A simple change in the salt shaker could save millions of lives each year, according to a new study that estimates a potassium-enriched salt substitute could prevent nearly three million deaths worldwide annually. The analysis, published in the journal Nature Health, was led by researchers at the George Institute for Global Health in Australia and also projects that more than 10 million cases of heart and kidney disease could be averted each year.
The researchers built a computer model covering 4.6 billion adults in 193 countries. Because the work relies on simulations rather than a clinical trial, its estimates depend on assumptions about how people would use the substitute and how it would affect health. The substitute replaces part of the sodium in ordinary salt with potassium and is designed to taste like regular salt, which the authors identify as a key reason it could be adopted at scale.
The case for the approach rests on the scale of high blood pressure. Roughly 1.4 billion adults worldwide live with the condition, and excess sodium is a well-established contributor. Sodium causes the body to retain fluid, which raises blood volume and pressure in the arteries, increasing the strain on the heart and kidneys over time. Potassium works in the opposite direction, and replacing part of the sodium with it is intended to lower that burden without changing the flavor of food.
The model examined several ways the substitute could be deployed. A swap used only in home cooking was estimated to avert about 1.85 million deaths a year. Substituting it in restaurant and processed food produced an estimated benefit of about 1.56 million deaths averted. A more targeted approach, offering the substitute to adults with hypertension, was projected to prevent about 590,000 deaths annually. The authors noted that in Western countries more than 70 percent of sodium intake comes from processed and restaurant food, which is why changes at the manufacturing and dining level matter so much in those settings.
The projected benefits vary considerably by country. China had the largest estimated gain, with about 1.08 million deaths averted each year. India was projected to avert about 400,000 deaths, and the United States about 105,000. The researchers also noted that the substitute costs roughly twice as much as regular salt on average, a factor that could affect how widely it is adopted, particularly in lower-income settings.
The study also highlights risks. Potassium can build up to dangerous levels in the blood, a condition known as hyperkalemia, which can cause potentially lethal heart rhythms. The danger is greatest for people whose kidneys cannot remove potassium efficiently, and the World Health Organization advises caution for this group. Some blood pressure medications also raise potassium-related risk, so the researchers stress that the benefit may not apply equally to everyone and that safety depends on the individual.
Dr. Nathan Goodyear of the Williams Cancer Institute, who was not involved in the research, offered an outside perspective on the findings. The estimates are a useful guide to potential public health gains, but they are projections rather than measured outcomes, and real-world results would depend on how the substitute is marketed, priced and used. Any broad policy push would need to account for people with kidney disease and those taking medications that affect potassium levels.