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BACKGROUND: Regular salt is about 100% sodium chloride (NaCl). Low-sodium salts have reduced sodium chloride content, most commonly through substitution with potassium chloride (KCl). Low-sodium salts have a potential role in reducing population sodium intake level and blood pressure, but its availability in global market was unknown. OBJECTIVE: The aim of this study was to assess the availability, formulation, labelling, and price of low-sodium salts currently available to consumers around the world. METHODS: Low-sodium salts were identified through a systematic literature review, Google search, online shopping sites search, and inquiry of key informants. The keywords of "salt substitute", "low-sodium salt", "potassium salt", "mineral salt", and "sodium reduced salt" in six official languages of the United Nations were used for search. Information about the brand, formula, labelling, and price was extracted and analysed. RESULTS: Eighty-seven low-sodium salts were available in 47 out of 195 countries around the world (24%), including 28 high-income countries, 13 upper-middle-income countries, and six lower-middle-income countries. The proportion of sodium chloride varied from 0% (sodium-free) to 88% (as percent of weight, regular salt is 100% NaCl). Potassium chloride was the most frequent another component with levels ranging from 0% to 100% (potassium chloride salt). Forty-three (49%) had labels advising potential health risk, 33 (38%) labelling the advice of potential health benefits. The median price of low-sodium salts in high-income, upper-middle-income, lower-middle-income countries was USD 15.0/kg (IQR: 6.4 to 22.5), USD 2.7/kg (IQR: 1.7 to 5.5) and USD 2.9/kg (IQR: 0.50 to 22.2) respectively. The price of low-sodium salts was between 1.1 and 14.6 times that of regular salts. CONCLUSIONS: Low-sodium salts are not widely available and are commonly more expensive than regular salts. Policies that promote the availability, affordability and labelling of low-sodium salts should enhance appropriate uptake for blood pressure lowering and cardiovascular prevention. CLINICALTRIAL: INTERNATIONAL REGISTERED REPORT: RR2-10.1111/jch.14054. |
