Image of Bruce Neal, Ph.D.; Image credit: George Institute for Global Health

Substituting a salt substitute for salt consumption slashes the rate of stroke, cardiovascular disease and death among people at high risk, a nearly five-year study of seniors has found. 

High levels of sodium intake and low levels of potassium intake are widespread and contribute to a high risk of these diseases and conditions, the researchers said. Partly replacing the culprit — sodium chloride — with potassium chloride can address the problem, they contended.

The study, which recruited more than 20,000 people in 600 rural Chinese villages, used a salt replacement with reduced sodium levels and increased potassium levels. The participants had a history of stroke or were 60 years of age or older and had high blood pressure. 

Participants were provided enough salt substitute to cover all household cooking and food preservation requirements. Their health outcomes over a median of 4.75 years were compared with those of residents in other villages who continued using regular salt. 

During that time, more than 3,000 participants experienced a stroke. But stroke risk was reduced by 14% among those who used the salt substitute. In addition, total cardiovascular events (strokes and heart attacks combined) were reduced by 13% and premature mortality risk fell by 12%, reported Bruce Neal, Ph.D., from the George Institute for Global Health in Sydney, Australia.

The researchers are calling for widespread changes to the manufacture and use of salt, including the following recommendations:

  • Salt manufacturers and retailers worldwide should switch to producing and marketing salt substitute at scale
  • Governments worldwide should design policies to promote salt substitute and discourage regular salt use
  • Consumers worldwide should cook, season and preserve foods with salt substitute — not regular salt

“Switching table salt to salt substitute is a highly feasible and low-cost opportunity to have a massive global health benefit,” Neal concluded.

The study was published in the New England Journal of Medicine.