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Recently, the World Health Organization (WHO) issued new guidelines promoting the use of Lower-Sodium Salt Substitutes (LSSS) to tackle the global burden of hypertension, cardiovascular diseases (CVDs), and stroke, which are largely driven by excessive sodium consumption. This is especially relevant for countries like India, with a high prevalence of high blood pressure and salt consumption.

What Are Lower-Sodium Salt Substitutes (LSSS)?

• LSSS are alternatives to regular table salt, where sodium chloride (NaCl) is partially replaced by potassium chloride (KCl), magnesium sulphate, or calcium chloride.
• They are designed to retain the taste of regular salt while significantly reducing sodium intake and improving heart health.
• LSSS can help lower blood pressure, thanks to the potassium content, which helps balance fluid levels and offset sodium’s harmful effects.

Key WHO Recommendations:

• Daily sodium intake should be restricted to less than 2 grams per day, equivalent to about 5 grams of salt.
• Avoid regular table salt, and replace it, wherever safe, with LSSS for household use.
• LSSS use is not recommended for:
  1. Pregnant women
  2. Children
  3. Individuals with kidney impairments or those requiring low-potassium diets
• The guidelines do not apply to packaged or restaurant foods, which are major contributors to overall sodium intake.

Why Is This Important or India?

• Salt Intake in India: Average salt consumption is 10.4 grams/day, over double the WHO recommendation.
• Hypertension Prevalence: Over 35.5% of India’s population (approx. 315 million people) suffers from hypertension (INDIAB Study).
• CVD Burden: Cardiovascular diseases accounted for 28.1% of all deaths in India (2016) – Global Burden of Disease Study.
• Dietary Impact: Globally, 8 million deaths annually are diet-related, with 1.9 million directly linked to high sodium intake.

Implementation and Policy Measures:

• India’s Response:
  • The Food Safety and Standards Authority of India (FSSAI) has initiated sodium reduction policies.
  • Edible salt must contain 97% sodium chloride, with anticaking agents limited to 2.2%.
  • New labelling norms enforce accurate “low sodium” and “sodium-free” claims.

Public Health and Safety Considerations:

• While LSSS are safe and beneficial for most adults, excess potassium can cause hyperkalemia, especially dangerous for those with kidney disease.
• WHO guidelines aim to maximize benefits and minimize risks by promoting regulated, evidence-based usage.
• Governments, policymakers, and health professionals are urged to integrate LSSS into public health strategies, especially in high-risk populations.

About WHO:

• Established in 1948, the World Health Organization is the UN agency dedicated to promoting global health, preventing disease, and coordinating international health responses.
• It leads efforts for universal health coverage and responds to global health emergencies.