Evidence of salt substitutes’ benefits

Dr. Neal told MNT that cardiologists regularly tell patients to replace salt with dietary salt substitutes to lower their blood pressure. He added that the large Salt Substitute and Stroke Study is valuable because it showed that using salt substitutes delivers outcomes outside of a number on a blood pressure cuff.

“Having the evidence that actually it doesn’t just lower blood pressure, it also lowers strokes, heart attacks, and death in a really large scale trial, that changes public perception in a massive way,” Dr. Neal explained. “There might have been a view among some people that this was sort of settled, but having that really big study is really important in terms of trying to get policymakers, salt manufacturers, and retailers to actually start recommending salt alternatives in a way that they currently don’t.”

Changing the world’s salt supply

Over the next decade, Dr. Neal plans to work on changing how the citizens of the world consume salt.

“The world’s salt supply has been changed once already over the last few decades from regular salt to iodized salt to try and address thyroid disease problems on a global basis,” Dr. Neal told MNT. “So what we would like to do now is work on changing the world salt supply from regular iodized salt to iodized potassium enriched salt.”

The impact on health would be enormous, Dr. Neal believes. While undertaking the Salt Substitute and Stroke Study, the researchers calculated the impact of people in China switching to iodized potassium-enriched salt.

“We found that if they did that, they would prevent a million strokes and heart attacks in China alone every year,” Dr. Neal said.

Making small changes in salt intake

A beautiful thing about it, Dr. Neal said, is that switching to dietary salt substitutes is a doable behavior modification. “They’re low cost and easy for people to use,” he said. “You don’t have to make big changes to your lifestyle.”

Roxana Ehsani, a registered dietitian, nutritionist, and national media spokesperson for the Academy of Nutrition and Dietetics, told MNT that the evidence is clear that individuals should try to limit their use of salt and switch to “salt substitutions primarily.” She also suggests incorporating dried herbs and spices into cooking because they “add flavor, antioxidants, but no sodium.”

Taylor Wallace, president and CEO of Think Healthy Group, a food science, and nutrition consulting firm, said this systemic review adds to a body of research suggesting a need for reducing the amount of sodium in processed foods.

He recommends increasing potassium intake generally to balance the sodium in our diets. “Potassium is mainly derived from plant foods like fruits and vegetables,” he told MNT. “. . .So make sure to indulge in your favorite fruits and veggies as well as reduce your sodium intake.”