Salt substitutes linked to lower mortality
Using less salt in your food may seem mundane, but recent research suggests that the benefits could be significant, potentially leading to a decreased risk of premature death. A study published Monday in the journal Annals of Internal Medicine indicates that employing a salt substitute during cooking could be associated with a lower risk of mortality from any cause or from cardiovascular disease.
Dr. Loai Albarqouni, the senior author of the study and an assistant professor at the Institute for Evidence-Based Healthcare at Bond University in Australia, expressed enthusiasm about the findings. He noted the novelty of providing evidence supporting the long-term effectiveness of salt substitutions, as previous studies had primarily focused on short-term outcomes lasting only a few weeks.
The study, a systematic review of 16 randomized controlled trials conducted before August 23, 2023, involved 35,251 participants, averaging around 64 years old, with an above-average risk of cardiovascular disease. Most trials were conducted in China, with additional trials in the United Kingdom, Taiwan, Peru, the Netherlands, and Norway.
Despite the predominance of research from China, the authors emphasized the scarcity of salt substitution studies outside of Asian countries. This limitation led to a grading of evidence as “low to very low certainty” for Western populations due to insufficient data supporting the effectiveness of salt substitutes in Western contexts.
Salt substitution was found to correlate with reduced sodium levels in urine and blood pressure, similar to the effects of blood pressure medications. However, the authors noted variations in the types of salt substitutes used across trials, some of which were not verified, raising questions about consistency and reliability.
The trials compared common salt, primarily sodium chloride with or without added iodine, with salt substitutes consisting of 25% to 30% potassium chloride and 60% to 75% sodium chloride. However, applying these findings to Western dietary patterns poses challenges, as salt consumption in North America is predominantly driven by processed and takeaway foods, unlike the home food preparation focus of the studied populations.
Experts caution against drawing definitive conclusions from the study, highlighting the need for further research. Dr. Andrew Freeman, a preventative cardiologist, emphasized the importance of reducing sodium intake while underscoring the benefits of potassium-rich foods like fruits and vegetables.
To lower salt intake, experts recommend checking food labels for sodium content, avoiding packaged and restaurant foods, and exploring salt-free seasonings or salt substitutes. However, individuals sensitive to potassium or other micronutrients should exercise caution.
While reducing sodium intake is just one aspect of cardiovascular risk reduction, alongside diet changes, smoking cessation, and increased physical activity, salt substitutes could play a role in improving health outcomes. Adjusting to lower salt intake may initially challenge taste preferences but can lead to long-term benefits for cardiovascular health.
