CHENNAI: Replacing regular table salt with potassium-enriched low-sodium substitutes could significantly reduce hypertension and cardiovascular deaths in India, according to a multi-institutional study that positions a simple dietary shift as a high-impact public health intervention.
The findings, presented in a white paper and consensus statement led by The George Institute for Global Health India in collaboration with Resolve to Save Lives, draw on clinical trials, modelling studies and expert consultations across institutions including AIIMS, New Delhi, the Centre for Chronic Disease Control, and inputs aligned with ICMR frameworks.
India's average salt intake remains between 8 and 11 grams per day, nearly double the recommended limit of 5 grams, while potassium consumption continues to fall short of the 3,500 mg daily requirement. The study notes that nearly 80% of the sodium intake comes from salt added during food preparation at home, making household consumption the most critical point of intervention.
Low-sodium salt substitutes, typically composed of 70-75% sodium chloride and 25-30% potassium chloride, have been shown to lower blood pressure and reduce cardiovascular risk. A randomised controlled trial in rural India recorded a 4.6 mm Hg reduction in systolic blood pressure among users. Large international evidence, including a five-year study involving over 20,000 participants, reported reductions of 14% in stroke, 13% in major cardiovascular events and 12% in overall mortality.
Modelling cited in the study suggests that nationwide adoption could prevent between 8 and 14% of cardiovascular deaths annually.
While the report outlines policy and food system measures, it underscores that the most immediate gains lie in changing the type of salt used in everyday cooking.
In Tamil Nadu, clinicians say the evidence is clear, but uptake remains limited. "This is a simple intervention backed by strong data, but it has not yet translated into routine practice," said Dr Meenakshi, dietician at the Tamil Nadu Government Multi Super Speciality Hospital, Chennai. "Government hospitals, medical colleges and nutrition programmes in the State can play a decisive role in taking this to the community," she said.
The study notes that the substitutes are safe for most individuals, with caution advised for those with advanced kidney disease, who may require medical supervision.
Doctors across Tamil Nadu's network of public health institutions, including primary health centres and tertiary hospitals, are expected to be central to driving awareness and adoption, particularly among patients with hypertension.
By focusing on a commonly used household ingredient, the report frames sodium reduction as an immediate and achievable step in addressing India's growing burden of non-communicable diseases.