Sodium reduction

Different sorts of other salt replacements

The most commonly known salt replacement is potassium chloride. Potassium has been shown to have a positive impact on blood pressure and bone density. The negative side, which is the main reason why plain replacement of sodium chloride by potassium chloride is not so prominent, is that the taste of pure potassium chloride is more bitter and metallic, and not "classically" salty as compared to sodium chloride. Importantly, potassium chloride needs to be handled with care by patients with kidney dysfunction.

Another option are yeast extracts, which are often considered as natural option. They come with a more brothy flavour and smell, and may cause dust formation if processed in large quantities in dry form.

Monosodium glutamate (MSG), also known as sodium glutamate, is the sodium salt of glutamic acid. It can be used as a flavour enhancer, and also comes with a meaty taste. In some countries it must be labelled as flavour enhancer if used.

Alternatively, the amount of sodium can be reduced if "just less" sodium chloride is used, or by changing the structure of the crystals. This enlarges their surface, leading to a "more salty" taste on the tongue. However, when the crystals are dissolved, the effect is usually gone.

What are the advantages of sub4salt® over other salt reduction systems?

  • Sodium reduction up to 50% without compromising taste
  • Easy handling
  • 1:1 replacement of salt
  • Usable in all food applications
  • Different granulations
  • Dedicated curing types for the meat industry

Medical aspects of salt reduction

How do we consume sodium with our food?

The main problem of sodium consumption is actually not the salt that we add intentionally on top of our dishes when we eat them on the table. This still makes about 15% of the daily consumption, and another 5% is naturally contained e.g. in vegetables. The main concern is actually the food industry which is responsible for the remaining 80% of our daily sodium intake.

This problem has been recognised by the Member States of the World Health Organization (WHO) already in 2013. The Member States adopted a "Global action plan for the prevention and control of non-communicable diseases 2013-2020" which included global reduction target of sodium consumption. Since then, governments of many countries around the globe set targets for the reduction of consumed sodium amounts and/or reacted with voluntary or even mandatory warning labels on front of packaging labels. Please refer to the section "legal aspects" for more detail and find more information on the WHO communication below.

Sodium consumption

Recommended and actual sodium intake

As elevated sodium intake has been associated with a number of health conditions including hypertension and cardiovascular disease, major health organisations such as the WHO have issued recommendations on the consumption of sodium. However, the population's actual sodium intake is still much higher than these guidelines suggest.

Sodium intake level

per day required to maintain vital functions

Sodium - maximum per day

recommendation by WHO1

Actual average intake

of sodium per day in the U.S.2

Deaths per year

attributable to high sodium intakes

Sodium intake targets

History of sodium intake recommendations

Major food and health organisations such as the WHO or the FDA have published guidelines on sodium intake.

2010 181 of 187 countries in the world exceeded the WHO recommendations of 2 g sodium per day
2013 Target of a 30% reduction in mean population intake of salt/sodium by the World Health Assembly
2021 The world is not on track to meet that goal therefore WHO released new benchmarks
2021 FDA issued guidance for voluntary, short-term (2.5 years) sodium reduction targets for processed, packaged and prepared foods

If sodium is needed, how can it be dangerous?

A diet high in sodium is ranked as the 16th YLL rank (YLL: years of life lost), which means that among the identified reasons that led to an earlier end of life, it ranked as 16th among the leading risk factors for YLL from 1990 to 2019 in the United States3. Why is that so?

The history of literature reporting on negative effects of excessive salt or sodium consumption is very long, which is why only some studies are cited here. Generally, a negative impact on blood pressure has been reported. Several studies concluded that if the consumption of salt is reduced, also blood pressure was reduced4/5 or vice versa, that a high sodium intake is associated with a higher risk for cardiovascular disease6.

Hypertension is a very common health challenge because it is directly linked to an increased risk for cardiovascular diseases (e.g. stroke)7.

One specific study that shall be mentioned here was published in the New England Journal of medicine in 20218. In this study, 20'995 individuals from 600 villages in China were evaluated for five years on stroke (primary outcome), major adverse cardiovascular events and death from any cause (secondary outcome). Individuals included in this study were older than 60 years old with a high blood pressure or had a history of stroke. During the time of the study, half of the participants used 100%  sodium chloride, while the other half used 75% sodium chloride and 25% potassium chloride for all classical salts applications (~20 g/d). As a result, it was found that participants who received the salt substitute showed significantly lower rates of stroke (-14%), major adverse cardiovascular events (-13%) and death (-12%) but no risk of clinical hyperkalemia.

Consumer market survey

General data:

Survey conducted in November - December 2020 with 35 questions and 558 participants in Germany. 
Female (65.8%), male (33.3%), employed (47.3%), student (35.5%), average salary: 2,001 € - 3,000 € 

  • 87% of respondents know that increased salt consumption is associated with risks
  • 55% of respondents do not know the difference between salt and sodium
  • 36% of respondents pay attention to reducing their salt consumption
  • 95% salt less
  • 35% do not eat convenience foods
  • 15% use salt substitutes (mineral salt mix, herbal mix)
  • Mainly under 30 year old people
  • 49% no awareness 
  • 35% see no need
  • 37% like to eat salty food
  • 11% there is no good alternative
  • 14% use salt substitutes, especially over 50 years old people 
  • 44% prevention of diseases 
  • 35% influence by other trends 
  • 15% increase in potassium 
  • 63% sea salt 
  • 29% mineral salt mix 
  • 17% reduced sodium salt 
  • 6% potassium chloride
  • 47% availability in stores 
  • 35% taste 
  • 28% price 
  • 23% ingredients 
  • 91% supermarket
  • 50% discount store
  • 35% drugstore
  • 31% organic market/reform store
  • 10% online

The WHO Global Report on sodium intake reduction

Massive efforts needed to reduce salt intake

On March 9th 2023, the WHO published a new report about the progress of the member states regarding reduction of sodium intake.

Learn more about the report here

In 2013, all 194 WHO Member States had committed to reduce population sodium intake by 30% by 2025. However, progress is slow, and until the publication of the report none of the member states has achieved the target yet. According to the WHO, cutting sodium intake is one of the most cost efficient methods to improve health. So-called "best buys" are suggested to the member states in order to work towards the target. These include (quote from WHO):
 

  1. Reformulating foods to contain less salt, and setting targets for the amount of sodium in foods and meals
  2. Establishing public food procurement policies to limit salt or sodium rich foods in public institutions such as hospitals, schools, workplaces and nursing homes
  3. Front-of-package labelling that helps consumers select products lower in sodium
  4. Behaviour change communication and mass media campaigns to reduce salt/sodium consumption

 

The WHO has checked the measures of each member state and calculated a "Sodium Country Score Card" from 1 (lowest level, just promises) to 4 (highest level, including mandatory measures and all best buys) for each country. The intention is now to encourage lower scored countries to build on the success stories of the few countries who already found a way to decrease their population's intake of sodium.

The WHO is committed to support member states in the implementation and monitoring of policies, regulations or other means to achieve the target. The overall goal is to "ensure that every adult and child enjoys healthy food environments to realise their human right to safe, secure and nutritious food, and the highest attainable standard of health."

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