A salt substitute, also known as low-sodium salt, is a low-sodium alternative to

edible salt In common usage, salt is a mineral composed primarily of sodium chloride (NaCl). When used in food, especially in granulated form, it is more formally called table salt. In the form of a natural crystalline mineral, salt is also known as ro ...

(table salt) marketed to reduce the risk of

high blood pressure Hypertension, also known as high blood pressure, is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms itself. It is, however, a major ri ...

and

cardiovascular disease Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases (e.g. angina, heart attack), heart failure, hypertensive heart disease, rheumati ...

associated with a high intake of

sodium chloride Sodium chloride , commonly known as Salt#Edible salt, edible salt, is an ionic compound with the chemical formula NaCl, representing a 1:1 ratio of sodium and chloride ions. It is transparent or translucent, brittle, hygroscopic, and occurs a ...

while maintaining a similar taste. 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 diet

Research

In 2021, a large randomised controlled trial of 20,995 older people in China reported 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. The study reported 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 reported 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. A separate systematic review and meta-analysis published in the same year of 21 trials involving salt substitutes reported protective effects of salt substitute on total mortality, cardiovascular mortality and cardiovascular events. Review in: A 2023 clinical trial engaged 1,612 residents of 48 residential care facilities in China. They were cluster-randomized via a 2 × 2 factorial design substituting 62.5% NaCl/25% KCl versus usual salt and progressively restricted versus usual supply for 2 years. The substitute lowered

systolic blood pressure Blood pressure (BP) is the pressure of circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term "blood pressure" r ...

(–7.1 mmHg, 95% confidence interval (CI) –10.5 to –3.8), meeting the primary endpoint, whereas restricted vs usual supply had no effect. Substitute lowered diastolic blood pressure (–1.9 mmHg, 95% CI –3.6 to –0.2) and resulted in fewer cardiovascular events (hazard ratio (HR) 0.60, 95% CI 0.38–0.96), but had no effect on total mortality.

Examples

Potassium

Potassium closely resembles the saltiness of sodium. In practice,

potassium chloride Potassium chloride (KCl, or potassium salt) is a metal halide salt composed of potassium and chlorine. It is odorless and has a white or colorless vitreous crystal appearance. The solid dissolves readily in water, and its solutions have a sa ...

(also known as potassium salt) is the most commonly used salt substitute. Its

toxicity Toxicity is the degree to which a chemical substance or a particular mixture of substances can damage an organism. Toxicity can refer to the effect on a whole organism, such as an animal, bacteria, bacterium, or plant, as well as the effect o ...

for a healthy person is approximately equal to that of table salt (the 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. The recommended daily allowance of potassium is higher than that for sodium, yet a typical person consumes less potassium than sodium in a given day. Potassium chloride has a bitter

aftertaste Aftertaste is the taste intensity of a food or beverage that is perceived immediately after that food or beverage is removed from the mouth. The aftertastes of different foods and beverages can vary by intensity and over time, but the unifying fea ...

when used in higher proportions, which consumers may find unpalatable. As a result, some formulations only replace half the sodium chloride with potassium. Various diseases and medications may decrease the body's excretion of potassium, thereby increasing the risk of potentially fatal

hyperkalemia Hyperkalemia is an elevated level of potassium (K+) in the blood. Normal potassium levels are between 3.5 and 5.0 mmol/L (3.5 and 5.0 mEq/L) with levels above 5.5mmol/L defined as hyperkalemia. Typically hyperkalemia does not cause symptoms. Oc ...

. People with

kidney failure Kidney failure, also known as renal failure or end-stage renal disease (ESRD), is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney fa ...

heart failure Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome caused by an impairment in the heart's ability to Cardiac cycle, fill with and pump blood. Although symptoms vary based on which side of the heart is affected, HF ...

, or

diabetes Diabetes mellitus, commonly known as diabetes, is a group of common endocrine diseases characterized by sustained high blood sugar levels. Diabetes is due to either the pancreas not producing enough of the hormone insulin, or the cells of th ...

are not recommended to use salt substitutes without medical advice. LoSalt, a salt substitute manufacturer, has issued an advisory statement that people taking the following prescription drugs should not use a salt substitute: amiloride, triamterene, Dytac,

captopril Captopril, sold under the brand name Capoten among others, is an ACE inhibitor, angiotensin-converting enzyme (ACE) inhibitor used for the treatment of hypertension and some types of congestive heart failure. Captopril was the first oral ACE inh ...

and other angiotensin-converting enzyme inhibitors,

spironolactone Spironolactone, sold under the brand name Aldactone among others, is classed as a diuretic medication. It can be used to treat edema, fluid build-up due to hepatic cirrhosis, liver disease or kidney disease. It is also used to reduce risk o ...

