Font size:
Print
Low-Sodium Salt Substitutes
Context:
The World Health Organisation (WHO) has recently issued new guidelines recommending the use of low sodium salt substitutes (LSSS) to reduce the risk of hypertension and related non-communicable diseases (NCDs).
More on News
- The guidelines suggest replacing regular table salt with substitutes that contain potassium chloride (KCl) and reducing the percentage of sodium chloride (NaCl) in table salt.
- Salt, especially iodised salt, played a major role in combating iodine deficiency in India since the 1950s, benefiting public health across generations.
Impact of Sodium on Health
- Excess sodium leads to high blood pressure by causing the body to retain more water, which increases blood volume.
- Reducing salt lowers blood pressure, positively impacting cardiovascular health and preventing strokes.
- Excessive salt also contributes to atherosclerosis, where fatty deposits restrict blood flow, increasing risks for heart attacks and strokes.
- Lower sodium also helps reduce vascular stiffness and improves vascular function.
Global Health Impact
- Poor diet-related deaths: 8 million globally annually, with 1.9 million linked to high sodium intake.
- Studies show that reducing sodium by 4.4 g/day can lower systolic blood pressure by 4 mmHg and diastolic by 2 mmHg, improving heart health.
WHO’s New Guidelines (Jan 26, 2025)
- WHO recommends using lower-sodium salt substitutes (LSSS), including potassium chloride, in households.
- Aim to reduce sodium intake to less than 2 g/day.
- Guidelines apply to adults (excluding pregnant women, children, and those with kidney conditions).
- The recommendation targets household salt use and not salt in packaged foods or foods cooked outside of home.
What Are K-Salts?
- K-salts replace sodium chloride (NaCl) with potassium chloride (KCl).
- Benefits: They help reduce sodium intake by about 30% and increase potassium consumption, which has been shown to reduce blood pressure.
- Potassium-rich foods include beans, peas, spinach, cabbage, bananas, and papaya.
Health Risks and Cautions
- Not recommended for people with kidney disease, as potassium intake can be harmful.
- Monitoring potassium levels (hyperkalemia) is important, especially in India where kidney disease is underdiagnosed.
Importance for India
- The guideline is particularly relevant for India, given the high burden of hypertension, heart attacks, and strokes, especially in younger populations.
- According to the INDIAB study, 35.5% of India’s population (around 315 million people) suffer from hypertension.
- Cardiovascular diseases accounted for 28.1% of deaths in India in 2016 (Global Burden of Disease study).
Indian Initiatives for Salt Reduction Awareness
- Sapiens Health Foundation Initiative: Launched Losalter Group to raise awareness about salt’s impact on health. Training 300 physicians nationwide to spread the message about salt reduction.
- Signal Labeling Advocacy: Efforts are being made to influence public behaviour, government policy, and the food industry to reduce salt consumption, with an emphasis on “signal labelling” for food products.
Challenges in Adopting the Guideline
- Taste addiction to high sodium foods makes it difficult to reduce sodium intake.
- High sodium content in food increases thirst, leading to higher consumption of mineral water and colas.
- Sodium-based salts improve food shelf life and help retain moisture, making them more cost-effective for food producers.
- These factors make it challenging to implement the switch in pre-packaged foods.
Policy Recommendations
- The WHO’s approach is to change what is available to people at the population level (low-sodium salt), rather than just providing individual advice on reducing salt intake.
- Government policy should encourage the use of low-sodium salt alternatives, and industry should ensure proper visibility and accessibility of these alternatives in stores.
