Landmark study shows simple salt swap could prevent millions of deaths each year

[2greys]

Replacing table salt with a reduced-sodium, added-potassium ‘salt substitute’ significantly reduces rates of stroke, heart attack and death, according to the results of one of the largest dietary intervention studies ever conducted.

Presented at a ‘hotline session’ at the European Society of Cardiology Congress in Paris on August 29, and simultaneously published in the New England Journal of Medicine, the results also showed that there were no harmful effects from the salt substitute.

High levels of sodium intake and low levels of potassium intake are widespread, and both are linked to high blood pressure and greater risks of stroke, heart disease and premature death. Using a salt substitute - where part of the sodium chloride is replaced with potassium chloride – addresses both problems at once. Salt substitutes are known to lower blood pressure but their effects on heart disease, stroke, and death were unclear, until now.

Lead investigator, Professor Bruce Neal of The George Institute for Global Health, said that the scale of the benefit seen in the study could prevent millions of early deaths if salt substitutes were widely adopted.

georgeinstitute.org/media-r...

New England Journal of Medicine. Study Paper:

nejm.org/doi/10.1056/NEJMoa...

[2greys]

I cut all additional common salt from my diet 55 years ago, including cooking, after having nose bleeds that would not stop for hours on end. Resulting in blood vessels being cauterised in my nose. I was in New York at the time and the doctor advised against using common salt. In all probability that advice may have saved my life, I still have BP problems now, although having emphysema is the probable cause of that now.

[Snackjack]

I was told not to add salt to anything when I had my heart attack in 1988. I did find Lo Salt which has 66% less sodium which I used for a while but haven't used even that for a long time now, so like you 2 greys that was probably good advice I was given back in 1988.

[Hidden]

The trouble is so many foods contain excessive salt. Soups, for example. There’s no need for it 🤷‍♀️

[2greys in reply to Hidden]

Too many processed foods contain excessive salt and also sugar. Even simple biscuits contain excessive salt and sugar. Takeaway food is also notoriously high in salt. You can get healthy levels of salt naturally, in a healthy diet, without adding it.

[hypercat54 in reply to 2greys]

Yes I agree. I do eat too many processed foods but I never use salt in cooking or on food. Except chips of course as they taste much better with salt.

[Ergendl in reply to Hidden]

That's why I still cook my own foods from fresh ingredients, while I can.

[Badbessie]

Just a warning from my own experience. As many of you know I worked on a dialysis unit and a number of years ago we had many patients come in with very high potassium levels. Not just high but at levels that could lead to cardiac arrest. On investigation they had all switched to low salt. Salt is very restricted in a renal diet and seeing a low salt alternative patients switched with nearly fatal results. Potassium as a number of roles so please ask your GP or consultant before using a potassium alternative it is not just renal patients who can have problems with excess potassium.

[2greys in reply to Badbessie]

I can remember when I cut salt out food tasted rather bland, but with perseverance I soon got used to it. Processed food contains Sodium Chloride (common salt) as a flavour enhancer as well as Sodium Mono glutamate. It is Sodium that is the problem. Replacing it with excessive Potassium will of course have it's own problems as well.

A new addiction, added salts to enhance the flavour of (poor quality?) food. Or as a competitive edge over rivals, to increase sales.

[Badbessie in reply to 2greys]

A bit of both I think. My father had serious heart problems from age 50 my mother brought him low salt. I made a comment that he was using far to much salt and got the reply " its low salt so it's fine". Looking at the ingredients I was horrified at the levels of potassium. To the point where I spoke with with the professor on the unit. He asked what medications my father was taking as some " Heart" medications already had potassium in them. In my father's case his renal function was good so he could deal with the potassium and his medications were also safe.

[Hidden in reply to Badbessie]

When in hospital 2yrs ago I was told my potassium levels were too low & to eat a banana every day & not drink too much. I don’t add salt to things & don’t use salt alternatives. My mother was hospitalised for weeks last year with dangerously low potassium levels (the symptoms were extreme weakness & confusion.) In fact it was nearly fatal. She’s still on restricted fluids.

It’s hard to know what to do isn’t it?

[hypercat54 in reply to Badbessie]

That's very interesting BB. My sister last year was taken into hospital with untreated and undiagnosed diabetes as well as other issues. They said her potassium level was very high too and put her on a machine for days trying to bring it down. It was at very dangerous levels and she was told it was damaging her kidneys and could have been fatal if not picked up. She was told another day and she wouldn't have made it.

[Badbessie in reply to hypercat54]

It was probably a glucose and insulin pump. It is a means of removing potassium from the blood and storing it in the cells thereby lowering blood levels. That is a simplistic explanation as there are other substances such as calcium irons involved. Basically if you have high levels of potassium it interferes with the hearts ability to pick up electrical pulses that allow the heart to beat regularly.

