ISLAMABAD, April 17 (Online): A new study finds that consuming salt substitutes instead of table salt can reduce the risk of cardiovascular events and all-cause death.The salt substitute researchers tested also contained additional potassium, which may partially explain its health benefits.<\/p>\n
However, the study analyzes data from studies conducted largely in China, and its applicability to Western populations is not clear due to differences between the East and West in the way food is prepared and consumed.
\nEven though it is widely known that excessive sodium intake is associated with cardiovascular disease and mortality, many people continue to consume unhealthy amounts of salt \u2014 sodium chloride \u2014 in their foods. One strategy for continuing to satisfy one\u2019s taste for salty foods while reducing health risks is the use of salt substitutes.<\/p>\n
A new study from Bond University in Australia finds that the use of salt substitutes can result in a lower incidence of cardiovascular disease and a reduced risk of death from any cause for up to 10 years.<\/p>\n
Salt substitutes are typically a mixture containing lower amounts of sodium and increased levels of potassium.<\/p>\n
The study analyzes the results of 16 randomized controlled trials (RCTs). Of these, eight reported incidences of major cardiovascular events, and all-cause mortality for six months or greater. Seven of the eight RCTs were conducted in China and Taiwan. The remaining RCTs tracked hypertension, cause-specific mortality, and effective urinary excretion after six months.<\/p>\n
The study is published in Annals of Internal Medicine.<\/p>\n
Food in the East vs. the West
\nWhile the study\u2019s findings are likely applicable to people living in Asia, they may not be as relevant to Western populations.<\/p>\n
The study\u2019s first author, Hannah Greenwood, PhD, BPsychSc, research assistant at Bond University in Australia, pointed out the preponderance of data in the study came from Asian RTCs.<\/p>\n
\u201cWhile salt substitutes may still benefit Western populations, the currently available research evidence cannot confirm this because the data is not available. This is partially why the \u2018certainty of evidence\u2019 for our findings is graded as \u2018low\u2019 or \u2018very low,\u2019\u201d she said.<\/p>\n
Greenwood also noted that sodium consumption follows different patterns in the East and West.<\/p>\n
\u201cIn the research populations,\u201d she said, \u201csalt consumption tends to be discretionary. That is, it is largely driven by salt added to food, which is only partially from added table salt, but also soy sauce and other condiments.\u201d<\/p>\n
Within the study population, food preparation more often occurs in the home, where adding sodium is a conscious choice.<\/p>\n
\u201cIn Western populations, salt consumption is more driven by processed, packaged, and takeaway\/restaurant food,\u201d Greenwood said.<\/p>\n
Jayne Morgan, MD, cardiologist and the Executive Director of Health and Community Education at the Piedmont Healthcare Corporation in Atlanta, GA, who was not involved in the study, noted the pervasiveness of sodium in the typical Western diet.<\/p>\n
\u201cNot only do many [Western] processed foods inherently contain salt, but often contain salt as a preservative as well as a flavor enhancer. This includes meats, etc., bought at supermarkets that are pre-seasoned,\u201d Morgan said.<\/p>\n
Snack foods also typically contain high amounts of sodium.<\/p>\n
Still, Morgan felt the study is \u201cdefinitely food for thought, as here in the U.S., we know that we are consuming too much sodium in our diets, but do not appear to be willing to give up the flavor. This, despite the hypertension, diabetes, obesity, and increased cardiovascular disease.\u201d<\/p>\n
How potassium in salt benefits health
\nThe added potassium in the study population\u2019s salt substitutes may also be a factor in the improved health outcomes observed.<\/p>\n
\u201cPotassium is essential for the balance of the electrical system of the heart, including heart muscle contraction and relaxation. It plays a role in the interplay of sodium and potassium in regulating blood pressure,\u201d explained Morgan.<\/p>\n
She also noted that one can ingest too much potassium, leading to hyperkalemiaTrusted Source, making a healthy balance between potassium and sodium a balancing act.<\/p>\n
