The leading salt substitutes are non-sodium table salts, which have their tastes as a result of compounds other than sodium chloride. Non-sodium salts reduce daily sodium intake and reduce the health effects of this element.
Low sodium dietedit
According to current WHO guidelines,[2][3] adults should consume less than 2,000 mg of sodium per day (i.e. about 5 grams of traditional table salt), and at least 3,510 mg of potassium per day.[4] In Europe, adults and children consume about twice as much sodium as recommended by experts.[5]
Researchedit
In 2021, a large randomised controlled trial of 20,995 older people in China found 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.[6]
The study found no significant difference in hyperkalaemia between the two groups, though people with serious kidney disease were excluded from the trial. The salt substitute used was 25% potassium chloride and 75% sodium chloride.
A 2022 Cochrane review of 26 trials involving salt substitutes found 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.[7] A separate systematic review and meta-analysis published in the same year of 21 trials involving salt substitutes found protective effects of salt substitute on total mortality, cardiovascular mortality and cardiovascular events.[8]
Examplesedit
Potassiumedit
Potassium closely resembles the saltiness of sodium. In practice, potassium chloride (also known as potassium salt) is the most commonly used salt substitute. Its toxicity for a healthy person is approximately equal to that of table salt (the LD50 is about 2.5 g/kg, or approximately 190 g for a person weighing 75 kg). Potassium lactate may also be used to reduce sodium levels in food products and is commonly used in meat and poultry products.[9] The recommended daily allowance of potassium is higher than that for sodium,[10] yet a typical person consumes less potassium than sodium in a given day.[11] Potassium chloride has a bitteraftertaste when used in higher proportions, which consumers may find unpalatable. As a result, some formulations only replace half the sodium chloride with potassium.[12]
Sodium malate is salty in taste and may be blended with other salt substitutes. Although it contains sodium, the mass fraction is lower.[14]
Monosodium glutamate is often used as a substitute to salt in processed and restaurant food, due to its salty taste and low sodium content compared to table salt, and can also be used effectively in home cooking.[15][16]
Seaweed granules are also marketed as alternatives to salt.[17]
Dehydrated, pulverized Salicornia (glasswort, marsh samphire) is sold under the brand name "Green Salt" as a salt substitute claimed to be as salty in taste as table salt, but with less sodium.[18][19]
Historicaledit
Historically (late 20th century), many substances containing magnesium and potassium have been tried as salt substitutes. They include:[20][21]
Even further back in the early 20th century, lithium chloride was used as a salt substitute for those with hypertension. However, overdosing was common and deaths have occurred, leading to its prohibition in 1949.[22]
Salt substitutes can also be further enriched with the essential nutrients. 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.[27][28] Such substances are promoted by UNICEF as a "super-salt".[29]
^Salt and Health (PDF). Scientific Advisory Committee on Nutrition (SACN)
^"WHO issues new guidance on dietary salt and potassium" (Press release). WHO. 31 January 2013.
^World Health Organization (2012). Guideline. Sodium intake for adults and children. Geneva, Switzerland. ISBN 978-92-4-150483-6. OCLC 849715509.{{cite book}}: CS1 maint: location missing publisher (link)
^Jarosz, Mirosław; Rychlik, Ewa; Stoś, Katarzyna; Wierzejska, Regina; Wojtasik, Anna; Charzewska, Jadwiga; Mojska, Hanna; Szponar, Lucjan; Sajór, Iwona (2017). Normy żywienia dla populacji Polski (in Polish). Warszawa: Instytut Żywności i Żywienia. ISBN 978-83-86060-89-4. OCLC 1022820929.
^Powles, John; Fahimi, Saman; Micha, Renata; Khatibzadeh, Shahab; Shi, Peilin; Ezzati, Majid; Engell, Rebecca E.; Lim, Stephen S.; Danaei, Goodarz; Mozaffarian, Dariush; Group (NutriCoDE), on behalf of the Global Burden of Diseases Nutrition and Chronic Diseases Expert (2013-12-01). "Global, regional and national sodium intakes in 1990 and 2010: a systematic analysis of 24 h urinary sodium excretion and dietary surveys worldwide". BMJ Open. 3 (12): e003733. doi:10.1136/bmjopen-2013-003733. ISSN 2044-6055. PMC3884590. PMID 24366578.
^Neal B, Wu Y, Feng X, Zhang R, Zhang Y, Shi J; et al. (2021). "Effect of Salt Substitution on Cardiovascular Events and Death". N Engl J Med. 385 (12): 1067–1077. doi:10.1056/NEJMoa2105675. hdl:10044/1/92012. PMID 34459569.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^Brand A, Visser ME, Schoonees A, Naude CE (2022). "Replacing salt with low-sodium salt substitutes (LSSS) for cardiovascular health in adults, children and pregnant women". Cochrane Database Syst Rev. 2022 (8): CD015207. doi:10.1002/14651858.CD015207. PMC9363242. PMID 35944931.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^Yin X, Rodgers A, Perkovic A, Huang L, Li KC, Yu J; et al. (2022). "Effects of salt substitutes on clinical outcomes: a systematic review and meta-analysis". Heart. 108 (20): 1608–1615. doi:10.1136/heartjnl-2022-321332. hdl:1959.4/unsworks_82252. PMID 35945000. S2CID 251468854.{{cite journal}}: CS1 maint: multiple names: authors list (link) Review in: Brophy, James (2022). "In the general population, salt substitutes vs. Regular salt reduce BP levels, CV outcomes, and mortality". Annals of Internal Medicine. 175 (12): JC139. doi:10.7326/J22-0091. PMID 36469919. S2CID 254247591.
