Experts have endorsed the World Health Organization’s (WHO) recent guideline advocating for the use of potassium-enriched salt to reduce hypertension and related heart risks. The WHO suggests replacing regular table salt, rich in sodium, with K-salt or potassium chloride to mitigate noncommunicable diseases (NCDs) such as cardiovascular diseases (CVDs) and chronic kidney disease.
By lowering sodium intake, potassium-enriched salt may also reduce the risk of conditions like gastric cancer. According to the WHO, each year, 8 million people die due to poor diet, with 1.9 million deaths attributed to high sodium intake.
“High sodium concentration is associated with higher blood pressure levels. Long-term impact leads to hypertension and heart disease,” explained Dr. Harshal R Salve, Additional Professor at the Centre for Community Medicine at AIIMS, New Delhi.
The WHO guidelines recommend reducing sodium intake to less than 2 grams per day, equivalent to about 5 grams of salt. The guidelines also encourage replacing table salt with potassium-enriched alternatives to further cut down sodium intake.
The guidelines provide evidence-informed guidance on the use of lower-sodium salt substitutes (LSSS). These substitutes can be used both for discretionary salt added during cooking or eating, and non-discretionary use in manufactured foods and restaurant dishes. Sodium-containing condiments like soy sauce and fish sauce, common in some countries, can also benefit from such alternatives. These salts contain less sodium and often include potassium chloride (KCl), mimicking the flavor of regular salt while providing health benefits.
Replacing some sodium with KCl offers advantages beyond sodium reduction. WHO recommends increasing potassium intake from food sources to reduce blood pressure and the risk of CVDs.
“LSSC like potassium should be promoted as a good alternative,” said Dr. Salve, adding that scaling up requires a more regulatory approach, especially for packaged food items.
However, the new recommendation does not apply to women, children, or people with kidney impairments due to insufficient data on the use of potassium-based salts in these groups.
Prof. Vivekanand Jha, Executive Director at The George Institute for Global Health India, emphasized the need to make low-sodium, potassium-enriched salts affordable and accessible. “This will help fight the growing problem of hypertension and heart and kidney disease in India, especially in rural areas,” he added.
Jha also highlighted the necessity of generating evidence on the safety and efficacy of salt substitutes in special populations, such as those with kidney diseases.
Concerns have been raised about the safety of LSSS containing potassium, as high levels of blood potassium (hyperkalemia) can be harmful, particularly for individuals with impaired kidney function. The WHO stressed the importance of systematically reviewing existing evidence on the health effects of LSSS intake.
