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A salt substitute, also known as low-sodium salt, is a low-sodium alternative to edible salt (table salt) marketed to reduce the risk of hypertension and cardiovascular disease associated with a high intake of sodium chloride Salt and Health (PDF). Scientific Advisory Committee on Nutrition (SACN) 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.
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 Blood pressure (–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.
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 statementLoSalt Advisory Statement (PDF) 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.
Monosodium glutamate 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.
Edible seaweed 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.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
Even further back in the early 20th century, lithium chloride was used as a salt substitute for those with hypertension. However, lithium overdose was common and deaths have occurred, leading to its prohibition in 1949.
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. Such substances are promoted by UNICEF as a "super-salt".
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