Swapping common salt for light can reduce the risk of early death, says study

Using less salt in your food may seem boring, but the benefits could be as great as a lower risk of death, new research finds.

Using a salt substitute when cooking, such as light versions with lower sodium content, was associated with a lower risk of dying prematurely from any cause or from cardiovascular disease in a new study published Monday in the journal Annals of Internal Medicine.

“We are excited to be able to provide evidence that salt replacements are effective in improving cardiovascular outcomes when used long-term, up to 10 years,” said study senior author Loai Albarqouni, assistant professor at the Institute for Based Health Care. in Evidence from Bond University, Australia. “Previous early studies tended to focus on short-term results, lasting just two weeks.”

The study is a systematic review of 16 randomized controlled trials published before August 23, 2023, which totaled 35,251 participants with an average age of about 64 years and with an above-average risk of cardiovascular disease. The trials were mainly carried out in China, with the rest in the United Kingdom, Taiwan, Peru, the Netherlands and Norway.

With two-thirds of the results coming from China, the authors “were surprised by the small amount of salt replacement research conducted outside of Asian countries,” Albarqouni said. “This partially explains why we rate the evidence as 'low to very low certainty' for Western populations – there simply isn't enough evidence to see whether salt substitutes would be as effective in the Western context.”

Salt replacement was also associated with a reduction in urine sodium and blood pressure, an effect similar to that of blood pressure medications, the authors found. This could explain the lower risk of death, Albarqouni said.

The authors acknowledged that in the trials, some of the salt substitutes were not verified and some were purchased by participants rather than provided by researchers.

The trials compared the use of common salt – made from about 100% sodium chloride, occasionally with iodine added – with the use of a salt substitute made up of 25% to 30% potassium chloride and 60% to 75% sodium chloride. % sodium chloride.

Another reason why applying the results to a Western context is difficult is that salt consumption patterns in North America are “driven by processed and restaurant foods, whereas consumption in the research context is more influenced by high amounts of salt.” added during food preparation at home,” said Albarqouni.

“This is not the strongest study to base a lot of conclusions on at this point,” said Dr. Andrew Freeman, a preventive cardiologist and director of cardiovascular prevention and wellness at National Jewish Health in Denver. “But it adds to the body of evidence and the signal in the noise that eliminating sodium salt from your diet is a big benefit and getting potassium in your diet is better,”

And “while we know potassium is beneficial, salt is salt,” added Freeman, who was not involved in the study. “Whether it’s sodium chloride or potassium chloride or magnesium chloride, it’s all salt. And the best way to get potassium in your body is to eat fruits and vegetables – that’s where potassium is most abundant.”

Decreasing salt intake

The American Heart Association's ideal daily sodium limit is 1,500 milligrams per day for most adults, especially those with high blood pressure, and a maximum of 2,300 milligrams daily.

“If the majority of your food intake comes from packaged or restaurant foods, your sodium intake is likely very high,” Albarqouni said in an email. “There are some physical signs that you may be consuming too much sodium, such as bloating or tiredness, high blood pressure, thirst and/or increased urination.”

If you're concerned about your intake, you can seek medical or nutritional advice from a professional, Albarqouni added.

When purchasing packaged foods, check the sodium content on the labels. Some foods may contain more sodium than you think, like poultry or cereals, Freeman said. A standard-sized pickle typically has about 1,500 milligrams of salt, she added.

In addition to reducing your salt intake by simply eliminating salt in food preparation at home, you can also try purchasing salt substitutes with a composition similar to those used in the study or using salt-free seasonings to add more flavor to your foods, experts said. .

The authors acknowledged that more research is needed to confirm whether salt replacement of the type in the study is safe for patients “sensitive to micronutrient manipulation,” including those sensitive to potassium — such as people with kidney deficiency, they said.

Lower-salt foods may seem bland at first, but your taste buds can adjust in just a few weeks, Freeman said, so give yourself time to adjust.

“It's also important to remember that reducing sodium intake is just one way to reduce cardiovascular risk without medication,” Albarqouni said. “Attitudes such as dietary changes, stopping smoking and increasing movement can also have an impact. Salt substitutes are not the Holy Grail for eliminating cardiovascular disease, but they are a piece of the puzzle that can help.”