Salt substitute

In 2021, a large randomised controlled trial of 20,995 older people in China reported that use of a potassium salt substitute in home cooking over a five-year period reduced the risk of stroke by 14%, major cardiovascular events by 13% and all-cause mortality by 12% compared to use of regular table salt.

[8] The study reported no significant difference in hyperkalaemia between the two groups, though people with serious kidney disease were excluded from the trial.

A 2022 Cochrane review of 26 trials involving salt substitutes reported their use probably slightly reduces blood pressure, non-fatal stroke, non-fatal acute coronary syndrome and heart disease death in adults compared to use of regular table salt.

[9] A separate systematic review and meta-analysis published in the same year of 21 trials involving salt substitutes reported protective effects of salt substitute on total mortality, cardiovascular mortality and cardiovascular events.

The substitute lowered systolic blood pressure (–7.1 mmHg, 95% confidence interval (CI) –10.5 to –3.8), meeting the primary endpoint, whereas restricted vs usual supply had no effect.

[15] Various diseases and medications may decrease the body's excretion of potassium, thereby increasing the risk of potentially fatal hyperkalemia.

LoSalt, a salt substitute manufacturer, has issued an advisory statement[16] that people taking the following prescription drugs should not use a salt substitute: amiloride, triamterene, Dytac, captopril and other angiotensin-converting enzyme inhibitors, spironolactone, and eplerenone.

A salt substitute can, analogously to the problem of iodine deficiency, help to eliminate the "hidden hunger" i.e. insufficient supply of necessary micronutrients such as iron.