^"Dietary Reference Intakes : Electrolytes and Water" (PDF). The National Academies. 2004. Archived from the original (PDF) on 11 October 2010. Retrieved 14 August 2011.
^Caggiula, AW; RR Wing; MP Nowalk; NC Milas; S Lee; H Langford (1985). "The measurement of sodium and potassium intake". American Journal of Clinical Nutrition. 42 (3): 391–398. doi:10.1093/ajcn/42.3.391. PMID 4036845. Retrieved 2008-11-17.
^Drake, S. L.; Drake, M. A. (2011). "Comparison of Salty Taste and Time Intensity of Sea and Land Salts from Around the World". Journal of Sensory Studies. 26 (1): 25–34. doi:10.1111/j.1745-459X.2010.00317.x. ISSN 1745-459X.
^Whitmore, Frank C. (2012). Organic Chemistry, Volume One : Part I: Aliphatic Compounds (2nd ed.). Mineola, New York: Dover Publications. p. 397. ISBN 978-0-486-31115-9.
^Inc, Bright Tribe. "MSG in Cooking". The Glutamate Association. Retrieved 2022-08-18. {{cite web}}: |last= has generic name (help)
^Maluly, Hellen D. B.; Arisseto-Bragotto, Adriana P.; Reyes, Felix G. R. (November 2017). "Monosodium glutamate as a tool to reduce sodium in foodstuffs: Technological and safety aspects". Food Science & Nutrition. 5 (6): 1039–1048. doi:10.1002/fsn3.499. PMC5694874. PMID 29188030.
^"Seaweed granules may replace salt in foods". foodnavigator.com. 22 September 2008.
^Florence Fabricant, "To Sprinkle: Add Some Green To Your Salt Lineup", New York Times, August 11, 2021, p. D3; online version "Add Green to Your Salt Lineup" August 9, 2021
^Lifton, R. P. (1995-09-12). "Genetic determinants of human hypertension". Proceedings of the National Academy of Sciences. 92 (19): 8545–8551. Bibcode:1995PNAS...92.8545L. doi:10.1073/pnas.92.19.8545. ISSN 0027-8424. PMC41004. PMID 7567973.
^Dahl, Lewis K.; Heine, Martha; Thompson, Keith (January 1974). "Genetic Influence of the Kidneys on Blood Pressure: Evidence from Chronic Renal Homografts in Rats with Opposite Predispositions to Hypertension". Circulation Research. 34 (1): 94–101. doi:10.1161/01.RES.34.1.94. ISSN 0009-7330. PMID 4588315.
^Marmol, F. (2008). "Lithium: Bipolar disorder and neurodegenerative diseases Possible cellular mechanisms of the therapeutic effects of lithium". Progress in Neuro-Psychopharmacology and Biological Psychiatry. 32 (8): 1761–1771. doi:10.1016/j.pnpbp.2008.08.012. PMID 18789369. S2CID 25861243.
^Lubin, Gus (2 February 2017). "Everyone should cook with MSG, says food scientist". Business Insider. Retrieved 27 January 2019.
^Huynh, Hue Linh; Danhi, Robert; Yan, See Wan (27 November 2015). "Using Fish Sauce as a Substitute for Sodium Chloride in Culinary Sauces and Effects on Sensory Properties". Journal of Food Science. 81 (1): S150–S155. doi:10.1111/1750-3841.13171. PMID 26613570.
^Afshin, Ashkan; Sur, Patrick John; Fay, Kairsten A.; Cornaby, Leslie; Ferrara, Giannina; Salama, Joseph S; Mullany, Erin C; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abebe, Zegeye; Afarideh, Mohsen (May 2019). "Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017". The Lancet. 393 (10184): 1958–1972. doi:10.1016/S0140-6736(19)30041-8. PMC6899507. PMID 30954305.
^Das, Jai K; Salam, Rehana A; Kumar, Rohail; Bhutta, Zulfiqar A (December 2013). "Micronutrient fortification of food and its impact on woman and child health: a systematic review". Systematic Reviews. 2 (1): 67. doi:10.1186/2046-4053-2-67. ISSN 2046-4053. PMC3765883. PMID 23971426.
^"VITAMIN & MINERAL DEFICIENCY: A GLOBAL PROGRESS REPORT" (PDF). Archived from the original (PDF) on 2021-01-26. Retrieved 2019-10-25.