Switch to ‘healthier’ salt could prevent 3 million deaths a year, study finds

Switching to potassium-enriched salt could prevent nearly 3 million deaths a year worldwide, according to a modelling study covering 193 countries.

Researchers estimated that replacing regular salt could also prevent more than 10m new cases of cardiovascular disease, a leading cause of stroke, and chronic kidney disease annually.

The figures are projections, not observed reductions in deaths or disease. They are based on hypothetical scenarios ranging from a complete global switch to targeted use among people with high blood pressure.

Researchers from The George Institute for Global Health and UNSW Sydney assessed the potential benefits across a combined adult population of approximately 4.6 billion.

Replacing all regular salt with a potassium-enriched alternative was estimated to prevent 2.96m deaths and 10.17m new cases of cardiovascular and kidney disease each year.

The potential benefits reflect the effects of sodium and potassium on blood pressure, a major risk factor for stroke, heart attack and kidney disease.

Bruce Neal, senior professorial fellow at The George Institute and conjoint professor at UNSW Sydney, said the benefits could extend across most countries.

He said: “Consuming too much sodium and not enough potassium are well established causes of high blood pressure – a major risk factor for life threatening conditions like strokes, heart attacks and kidney disease.

“Switching to potassium-enriched salt addresses both these dietary issues at the same time, with substantial health benefits.”

Potassium-enriched salt is made by replacing some of the sodium chloride in regular table salt with potassium chloride.

It looks, tastes and cooks like conventional salt but contains less sodium.

In 2025, the World Health Organization endorsed its use to reduce blood pressure and cardiovascular disease risk.

Approximately 1.4 billion adults aged 30 to 79 worldwide have high blood pressure, equivalent to one in three people in that age group.

Cardiovascular disease is the leading cause of death and disability globally, accounting for 19.2m deaths in 2023, nearly 50 per cent more than 30 years earlier.

The researchers modelled different levels of salt substitution to estimate their potential health effects.

Replacing only regular table salt used in homes could prevent 1.85m deaths and 6.19m new cases of cardiovascular and chronic kidney disease annually.

Switching only the salt used in processed foods and restaurants produced estimates of 1.56m deaths and 5.46m new cases prevented.

Combining both approaches offered the greatest potential benefit, with almost 3m deaths prevented each year.

More targeted approaches were also assessed.

Replacing household salt among 80 per cent of people with diagnosed high blood pressure could prevent an estimated 590,000 deaths and 1.72m new cases of cardiovascular and kidney disease annually.

Restricting the switch to 80 per cent of people receiving treatment for high blood pressure reduced those estimates to 480,000 deaths and 1.41m new cases prevented.

The analysis also considered the risks of increased potassium intake.

People with advanced kidney disease can develop hyperkalaemia, a condition in which potassium levels in the blood become dangerously high.

The modelling suggested that the overall benefits would outweigh the risks even among these patients, although precautions would be necessary.

Vivek Jha, nephrologist and senior professorial fellow at The George Institute in India, said: “People with serious kidney disease and those taking medications that significantly raise blood potassium levels need to take precautions.

“Risks for this group can be managed effectively through patient education, product labelling, and clinical oversight.”

The researchers said strategies for increasing the use of potassium-enriched salt would need to reflect differences in how salt is consumed.

In Europe and North America, more than 70 per cent of salt intake comes from processed foods and restaurant meals, making changes within the food industry particularly important.

Neal said wider adoption would also require investigation into how potassium chloride production could be increased to meet demand.

Country-level estimates showed substantial differences in the potential benefits of a complete switch.

China had the highest estimated benefit among the countries listed, with 1.08m deaths and 3.61m new cases of cardiovascular and kidney disease potentially prevented annually.

India followed with approximately 400,000 deaths and 1.53m new cases prevented.

In the US, the estimates were 104,787 deaths and 491,905 new cases, compared with 12,951 deaths and 59,988 new cases in the UK.

For Australia, the projected annual reductions were 2,076 deaths and 15,674 new cases.

The researchers acknowledged that achieving a complete worldwide switch would be ambitious.

Neal said the findings could help governments consider potassium-enriched salt as another way to reduce the health burden associated with excessive sodium consumption.