, and eplerenone.

Other types

Sodium malate is salty in taste and may be blended with other salt substitutes. Although it contains sodium, the mass fraction is lower.

Monosodium glutamate Monosodium glutamate (MSG), also known as sodium glutamate, is a sodium salt of glutamic acid. MSG is found naturally in some foods including tomatoes and cheese in this glutamic acid form. MSG is used in cooking as a flavor enhancer with a ...

is often used as a substitute for 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.

Seaweed Seaweed, or macroalgae, refers to thousands of species of macroscopic, multicellular, marine algae. The term includes some types of ''Rhodophyta'' (red), '' Phaeophyta'' (brown) and ''Chlorophyta'' (green) macroalgae. Seaweed species such as ...

granules are also marketed as alternatives to salt. 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.

Historical

Historically (late 20th century), many substances containing

magnesium Magnesium is a chemical element; it has Symbol (chemistry), symbol Mg and atomic number 12. It is a shiny gray metal having a low density, low melting point and high chemical reactivity. Like the other alkaline earth metals (group 2 ...

and

potassium Potassium is a chemical element; it has Symbol (chemistry), symbol K (from Neo-Latin ) and atomic number19. It is a silvery white metal that is soft enough to easily cut with a knife. Potassium metal reacts rapidly with atmospheric oxygen to ...

have been tried as salt substitutes. They include: *

carnallite Carnallite (also carnalite) is an evaporite mineral, a hydrated potassium magnesium chloride with formula KCl.MgCl2·6(H2O). It is variably colored yellow to white, reddish, and sometimes colorless or blue. It is usually massive to fibrous with r ...

(KMgCl₃•6H₂O) *

kainite Kainite ( or ) (KMg(SO4)Cl·3H2O) is an evaporite mineral in the class of "Sulfates (selenates, etc.) with additional anions, with H2O" according to the Nickel–Strunz classification. It is a hydrated potassium-magnesium sulfate-chloride, natu ...

(KCl•MgSO₄•2H₂O) * langbeinite (K₂Mg₂(SO₄)₂) *

sylvite Sylvite, or sylvine, is potassium chloride (KCl) in natural mineral form. It forms crystals in the isometric system very similar to normal rock salt, halite ( NaCl). The two are, in fact, isomorphous. Sylvite is colorless to white with shades ...

(KCl) – currently used *

polyhalite Polyhalite is an evaporite mineral, a hydrated sulfate of potassium, calcium and magnesium with formula: . Polyhalite crystallizes in the triclinic system, although crystals are very rare. The normal habit is massive to fibrous. It is typica ...

(K₂MgCa₂(SO₄)₄•2H₂O) * Epsomite () * kieserite () Even further back in the early 20th century,

lithium chloride Lithium chloride is a chemical compound with the formula Li Cl. The salt is a typical ionic compound (with certain covalent characteristics), although the small size of the Li+ ion gives rise to properties not seen for other alkali metal chlorid ...

was used as a salt substitute for those with hypertension. However, overdosing was common and deaths have occurred, leading to its prohibition in 1949.

Additives

Flavor enhancers, although not true salt alternatives, help reduce the use of salt by enhancing the savory flavor (

umami Umami ( from ), or savoriness, is one of the five basic tastes. It is characteristic of broths and cooked meats. People taste umami through taste receptors that typically respond to glutamates and nucleotides, which are widely present in me ...

). Hydrolyzed protein or 5'-nucleotides are sometimes added to potassium chloride to improve the flavour of salt substitutes.

Fish sauce Fish sauce is a liquid condiment made from fish or krill that have been coated in salt and fermented for up to two years. It is used as a staple seasoning in East Asian cuisine and Southeast Asian cuisine, particularly Myanmar, Cambodia, L ...

has the same effect. Salt substitutes can also be further enriched with the essential nutrients. A salt substitute can, analogously to the problem of

iodine deficiency Iodine deficiency is a lack of the trace element iodine, an essential nutrient in the diet. It may result in metabolic problems such as goiter, sometimes as an endemic goiter as well as congenital iodine deficiency syndrome due to untreated ...

, help to eliminate the "hidden hunger" i.e. insufficient supply of necessary micronutrients such as iron. Such substances are promoted by

UNICEF UNICEF ( ), originally the United Nations International Children's Emergency Fund, officially United Nations Children's Fund since 1953, is an agency of the United Nations responsible for providing Humanitarianism, humanitarian and Development a ...

as a "super-salt".

References

{{Portal bar, Food Edible salt Potassium compounds Imitation foods