The George Institute for Global Health India welcomes WHO's recommendation on potassium-enriched salt to combat hypertension
The World Health Organization's (WHO) recommendation to replace regular table salt with potassium-enriched, lower-sodium salt substitutes marks a transformative step toward reducing hypertension and cardiovascular disease globally. The George Institute for Global Health India supports this evidence-based guidance, highlighting its potential to save millions of lives, particularly in countries like India, where sodium intake is high, and potassium consumption remains critically low.
Recent research by The George Institute for Global Health India, in collaboration with PGIMER Chandigarh, highlights the urgent need for dietary changes in India. The study revealed that excessive salt consumption far exceeds recommended levels, while potassium intake is critically low—key contributors to the growing prevalence of hypertension, cardiovascular disease, and chronic kidney disease. These findings are part of a broader initiative to understand India’s dietary landscape and its impact on non-communicable diseases (NCDs).
Prof. Vivekanand Jha, Executive Director, The George Institute for Global Health India said, “To fight the growing problem of hypertension and heart and kidney disease in India, especially in rural areas, we need to make the low-sodium, potassium-enriched salts affordable and easily available. By working with policymakers and the food industry, and by educating people about their benefits with clear labeling and subsidies, we can encourage their use, save lives, and tackle India’s high salt intake for a healthier future."
Prof Jha also emphasised the need to generate evidence on the safety and efficacy of salt substitutes in special populations, such as those with kidney diseases.
The Salt Substitute in India Study (SSiIS) underscores the promise of reduced-sodium, added-potassium salt substitutes in lowering blood pressure among rural Indian hypertensive patients. Baseline data from the study revealed excessive sodium intake, with average urinary salt excretion at 10.4 g/day—more than double the WHO’s recommended intake. The trial demonstrated that the use of salt substitutes is a practical, effective intervention for managing hypertension in high-risk populations, providing a cost-efficient solution to a pressing public health issue.
This study by Sudhir Raj Thout, a Research Fellow at The George Institute for Global Health India, focused on 502 hypertensive participants from rural India and further affirmed the benefits of potassium-enriched salts. Participants using reduced-sodium, added-potassium salt substitutes for three months experienced significant reductions in systolic blood pressure (4.6 mmHg) and diastolic blood pressure (1.1 mmHg) compared to those consuming regular salt. Additionally, the substitutes improved urinary potassium levels and the sodium-to-potassium ratio, while participants reported regular use and found the taste acceptable. This highlights the feasibility and effectiveness of adopting salt substitutes as a low-cost intervention in rural settings to combat hypertension.
Sudhir Raj Thout, Research Fellow at The George Institute for Global Health India, said, “The WHO’s recommendations and guidance on use of lower-sodium salt substitutes are particularly important for India in lowering the blood pressure and cardiovascular risk, given the current high prevalence of excess sodium intake. This recommendation on the use of lower sodium salt substitutes supports widespread use, as a healthy alternative to regular table salt that provides obvious benefits for blood pressure and heart health.”
Global and Indian studies demonstrate the effectiveness of potassium-enriched salts in reducing blood pressure without compromising taste, making them an accessible intervention for most populations. While individuals with advanced kidney disease should avoid these substitutes, they are safe and effective for the vast majority.
The George Institute for Global Health India is committed to advocating for the widespread adoption of potassium-enriched salts and collaborating with policymakers, healthcare providers, and the food industry to foster healthier dietary habits.
For further reading, access the full studies here:
Study on dietary trends in India, Frontiers in Nutrition
Study on potassium-enriched salts, American Heart Association’s journal Hypertension
Salt Substitute in India Study (SSiIS) – A randomised controlled trial
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Further reading
Media release: 28/01/2025