[hypercat54 in reply to Badbessie]

Yes I'm sure you are right. She had been ill so I made her some toast and gave her 2 bananas - full of potassium.

[Carnival567]

With having congenital heart disease anyway I haven’t had common salt for years, but I don’t use a potassium substitute either. I would rather have my daily banana, which is a natural source of potassium.

[cofdrop-UK]

Another point, if you have positional hypotension, as I do, the advice is to have more salt and drink lots and lots of water. I found it unusual at first as I didn’t use salt in cooking or at the table before being advised To do this. Cx

[Jaybird19]

I have used lo salt in the past but was given losartan potassium by doctor so stopped lo salt but would it be better to stop losartan and just use lo salt instead?

[2greys in reply to Jaybird19]

See what your GP says, it may be more beneficial to cut it all out if you can. It does take a little getting used to, but you get adequate salt in your diet and that is without eating any processed food that is usually loaded with it. Even cheese is loaded with salt.

[Lfcpremier]

Such an easy & positive step to take. I did this a few years ago. 😊

[Thepainterswife]

We’re always being told to reduce salt intake by using more herbs and spices but even though I enjoy cooking I found that very difficult until two years ago when I gave up eating meat . It’s amazing how many beneficial herbs and spices are included in vegetarian recipes ,some I’ve never used or even heard of before, I find I don’t need salt at all in these dishes and they really are delicious 😃 😋

[2greys in reply to Thepainterswife]

Whilst will eat meat, I always use herbs and spices extensively in the slow cooker as I cannot abide the fumes from the cooker anymore.

[Thepainterswife in reply to 2greys]

That’s a brilliant idea which I’m going to try . I tend to close the kitchen door , put the extractor fan on full and turn up the air purifier next to hubby when I’m cooking but he’s still sometimes affected by fumes ! I’ll dig the slow cooker out from the back of the cupboard 😃

[Gladwyn in reply to 2greys]

Interesting.

[Hidden in reply to Thepainterswife]

Interested to know which recipe's in particular Tpw? I've not added any salt to my food for over 40 years although occasionally I will use Marigold Swiss Vegetable Bouillon Powder - it does have salt, but its a delicious hot drink in the winter or just when wanting to taste the salt.

[Thepainterswife in reply to Hidden]

I agree sometimes we need some salt , I make a meat free base in place of mince for cottage pie chilli etc etc from softened onions and red lentils cooked in water containing a beef stock cube but I also make entirely salt free recipes , my favourite mushroom bourguignon is made with a splash of red wine, garlic , tomato purée ( though I substitute ketchup to give a bit of sweetness) rosemary and thyme . I also like eggs in a creamy spinach sauce that gets it flavour from turmeric, cinnamon and nutmeg . I’ll give the Swiss powder a try , thank you 😊

[Hidden in reply to Thepainterswife]

Great,Many thanks, I shall give those a go, I have just purchased the chilli bean mince in Green cuisine range - that's got me going, Thank you for the tips

[Thepainterswife in reply to Hidden]

Tesco vegetable burgers are good and really good value for money, I also buy Richmond meat free sausage ( best I’ve found ) and Vivera Greek style kebab (also from Tesco) which I do in wraps with salad and sweet chilli sauce . All good for days when I don’t want to spend too much time cooking . 😊

[Hidden in reply to Thepainterswife]

That's great, thanks Tpw. I do get some meat free already and my neighbour will ask for some too when I get my home delivery, I will definitely make a note of your recommendations. Currently in the fridge I have a pack of Italian Squeaky Bean Ham (looks very nutritious on the ingredients) I thought I would try, it but I ended up getting stuck with a Quorn vegan smoky ham free slices, (the latter only because the neighbour changed their min) fortunately it has a long use by date. But not tried either yet. Carbs are really low, salt on the Quorn is o.45 qtr pack and on the squeaky bean its higher 2.06 on 100g, the is 90g, so would have to watch not eating too much of that one.

Great to exchange info thanks again.

🍇😊

[Alberta56 in reply to Hidden]

There are some tasty vegetarian recipes on the diabetes UK web site.

[Gladwyn in reply to Hidden]

I have been using pink Himalayan salt….. is that a no-no too?

[Dixy]

We were told in 1999 not to use salt and on no account to use any of the low salt products as they were just as bad if not worse.

[zube-UK]

My blood has low salt levels, below normal, I eat a lot of sea salt and my GP advised me to eat even more salt and drink less water to bring the sodium level in my blood up, totally confused and do not feel well, I think my Bronchiectasis from birth is a variant of CF but they only tested for the most common CF gene, it’s not that.