TY - JOUR
T1 - Availability, formulation, labeling, and price of low-sodium salt worldwide
T2 - Environmental scan
AU - Yin, Xuejun
AU - Liu, Hueiming
AU - Webster, Jacqui
AU - Trieu, Kathy
AU - Huffman, Mark D.
AU - Miranda, J. Jaime
AU - Marklund, Matti
AU - Wu, Jason H.Y.
AU - Cobb, Laura K.
AU - Li, Ka Chun
AU - Pearson, Sallie Anne
AU - Neal, Bruce
AU - Tian, Maoyi
N1 - Funding Information:
This research received no specific grant from any funding agency in public, commercial, or not-for-profit sectors. XY and KCL are supported by the University of New South Wales Scientia PhD scholarship. JW is supported by a National Heart Foundation Future Leader II Fellowship (APP102039) and receives funding for work on salt reduction from the National Health and Medical Research Council, the WHO, and the Victorian Health Promotion Foundation. KT was supported by an Early Career Fellowship (APP1161597) from the National Health and Medical Research Council of Australia and a Postdoctoral Fellowship (Award ID: 102140) from the National Heart Foundation of Australia. JHYW is supported by a University of New South Wales Scientia Fellowship. HL is supported by a National Health and Medical Research Council of Australia program grant fellowship.
Funding Information:
In the past 3 years, MDH received funding from the World Heart Federation to serve as its senior program advisor for the Emerging Leaders program, which is supported by Boehringer Ingelheim and Novartis with previous support from BUPA and AstraZeneca. MDH also receives support from the American Heart Association, Verily, AstraZeneca, and the American Medical Association for food system surveillance–related research. The George Institute for Global Health’s wholly owned enterprise, George Health Enterprises, has received investment funds to develop fixed-dose combination products containing aspirin, statin, and blood pressure–lowering drugs. MDH plans to submit patents for heart failure polypills, including for heart failure with reduced ejection fraction. BN has received in kind support (salt substitute supplies) from Nutek and the Beijing Salt Manufacturing Corporation for studies of the effects of salt substitutes. JW is the Director of the World Health Organization Collaborating Centre on Population Salt Reduction at the George Institute for Global Health.
Publisher Copyright:
© Xuejun Yin, Hueiming Liu, Jacqui Webster, Kathy Trieu, Mark D Huffman, J Jaime Miranda, Matti Marklund, Jason H Y Wu, Laura K Cobb, Ka Chun Li, Sallie-Anne Pearson, Bruce Neal, Maoyi Tian. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 14.07.2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on https://publichealth.jmir.org, as well as this copyright and license information must be included.
PY - 2021/7
Y1 - 2021/7
N2 - Background: Regular salt is about 100% sodium chloride. Low-sodium salts have reduced sodium chloride content, most commonly through substitution with potassium chloride. Low-sodium salts have a potential role in reducing the population's sodium intake levels and blood pressure, but their availability in the global market is unknown. Objective: The aim of this study is to assess the availability, formulation, labeling, and price of low-sodium salts currently available to consumers worldwide. Methods: Low-sodium salts were identified through a systematic literature review, Google search, online shopping site searches, and inquiry of key informants. The keywords “salt substitute,” “low-sodium salt,” “potassium salt,” “mineral salt,” and “sodium reduced salt” in six official languages of the United Nations were used for the search. Information about the brand, formula, labeling, and price was extracted and analyzed. Results: A total of 87 low-sodium salts were available in 47 out of 195 (24%) countries worldwide, including 28 high-income countries, 13 upper-middle-income countries, and 6 lower-middle-income countries. The proportion of sodium chloride varied from 0% (sodium-free) to 88% (as percent of weight; regular salt is 100% sodium chloride). Potassium chloride was the most frequent component with levels ranging from 0% to 100% (potassium chloride salt). A total of 43 (49%) low-sodium salts had labels with the potential health risks, and 33 (38%) had labels with the potential health benefits. The median price of low-sodium salts in high-income, upper-middle-income, and lower-middle-income countries was US $15.00/kg (IQR 6.4-22.5), US $2.70/kg (IQR 1.7-5.5), and US $2.90/kg (IQR 0.50-22.2), 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 labeling of low-sodium salts should increase uptake, helping populations reduce blood pressure and prevent cardiovascular diseases.
AB - Background: Regular salt is about 100% sodium chloride. Low-sodium salts have reduced sodium chloride content, most commonly through substitution with potassium chloride. Low-sodium salts have a potential role in reducing the population's sodium intake levels and blood pressure, but their availability in the global market is unknown. Objective: The aim of this study is to assess the availability, formulation, labeling, and price of low-sodium salts currently available to consumers worldwide. Methods: Low-sodium salts were identified through a systematic literature review, Google search, online shopping site searches, and inquiry of key informants. The keywords “salt substitute,” “low-sodium salt,” “potassium salt,” “mineral salt,” and “sodium reduced salt” in six official languages of the United Nations were used for the search. Information about the brand, formula, labeling, and price was extracted and analyzed. Results: A total of 87 low-sodium salts were available in 47 out of 195 (24%) countries worldwide, including 28 high-income countries, 13 upper-middle-income countries, and 6 lower-middle-income countries. The proportion of sodium chloride varied from 0% (sodium-free) to 88% (as percent of weight; regular salt is 100% sodium chloride). Potassium chloride was the most frequent component with levels ranging from 0% to 100% (potassium chloride salt). A total of 43 (49%) low-sodium salts had labels with the potential health risks, and 33 (38%) had labels with the potential health benefits. The median price of low-sodium salts in high-income, upper-middle-income, and lower-middle-income countries was US $15.00/kg (IQR 6.4-22.5), US $2.70/kg (IQR 1.7-5.5), and US $2.90/kg (IQR 0.50-22.2), 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 labeling of low-sodium salts should increase uptake, helping populations reduce blood pressure and prevent cardiovascular diseases.
KW - Availability
KW - Blood pressure
KW - Cardiology
KW - Formulation
KW - Labeling
KW - Low-sodium salt
KW - Price
KW - Salt
KW - Salt substitute
KW - Sodium
UR - http://www.scopus.com/inward/record.url?scp=85110355160&partnerID=8YFLogxK
U2 - 10.2196/27423
DO - 10.2196/27423
M3 - Article
C2 - 33985938
AN - SCOPUS:85110355160
SN - 2369-2960
VL - 7
JO - JMIR Public Health and Surveillance
JF - JMIR Public Health and Surveillance
IS - 7
M1 - e27423
ER -