New Research on Salt Subsitutes

Family Practice News reported exciting news on potassium-containing salt substitutes.

I picked up my daughter’s September 2022 copy of Family Practice News and saw an interesting article with some very good news.  It stated, “More evidence salt substitutes lower risk of CVD and death.”  (CVD refers to cardiovascular disease, the leading cause of death for Americans.)

As soon I saw the headline, I combed through it and got to work creating a post to share with you. 

The article suggests potassium-containing salt substitutes may benefit people with heart disease by lowering blood pressure. It’s likely due to both a decrease in sodium and an increase in potassium provided by these products. This is excellent news for heart failure patients on a low sodium diet.

Before we continue, be sure to check with your physician before buying potassium containing salt substitutes. Too much potassium can be dangerous for people with kidney disease and other conditions. Hyperkalemia, or too much potassium in the blood, is possible, so use caution.

Potassium works to lower blood pressure in two ways

  • Eating foods rich in potassium actually causes your kidneys to get rid of more sodium in your urine
  • Potassium relaxes the walls of your blood vessels. Relaxed, more elastic blood vessels can better expand, decreasing blood pressure throughout your body.

How Did the Researchers Discover This?

According to the researchers, using potassium-containing salt substitutes both lowered blood pressure and decreased the risk of death in people with cardiovascular disease.  This research was in the form of a meta-analysis. A meta-analysis is when experts examine multiple studies, combine the results, and draw conclusions from these large groups.   

This analysis compared twenty-one studies with over 30,000 participants!  This is one of the benefits of a meta-analysis. Large groups can be studied using this method. The researchers reviewed and published their findings in a scientific journal called Heart.  Another publication, Family Practice News, summarized these exciting findings in their September 2022 edition.   

Background Information 

Table salt is the combination of sodium and chloride or NaCl. Sodium restricted diets have lead to the development of salt substitutes.

Some salt substitutes use potassium chloride or KCl to replace all of the sodium in the product.  Others contain both sodium and chloride in different percentages. And, some salt substitutes are spice blends that have zero sodium or potassium. 

Salt Substitutes Used in this Research

Important to note! This research looked at salt substitutes that are a blend of sodium and potassium, containing between 33% and 75% potassium.  

Here are some examples of sodium potassium blends similar to those reviewed in this research.

  • Morton’s Lite Salt 
  • Anderson’s Fortisalt   
  • Reduced Sodium Gourmet Seasoning 
  • Salt for Life Salt Substitute  

Spice Based Salt Substitutes

Spices and spice based salt substitutes were not part of this study. That is because these products don’t have any potassium at all. Therefore they would not have any effect on blood pressure.

The most common brands of spice based salt substitutes are Dash and Flavor Mate. There are many different spice blends on the market. At hospitals, we have packets of “Chef Seasoning” which fall into this category. Be sure to let me know if you have discovered another favorite!

Spice based salt substitutes still make great alternatives for people on a low sodium diet and will be covered in detail in later blog posts.  

They can taste very similar to salt which makes them appealing.  (See the blog for a review of salt substitutes.) 

Sodium Free Salt Substitutes

The following products are 100% KCl or Potassium Chloride. They are sodium free and may have a similar effect on cardiovascular health. However, they were not among the salt substitutes used for this research.

  • Morton’s Salt Substitute 
  • NoSalt 
  • NuSalt 
  • Great Value Salt Substitute.   

Research Conclusions 

The research showed that blood pressure was lowered in all groups, regardless of age, weight, country of origin, or gender. And the lower the amount of sodium in each substitute the more significant the reduction in blood pressure.   

According to a physician interviewed for the article, these findings may lead to salt substitutes being routinely included in patient recommendations. 

And, the salt substitutes did not show any adverse effects.  In other words, no participants showed signs of high potassium (hyperkalemia) or any other negative side effects.  This is very good news! 

A Word of Caution 

While this study did not show any negative effects of salt substitutes, those at high risk were excluded from the studies examined. That means that people with kidney disease and other conditions that cause high blood potassium were not participants in any of these studies.   

Salt substitutes containing potassium chloride can be dangerous for people with kidney disease because they are not able to balance and remove any excess potassium in their blood.  

Salt substitutes can also be dangerous for people on a certain type of blood pressure medication called ACE inhibitors. This group of drugs can raise blood potassium levels too high. And it is definitely possible to get too much potassium from a salt substitute, especially if you use it in cooking and putting it on the dinner table next to the pepper shaker.   

Always read labels carefully to determine how much sodium or potassium a particular brand of salt substitute contains. And always check with your physician before using them. 

Important to Note 

The symptoms of high blood potassium levels are irregular heartbeat, chest pain, weakness, tingling, shortness of breath, nausea, and vomiting.  


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