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Consuming low-sodium salt substitutes instead of common salt is probably beneficial for cardiovascular health

Consuming low-sodium salt substitutes instead of common salt is probably beneficial for cardiovascular health

An evaluation by Nutrimedia reveals that although the reduction in cardiovascular risk is very small on the individual level, the benefit might affect the population as a whole. The analysis of the most relevant studies shows that salt substitutes probably reduce blood pressure slightly. However, there is a lack of evidence on the effects of these products on children, pregnant women and people with high potassium levels, thus preventing extrapolating the conclusions to the population in general.

14.11.2022

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Excessive salt intake, above the WHO’s recommended limit of 5 grams per day, contributes to increased blood pressure, which then raises the risk of stroke and other cardiovascular diseases. Although hypertension can be treated effectively with drugs, the use of low-sodium salt substitutes is being considered as a possible alternative to reduce salt consumption.

A new evaluation by Nutrimedia, which analyses the veracity of news items that state that salt substitutes reduce the risk of stroke and cardiovascular mortality, concludes that this message is true. This evaluation by Nutrimedia, a project of Pompeu Fabra University’s Observatory of Scientific Communication and the Iberoamerican Cochrane Center, also shows that salt substitutes probably slightly lower blood pressure. It also points out that the beneficial effects on cardiovascular health are very small individually, although they may be relevant at the level of the population in general.

Substitute sodium with potassium

Salt substitutes have less sodium than common salt because they replace some of the sodium with potassium or other minerals. The rationale behind these products is to help reduce the health risks associated with excessive salt intake, since consuming too much sodium and too little potassium contributes to high blood pressure. Worldwide, high blood pressure is the biggest cause of preventable deaths (more than 10 million per year), principally because it causes stroke, acute coronary syndrome, and kidney problems.

Nevertheless, salt substitutes can also present health risks. The use of these products could result in a higher-than-normal blood potassium level (hyperkalaemia), which causes problems in the speed and rhythm of heart beats or can cause it to stop. These risks are greater in certain people, such as those whose kidneys do not work properly to eliminate potassium.

Salt substitutes can also present health risks

The Nutrimedia evaluation is based on a Cochrane systematic review published in August 2022, in which the most relevant clinical trials have been reviewed to find out the beneficial and harmful effects of the use of low-sodium salt substitutes. Scientific evidence from this review shows that replacing common salt with these substitutes probably increases the level of potassium in the blood, albeit slightly.

The available studies do not provide sufficient evidence concerning the effects of these products on children, pregnant women and people who already have hyperkalaemia, which prevents generalizing the conclusions of this review. In addition, it should be noted that the knowledge provided by these trials focuses on the use of table and cooking salt substitutes, but does not provide enough information on the use of these products in processed foods.

Nutrimedia is a project of the Science Communication Observatory of Pompeu Fabra University (OCC-UPF) and the Iberoamerican Cochrane Center (CCIb), which scientifically evaluates the degree of truthfulness of messages about food and health (news, advertisements, myths and questions from the public). The results of the evaluations, which are published on the project website, are intended to provide scientific data and criteria to help citizens make informed decisions concerning nutrition. The OCC-UPF is a special research centre for the study of the transfer of scientific and technological knowledge to society. The CCIb is one of the international centres of Cochrane, an international organization whose systematic reviews have helped to transform decision-making on health interventions.

Further information:

• Full evaluation

• Technical report (PDF)

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