In the kitchen, salt almost seems to cheat. Adding just a proper pinch of salt instantly enhances the flavor of almost any savory dish, but there is a definite drawback to this plentiful and inexpensive ingredient.
Simply put, too much salt goes wrong. More specifically, too much sodium hurts you and sodium is one of the two main elements that make up salt (also known as the chemical compound sodium chloride).
Many previous studies have investigated the links between excessive dietary sodium levels and health problems, such as an increased risk of cardiovascular disease.
At the same time, other studies have represented the health impacts of insufficient potassium in people’s diet, which also has a negative effect on blood pressure.
As it happens, a product, which is commonly found in many supermarkets, can alleviate these two problems at the same time: salt substitutes designed to taste the same as salt, but with reduced levels of sodium and an additional amount of potassium. .
Despite the promise of salt substitutes, however, large clinical trials measuring their impact on stroke, heart disease and death have been lacking, leaving questions about their effectiveness.
Now, a giant study conducted in China seems to suggest that almost everyone would benefit from making the change.
“Almost everyone in the world eats more salt than they should,” says clinical epidemiologist Bruce Neal of the George Institute for Global Health in Australia.
“If salt were changed to replace salt worldwide, several million premature deaths would be prevented each year.”
In the study, Neal and his team examined more than 20,000 villagers in rural China, recruiting participants with a history of stroke or poor blood pressure. People came from 600 villages in total, with an average age of about 65 at the start of the trial.
In the experiment, half of the participants received a free supply of salt substitute to use during the course of the trial (designed as a five-year experiment, but slightly affected by the COVID-19 pandemic).
The salt substitute given to them had less sodium and added potassium, and they were encouraged to use it more sparingly than they used to use salt, to maximize their overall sodium reduction.
Meanwhile, the other half of the villagers acted as a control group and continued to use salt in the kitchen and in the preparation of food as usual.
At the end of the study, there was a marked contrast in the health outcomes of these two groups.
Overall, about five years after the experiment began, more than 4,000 of the participants had died, more than 3,000 had suffered a stroke, and more than 5,000 had some sort of major cardiovascular event: sad and unfortunate, but not unexpected, results. given his age. and health at the beginning of the trial.
Among the results, however, the group of salt substitutes was significantly less likely to suffer strokes compared to regular salt consumers (29.14 events versus 33.65 events per 1,000 person-years), as well. the lower the chances of major cardiovascular events (49.09 events vs. 56.29 events) and death (39.28 events versus 44.61 events).
Researchers claim that their results effectively confirm earlier models in China, which suggest that nationwide salt substitutions could save the lives of some 460,000 people each year, simply by avoiding early deaths related to the effects of excessive sodium intake on health.
By extension, and this part is hypothetical, researchers suggest that the simple replacement itself would save millions of lives a year, if people around the world switched from normal salt to a healthier, slightly modified alternative.
A potential barrier to seeing these protective effects could be due to different forms of food processing in different countries.
“In rural China … processed foods are not generally used; dietary sodium chloride is added during food preparation in every home,” explains pediatrician Julie R. Ingelfinger of Massachusetts General Hospital , who did not participate in the study, in a comment on the research.
“In contrast, in much of the world, commercial preservation of food adds a lot of sodium chloride to the diet and the use of salt substitutes would not account for the total salt intake.”
One answer could be to replace salt not only in domestic cooking, but also in industrial cooking, where commercially manufactured processed foods are made.
In terms of cost, the researchers say there isn’t that much difference, as the salt substitute costs about 50 percent more, but considering how cheap the normal salt is (about $ 1.08 a kilogram), and the little that is usually needed in the kitchen, making the replacement is quite affordable, especially considering the benefits.
“While salt substitutes are a little more expensive than regular salt, they are still very cheap, only a few dollars a year to make the change,” says Neal.
“This is simply the most valuable research I have ever had.”
The findings are reported in The NEJM.