- A study published this week in The New England Journal of Medicine found that replacing table salt with a salt substitute that contains at least one quarter potassium could cut the risk of stroke 14% among older adults and those at risk of cardiovascular events.
- The 5-year-long study involved over 20,000 subjects living in rural China, most of whom were over 60 and had a heavy salt intake, with more than 72% having a history of stroke. The subjects were given either 100% sodium chloride or a 25% potassium salt substitute. The group that consumed the substitute had a lower risk of having a stroke, major cardiovascular health event or death.
- Heavy use of salt has long been known to have negative cardiovascular health effects, but this study highlights an affordable, easy way to prevent stroke and cardiovascular death through the use of salt substitutes.
Many food and beverage companies have pledged to reduce the amount of salt in their products in recent years. This study’s findings point to the promise of potassium chloride as a way to hit their goals.
Bruce Neal, a health expert with the George Institute for Global Health in Sydney, Australia, who was part of the research team, said that a positive takeaway from the study is that intervention to prevent strokes can be "taken up very quickly at very low cost." He noted that one kilogram of salt costs $1.08 in China, while a salt substitute costs $1.62.
"The trial result is particularly exciting because salt substitution is one of the few practical ways of achieving changes in the salt people eat," Neal said. "Other salt reduction interventions have struggled to achieve large and sustained impact."
A 2019 report from the National Academies of Sciences, Engineering, and Medicine recommended that people over age 14 reduce their daily sodium intake to 2,300 mg or less, 50% less than the average per capita consumption of 3,400 mg. Amid the continued push to lower sodium, food and beverage companies have made pledges to reformulate food in order to reduce its salt content. PepsiCo has pledged that by 2025, at least three-quarters of its global foods sales volume would not exceed 1.3 milligrams of sodium per calorie. In 2020, PepsiCo said that 64% of its food sales volume in its top 23 markets had hit this goal.
Nestlé set a 2020 goal to reduce the sodium in its products by 10%, and said it is a "gradual process" as it reworks recipes of products. This includes its Maggi Tablet Light chicken broth cubes, which now contain 15% less sodium.
Earlier this year, Smithfield Foods Inc. pledged that by 2025, it would reduce sodium and sugar content in all of its products by 10%, thus far the only major meat company to do so.
Potassium chloride is a popular salt substitute in the food industry. Last December, the Food and Drug Administration granted approval for manufacturers to use the name "potassium salt" on ingredients labels, which could have stronger consumer appeal than the chemical-sounding potassium chloride.
Supplementing foods with potassium could also have additional health benefits. According to Harvard Health Publishing, Americans on average get under half of their recommended daily amount of potassium, a nutrient that regulates blood pressure and heartbeat. A 2013 Mayo Clinic study found that consuming higher amounts of potassium decreases the risk of cardiovascular diseases like strokes.
While this new study highlights the potential of salt substitutes that contain potassium, ingredient manufacturers have offered other alternatives. Colorado based food tech startup MycoTechnology said its mushroom-based ClearTaste ingredient can mask the metallic aftertaste of potassium chloride. Seaweed flakes that contain 85% less sodium than table salt debuted on the shelves of U.K. grocery store Tesco in 2019. And some ingredients offer the ability to cut sodium content by changing how consumers taste salt. Cargill’s Purified Sea Salt Flour, introduced this year, contains fine particles that increase the perception of saltiness by raising the rate of dissolution in the mouth. Cargill said this phenomenon could enable sodium reduction in food applications.