Could changing just one ingredient in our diets save millions of lives?

It sounds like a claim to take with a grain of salt.

But new research suggests that swapping ordinary table salt for a healthier alternative could prevent millions of deaths from heart and kidney disease every year.

The salt sub? Potassium-enriched salt. You’ve probably passed it at your grocery store countless times.

Researchers say it’s a low-cost and practical intervention to help lower disease across huge populations. Here’s why.

What is potassium-enriched salt?

Did you know you can lower your sodium while using the same amount of salt?

Brands like Morton Lite Salt, Nu-Salt, and LOSALT all take out a quarter up to a half of the salt and mix in potassium chloride to make up the difference. Most people can’t tell anything’s been changed at all.

The concept has been around for almost a century. According to the American Heart Association it works two ways: it reduces sodium, which increases blood pressure. But it also boosts potassium, which reduces the effect of sodium.

The more potassium you consume, the more sodium comes out in your urine. Potassium also eases tension in blood vessel walls, helping lower blood pressure.

But not everyone should have it. Those with advanced kidney disease, are taking potassium supplements, or on diuretics that prevent the loss of potassium in pee (like spironolactone) are a few.

Too much potassium can build up when the kidneys don’t remove it efficiently, causing issues like nausea, vomiting, or irregular heart rate in extreme cases.

A study worth its salt

Researchers modeled potential benefits of swapping regular table salt with potassium-enriched salt across 193 countries, including the US.

The authors identified four conditions that would account for the greatest benefits:

  • Ischemic heart disease: narrowed or blocked arteries, which can lead to heart attacks
  • Hypertensive heart disease: caused by high blood pressure and can lead to heart failure
  • Stroke: brain damage caused by blocked or ruptred blood vessels
  • Chronic kidney disease: progressive loss of kidney function which can lead to kidney failure

They found that replacing all salt around the world would prevent 2.96 million deaths from these diseases, every year.

But partial and more specific substitutions also helped. As many as 1.85 million deaths would be prevented if salt was swapped only at home. Replacing 50% of all salt would save 1.72 million while 20% would save 700,000.

They estimated that new cases of these diseases would drop by 10.17 million each year.

In the US specifically, switching all salt could prevent 104,787 deaths and 491,905 new cases of these diseases every year.

Back to the salt mines

The authors acknowledge that replacing all salt eaten around the world is a bit unrealistic in the short term. Especially when potassium-enriched salt costs about twice as much as regular salt.

The thing is, there’s some precedent for a salt swap for public health. In the late 1800s and early 1900s, large swaths of the US had iodine deficiency, causing thyroid issues. In the early 1900s, scientists started adding iodine to salt, and it’s still widely used today.

If you’re interested in making the switch, clear it with your doctor to make sure your kidneys can handle it, and you’re not on medication that could cause problems with increased potassium.

A study published by the American Heart Association recommends those with high blood pressure (who get a doc’s OK) make the switch.

They recommend using a mix of 75% salt and 25% potassium chloride. Use it 1:1 as a replacement — there’s no gradual transition needed.

And don’t take the switch as a license to pile on more salt — that could cancel out the benefits.

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