A systemic analysis of available evidence published recently in the journal Heart found that dietary salt substitutes lower the risk of heart attack, stroke, and death from all causes, as well as cardiovascular disease.
Blood pressure is associated with high sodium intake and low potassium levels, according to studies. Around 1.28 billion people around the world have high blood pressure, and only 42 percent of them are diagnosed and treated. Hypertension, another term for high blood pressure, is a major cause of premature death globally.
A portion of sodium chloride (NaCl) is replaced with potassium chloride (KCl) in salt substitutes.
The effect of salt substitutes has been studied in a large scale.
Bruce Neal, executive director of the George Institute for Global Health Australia and professor of medicine at the University of New South Wales Sydney, was one of the five researchers who conducted the Salt Substitute and Stroke Study, which began in 2014 and covered 20,000 people from 600 remote areas in China. The study, which began in 2014, is billed as one of the largest dietary interventions ever conducted, has found that substituting regular salt for dietary salt substitute decreased the risk of stroke by 14%, major cardiovascular events by 13%,
Researchers conducted a systemic review to demonstrate that it's not only Chinese who have something to gain from switching to diet salt substitutes.
Dr. Jennifer Wong, a cardiologist and medical director of noninvasive cardiology at MemorialCare Heart and Vascular Institute in Fountain Valley, California, said her objective was to demonstrate consistency in their findings across different populations and areas.
Global data analysis
Researchers searched databases for studies that focused on salt substitutes. Ultimately, they included 21 studies in the meta-analysis.
.. We basically go through the papers in a really systematic, standardized way, extract the same information from every paper, and then combine it in a narrative summary to determine what it all really means as a whole, according to Dr. Neal.
The 21 research were conducted in Europe, the Western Pacific Region, the Americas, and South-East Asia. The duration of the intervention with a dietary salt substitute varied from one to 60 months. The percentage of sodium chloride in the salt substitutes varied from 33% to 75%; and the proportion of potassium chloride varied from 25% to 65%.
Blood pressure and salt substitute
Blood pressure is measured in mm HG. It includes two numbers: systolic and diastolic. Systolic is the higher number that indicates the heart's pumping blood around the body, while diastolic is the lower number that indicates the decreased pressure in the veins during the brief resting period between heartbeats.
The researchers' analysis of the systemic review found that dietary salt substitutes resulted in a 4.61 mm HG reduction in systolic blood pressure, while the overall decrease in diastolic blood pressure was 1.61 mm HG.
Factors such as geography, age, gender, history of high blood pressure, height, baseline blood pressure, and baseline urinary sodium and potassium levels did not seem to impact on the reductions in blood pressure.
There was no evidence that increased dietary potassium from salt substitutes caused any harm to participants, according to the studies.
Dr. Wong said she appreciated hearing about that because she is concerned about the detrimental effects of too much potassium on kidney patients. It's very comforting to have a large study that proves that there can't be any adverse effects, at least at the level of potassium that they used in these studies, according to Dr. Wong.
Benefits of salt substitutes are evident.
Dr. Neal told MNT that cardiologists tell patients to replace salt with dietary salt substitutes to lessen their blood pressure. He added that the large Salt Substitute and Stroke Study is important because it demonstrated that using salt substitutes produces outcomes that are beyond the scope of a blood pressure cuff.
Dr. Neal explained that having evidence that it does not only lower blood pressure, but also lowers strokes, heart attacks, and mortality in a really large scale study, is crucial in order to get politicians, salt manufacturers, and retailers to endorse salt alternatives in a manner that they currently do not.
The world's salt supply is being transformed.
Dr. Neal wants to transform the way people around the globe consume salt over the next decade.
Dr. Neal told MNT that the world's salt supply has been changed once already over the last few decades from regular salt to iodized salt in order to address thyroid disease problems on a global basis. So what we would like to do now is change the world's salt supply from regular iodized salt to iodized potassium enriched salt.
According to Dr. Neal, the impact on health would be significant. While doing the Salt Substitute and Stroke Study, the researchers calculated the impact of people in China switching to iodized potassium-enriched salt.
Dr. Neal said that if they did this, they would reduce a million strokes and heart attacks in China alone every year.
Making minor adjustments in salt intake
Dr. Neal believes that dietary salt substitutes are a feasible behavior modification. They are inexpensive and easy for people to use, and you don't have to make major changes to your diet.
Roxana Ehsani, a registered dietitian, nutritionist, and national media spokesperson for the Academy of Nutrition and Dietetics, told MNT that the evidence suggests that individuals should avoid salt use and rather opt for salt substitutions first. She also recommends using dried herbs and spices in cooking because they provide flavor and antioxidants, but no sodium.
Taylor Wallace, the president and CEO of Think Healthy Group, a food science and nutrition consulting company, said the systemic review adds to a body of research suggesting a need to reduce the amount of sodium in processed foods.
He advises increasing potassium intake as a way to increase the amount of sodium in our diets. Potassium is mostly made from plant foods, like fruits and vegetables, according to MNT... So make sure to eat your favorite fruits and veggies as well as reduce your sodium intake.