The study, which analysed 193 countries, was published in the journal Nature Health. It estimated that nearly 30 lakh deaths and one crore new cases of cardiovascular and kidney disease could be prevented globally every year through the widespread adoption of potassium-enriched salt.
Potassium-enriched salt is produced by replacing a portion of the sodium chloride in conventional table salt with potassium chloride. Bruce Neal, senior professorial fellow at The George Institute for Global Health, Australia, said switching to this alternative could deliver widespread health benefits, potentially preventing as many as one in ten cardiovascular deaths in most countries.
"Consuming too much sodium and not enough potassium are well established causes of high blood pressure -- a major risk factor for life threatening conditions like strokes, heart attacks and kidney disease. Switching to potassium-enriched salt addresses both these dietary issues at the same time, with substantial health benefits," he said.
Potassium-enriched salt looks, tastes and cooks like regular table salt. The World Health Organization (WHO) recommends replacing conventional table salt with lower-sodium salt substitutes containing potassium. It has also identified reducing sodium intake as a cost-effective approach to improving public health and lowering the burden of noncommunicable diseases.
Neal said a complete global transition from regular salt to potassium-enriched alternatives might be an aspirational goal, but the findings provide an opportunity for countries to consider the potential benefits of such a shift.
"While a global shift from regular salt to a potassium-enriched substitute is aspirational, this is a starting point to get countries thinking about the opportunity -- with much greater potential and at much lower cost than many drug-based treatments," he said.
The researchers evaluated several hypothetical scenarios, ranging from a complete global replacement of regular salt to more targeted adoption among people diagnosed with and receiving treatment for high blood pressure. Even the most limited level of replacement was found to offer substantial health benefits.
According to the study, replacing only regular table salt used in households with potassium-enriched salt could prevent 18.5 lakh deaths and approximately 62 lakh cases of cardiovascular and chronic kidney disease every year.
In another scenario, replacing salt used exclusively in processed foods and restaurant meals could prevent 15.6 lakh deaths and 54.6 lakh cases of cardiovascular and chronic kidney disease.
The benefits would be considerably greater if both household table salt and salt used in processed and restaurant foods were replaced. Such a combined shift could prevent nearly 30 lakh deaths and more than one crore cases of cardiovascular and chronic kidney disease annually.
"Worldwide replacement of all salt could prevent 2.96 million deaths, 10.17 million new cases and 69.43 million disability-adjusted life years each year from cardiovascular disease and chronic kidney disease," the authors wrote.
However, the researchers also highlighted concerns about hyperkalaemia, a condition characterised by excessively high potassium levels in the blood. The risk is particularly relevant for people with advanced kidney disease.
Despite this concern, the study found that the potential health benefits of potassium-enriched salt outweighed the associated risks, even among patients with advanced kidney disease.
Vivek Jha, nephrologist and senior professorial fellow at The George Institute in India, said people with serious kidney conditions and those taking medications that significantly increase potassium levels in the blood need to exercise caution.
"People with serious kidney disease and those taking medications that significantly raise blood potassium levels need to take precautions. Risks for this group can be managed effectively through patient education, product labelling, and clinical oversight," Jha said.
The findings highlight the potential of potassium-enriched salt as a public health intervention, with the study estimating that replacing conventional salt could prevent millions of deaths and reduce the annual burden of cardiovascular and chronic kidney disease worldwide. For India, the estimated reduction of around four lakh deaths and more than 15 lakh disease cases underscores the potential impact of changes in everyday salt consumption.
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