Salt Substitutes Linked to Reduced Risk of Heart Problems

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April 9, 2024 – Swapping salt for salt substitute products in food may help protect people from early death and, particularly, from dying of heart problems like heart attack or stroke. 

The benefits of salt substitutes were observed in the risks for a group of health problems known as cardiovascular disease, which includes heart disease, heart valve problems, and abnormal heart rhythm, as well as events like heart attack or stroke.

The findings, from researchers in Australia and published Tuesday in the journal Annals of Internal Medicine, are based on a new analysis of data from 18 previous studies, the majority of which only included people living in Asian countries such as China or Taiwan. For that reason, the researchers cautioned that the use of salt substitutes may not be linked to the same health outcomes for people who eat a Western diet. Americans tend to get most of their salt intake from eating processed and packaged foods, whereas the traditional Asian diet tends to source salt from salt added during home cooking.

Salt substitutes are products that contain less sodium and, instead, increased amounts of potassium. The researchers sought to only include studies that examined the use of salt substitutes, purposely excluding research studies that only looked at reducing salt intake.

The people in the analysis tended to be older and have an increased risk for heart problems, so people at average risk of heart problems or lower may not necessarily experience the protective benefits from salt substitution.

Overall, the researchers characterized their findings as being based on “low-certainty evidence.” But they noted that their findings align with other research, such as links between sodium reduction, reduced blood pressure, and reduced risk of death. 

They cautioned that some people may be sensitive to such a substitution, particularly people with kidney problems.

Another challenge, the authors wrote, is that salt substitutes are not widely available and may be more expensive than table salt products. They suggested that public health initiatives to offset the cost may be worthwhile, since many of the people most at risk of heart problems tend to live in low-income households.

Heart disease is the leading cause of death in the U.S. and worldwide, and therefore the authors wrote that despite the limitations of their study, the findings are promising. As many as 10% of all global deaths due to heart problems can be linked to high levels of salt in people’s diets, they noted.

“The improved cardiovascular outcomes and reductions in mortality shown in the current review could have major clinical and public health implications given the significance and burden of [cardiovascular disease] on global health,” the researchers wrote.