Potassium-enriched salt substitute (75 % NaCl / 25 % KCl)

The short version

What it does You replace your table salt, and that is all. The trial measured 14 % fewer strokes and 12 % fewer deaths.

What it does not do FIRMLY inadvisable if you have a kidney problem or take medication that retains potassium: those people were excluded from the trial. Ask your doctor first. And note: it is not a “more natural” salt that works, it is the POTASSIUM. Himalayan pink salt does not have this effect.

What the studies say

The SSaSS trial is one of the largest ever run on a dietary intervention: 20,995 adults in 600 villages, followed for 4.7 years. Replacing ordinary salt with one at 75 % sodium chloride and 25 % potassium chloride reduced strokes by 14 %, major heart problems by 13 % and deaths from any cause by 12 %. Hyperkalaemia did not increase significantly.

The population was older, high-risk — three quarters had already had a stroke — and rural, in northern China. People at kidney risk had been EXCLUDED from recruitment: nothing can therefore be concluded for them. The reduction was clearer on haemorrhagic strokes than on ischaemic ones.

It is the product on this site whose benefit was measured on the events that really matter, not on an intermediate marker. And it is the cheapest.

How to take it

Relevant after 50, with high blood pressure, or a family or personal cardiovascular history. FIRMLY inadvisable in kidney failure or on potassium-sparing medication.

Simply replace your table and cooking salt. Nothing else to change. If the slight bitterness bothers you, start with a mix of half ordinary salt, half enriched salt, then switch over gradually.

The result is read on your blood pressure monitor, on a seven-day series before and a series three months after. If you take an ACE inhibitor, a sartan or a potassium-sparing diuretic, ask your doctor FIRST: the combination can cause dangerous hyperkalaemia.

What is inside

Sodium chloride and potassium chloride, often with an anti-caking agent. The tested ratio is 75 / 25: that is what to look for on the label. For scale: one gram of this salt provides about 250 mg of potassium, against 2.8 mg for a gram of Himalayan pink salt and 0.9 mg for table salt. The gap is a factor of ninety.

Three things to check. The potassium chloride percentage — above 30 %, the bitterness becomes difficult and the risk for fragile kidneys rises. The “not fluoridated” statement if you do not want fluoride: some French table salts are fluoridated, and it says so on the label. And whether iodine is present: many people get their iodine from table salt, and switching without thinking creates a gap.

Himalayan pink salt, fleur de sel and sea salt do NOT have this effect: they are about 98 % sodium chloride, like table salt. Their trace elements exist, but in quantities too small to count — you would have to eat more than a kilo of pink salt a day to reach the recommended potassium intake. What works here is replacing sodium with potassium, not the geological origin of the salt. And any self-medication in kidney disease: that is a contraindication, not a precaution.

Cautions

• Chronic kidney failure
• Treatment with an ACE inhibitor, sartan or potassium-sparing diuretic
• Known hyperkalaemia