyen A General Hospital in TP HCM, the core issue from a medical and nutritional perspective is not which is better, but the total amount of sodium consumed daily. Both are significant sources of sodium, each with distinct components and nutritional properties, requiring judicious use.

Salt, an inorganic compound, consists almost entirely of sodium chloride (NaCl). This seasoning has a high sodium density, with 1 g of salt containing approximately 400 mg of sodium. While salt provides no energy, protein, fat, or vitamins, table salt is often fortified with iodine. Iodine is a vital micronutrient that helps synthesize thyroid hormones, regulate energy metabolism, support growth, and maintain many physiological functions.

Fish sauce is derived from the hydrolysis of fish protein through the action of enzymes and salt-loving bacteria. Compared by weight, fish sauce has a lower sodium density than salt due to its higher water content. A tablespoon (approximately 15 ml) of fish sauce provides 1,000 to 1,200 mg of sodium, equivalent to the sodium in less than 3 g of salt. Traditional fish sauce, produced through natural fermentation, also offers free amino acids, enhancing its biological value and optimizing protein absorption. Additionally, it contains small amounts of vitamin B12 and minerals like iron and zinc. The amino acids create an umami flavor, enriching dishes with a natural savory taste even when used sparingly.

Fish sauce has lower sodium density than salt, and is rich in nutrients and flavor. Photo: Bui Thuy

To protect cardiovascular and kidney health, consumers can combine the two seasonings following medical recommendations. The World Health Organization (WHO) advises that adults consume less than 2,000 mg of sodium per day, which is equivalent to 5 g of salt or about 1,5 to 2 tablespoons of fish sauce. Here are some principles for proper use:

Marinating with iodized salt: Use iodized salt during the preparation and marinating stages to ensure adequate iodine intake, preventing goiter and metabolic disorders.

Seasoning and dipping sauces with fish sauce: The natural umami flavor from amino acids in fish sauce makes dishes more palatable and flavorful, while helping to keep total sodium intake lower than when using salt.

Caution with chronic conditions: Individuals with hypertension, kidney failure, or heart failure cannot solve the issue simply by switching from salt to fish sauce. The most important step is to reduce all sources of salty seasonings and sauces across the board.

Beware of "hidden sodium": Beyond directly added salt and fish sauce, sodium is prevalent in processed foods such as canned goods, sausages, instant noodles, and monosodium glutamate (MSG).

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