Salt substitute

Salt substitutes are low-sodium table salt alternatives marketed to circumvent the risk of high blood pressure and cardiovascular disease associated with a high intake of sodium chloride[1] while maintaining a similar taste.

A salt substitute by AlsoSalt

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.

Examples of such substances are primary substances containing magnesium and potassium, including:[2][3]

In practice, potassium chloride (also known as potassium salt) is most commonly used. 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.[4] The recommended daily allowance of potassium is higher than that for sodium,[5] yet a typical person consumes less potassium than sodium in a given day.[6] Potassium chloride has a bitter aftertaste when used in higher proportions, which consumers may find unpalatable.[7] Hydrolyzed protein[8] or 5'-nucleotides[9] are sometimes added to potassium chloride to improve the flavour of salt substitutes.

Seaweed granules are also marketed as alternatives to salt.[10]

Various diseases and medications may decrease the body's excretion of potassium, thereby increasing the risk of potentially fatal hyperkalemia. People with kidney failure, heart failure, or diabetes are not recommended to use salt substitutes without medical advice. LoSalt, a salt substitute manufacturer, has issued an advisory statement[11] 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.

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 and iron or other micronutrients).[12][13] Such substances are promoted by UNICEF as a "super-salt".[14]

Low sodium diet
Main article: Low sodium diet

According to current WHO guidelines,[15][16] 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.[17] However, both adults and children in Europe consume about twice as much traditional salt as recommended by experts.[18]

People struggling with elevated sodium or low potassium levels may be at risk for hypertension,[19][20] which increases the risk of heart disease and stroke.[21] International studies covering hundreds of thousands of people estimate that the number of deaths that can be attributed to excessive sodium intake reaches at least 1.65 million people a year.[22] Hypertension, strokes, heart attacks, stomach cancer, and osteoporosis are some of the severe health effects and complications resulting from excessive intake of traditional salt (sodium chloride). After many approaches to deal with this serious public health problem, researchers and government officials state that a significant step forward cannot be made without a wide adoption of non-sodium salt both in daily use and as a part of the manufacturing process. It is impossible to achieve this goal with a lack of sufficient products that would combine similar tastes, low sodium levels, and a high amount of desired nutrients.

See also

References
  1. Scientific Advisory Committee on Nutrition (SACN) Salt and Health (PDF)
  2. Lifton, R. P. (1995-09-12). "Genetic determinants of human hypertension". Proceedings of the National Academy of Sciences. 92 (19): 8545–8551. doi:10.1073/pnas.92.19.8545. ISSN 0027-8424. PMC 41004. PMID 7567973.
  3. 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.
  4. Low sodium meat products. http://www.purac.com/purac_com/01d7a1a1dce330c46ada4f832de8e6ca.php/
  5. "Dietary Reference Intakes : Electrolytes and Water" (PDF). The National Academies. 2004. Archived from the original (PDF) on 11 October 2010. Retrieved 14 August 2011.
  6. 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.
  7. 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.
  8. United States Patent 4451494
  9. United States Patent 4243691
  10. http://www.foodnavigator.com/Science-Nutrition/Seaweed-granules-may-replace-salt-in-foods
  11. LoSalt Advisory Statement (PDF)
  12. 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. PMID 30954305.
  13. 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. PMC 3765883. PMID 23971426.
  14. "VITAMIN & MINERAL DEFICIENCY: A GLOBAL PROGRESS REPORT" (PDF).
  15. "WHO issues new guidance on dietary salt and potassium".
  16. World Health Organization. Guideline. Sodium intake for adults and children. Geneva, Switzerland. ISBN 9789241504836. OCLC 849715509.
  17. 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 9788386060894. OCLC 1022820929.
  18. 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. PMC 3884590. PMID 24366578.
  19. McGuire, Shelley (2014-01-01). "Institute of Medicine. 2013, Sodium Intake in Populations: Assessment of Evidence. Washington, DC: The National Academies Press, 2013". Advances in Nutrition. 5 (1): 19–20. doi:10.3945/an.113.005033. ISSN 2161-8313. PMC 3884094. PMID 24425717.
  20. He, Feng J.; Li, Jiafu; MacGregor, Graham A. (2013-04-04). "Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials". BMJ. 346: f1325. doi:10.1136/bmj.f1325. ISSN 1756-1833. PMID 23558162.
  21. Kotchen, Theodore A.; Cowley, Allen W. Jr; Frohlich, Edward D. (2013-03-27). "Salt in Health and Disease — A Delicate Balance". New England Journal of Medicine. 368 (13): 1229–1237. doi:10.1056/nejmra1212606. PMID 23534562.
  22. Mozaffarian, Dariush; Fahimi, Saman; Singh, Gitanjali M.; Micha, Renata; Khatibzadeh, Shahab; Engell, Rebecca E.; Lim, Stephen; Danaei, Goodarz; Ezzati, Majid (2014-08-13). "Global Sodium Consumption and Death from Cardiovascular Causes" (PDF). New England Journal of Medicine. 371 (7): 624–634. doi:10.1056/nejmoa1304127. PMID 25119608.
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