Senior investigator of the study, Loai Albarqouni, MD, PhD, MSc, assistant professor at Bond University in Australia, said it is hard to say how much extra potassium study participants received.<\/p>\n
\u201cThis is difficult to quantify as our study did not examine whether it is the decreased sodium alone that is driving the effect, or whether the increased potassium has additional benefit,\u201d he said.<\/p>\n
\u201cAnother studyTrusted Source looking at both salt substitution and sodium restriction found reductions in cardiovascular risk for salt substitution but not salt restriction, pointing towards the benefit of increased potassium intake,\u201d Greenwood added.<\/p>\n
\u201cIn this area of China, people known to have lower potassium values, and so any increase might be beneficial but not push them into the range of hyperkalemia,\u201d Morgan pointed out.<\/p>\n
\u201cSo while our research doesn\u2019t allow us to estimate the contribution of added potassium to the effect,\u201d said Albarqouni, \u201cwe suspect that it plays a part.\u201d<\/p>\n
Salt in Asian soy sauce and condiments
\nThe RCTs investigated table salt substitutes instead of soy sauce substitutes that more commonly add salty flavorings in Asia.<\/p>\n
Greenwood explained that this was because \u201cthere are currently no commercially available soy sauce products that have been similarly formulated to have reduced sodium and added potassium, although reduced sodium products already exist.\u201d<\/p>\n
She noted that many condiments, including soy sauce, used in Asia contain high levels of sodium, \u201cso creation of and research into \u2018salt substitute\u2019 condiments may be worthwhile.\u201d<\/p>\n
A few limitations
\nAs with any meta-study, there were variations between the RTCs included that limited the range of its findings.<\/p>\n
Albarqouni mentioned \u201cdifferences between our population of interest \u2014 Western, average cardiovascular risk \u2014 and the original research context, largely non-Western, higher than average cardiovascular risk, which affect generalizability of the results.\u201d<\/p>\n
\u201cOther limitations include variations in methodological quality of the included studies and variation in how salt substitution was conducted between different studies,\u201d he said.<\/p>\n
\u201cIt\u2019s important to remember that salt substitutes are not a holy grail to ending cardiovascular disease,\u201d said Greenwood.<\/p>\n
\u201cThere are many factors other than sodium intake that contribute to cardiovascular health, including smoking, diet, and exercise. There are also many other ways to reduce sodium intake, such as going for whole\/unprocessed home-prepared food over processed or takeaway food. For someone looking for an easy way to reduce their sodium intake, without breaking the habit of adding salt to their food, using a salt substitute is a great option.\u201d
\n\u2014 Hannah Greenwood<\/p>\n
Low salt alternatives for a healthy heart
\nMichelle Routhenstein, MS, RD, CDCES, preventive cardiology dietitian at EntirelyNourished.com, who was also not involved in the study, suggested some salt substitutes.<\/p>\n
\u201cLow-salt alternatives to soy sauce can include coconut aminos or a homemade soy sauce using ingredients like balsamic vinegar, honey, ginger powder and sesame oil,\u201d she said.<\/p>\n
Diet is also not the only way to protect your heart, said Routhenstein. \u201cOther strategies to reduce the risk of cardiovascular disease include focusing on adding in foods to your diet in appropriate volumes that improve blood vessel health and cardiometabolic risk factors.\u201d<\/p>\n
These risk factors include high cholesterol, high blood sugar, and inflammation.<\/p>\n
\u201cEngaging in regular physical activity, and implementing stress reduction techniques can also promote cardiovascular health,\u201d Routhenstein said.<\/p>\n","protected":false},"excerpt":{"rendered":"
ISLAMABAD, April 17 (Online): A new study finds that consuming salt substitutes instead of table salt can reduce the risk of cardiovascular events and all-cause death.The salt substitute researchers tested also contained additional potassium, which may partially explain its health benefits. However, the study analyzes […]<\/p>\n
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