(HealthDay News) — The impact of replacing salt with low-sodium salt substitute (LSSS) has been examined in adults and children in a review published online in the Cochrane Library.

Amanda Brand, PhD, from Stellenbosch University in South Africa, and colleagues examined the effects and safety of replacing salt with LSSS to reduce sodium intake on cardiovascular health among adults, pregnant women, and children. Data were included from 26 randomized controlled trials, with 34,961 adults and 92 children who were randomly assigned to either LSSS or regular salt. No studies were identified in pregnant women.

The researchers found that compared with regular salt, LSSS probably reduces diastolic blood pressure (DBP) and systolic blood pressure (SBP) slightly (mean difference, −2.43 and −4.76 mm Hg, respectively) among adults. Compared with regular salt, LSSS probably reduces nonfatal stroke, nonfatal acute coronary syndrome, and cardiovascular mortality (absolute effect, 20, 150, and 180 fewer/100,000 person-years, respectively) and probably increases blood potassium slightly (mean difference, 0.12 mmol/L). On average, compared with regular salt, LSSS may result in little to no difference in hypertension and hyperkalemia (absolute effect, 17 fewer and 4 more/100,000, respectively). Very uncertain evidence was found for the effects of LSSS on blood pressure control, various cardiovascular events, stroke mortality, hypokalemia, and other adverse events. The evidence is very uncertain about the impact of LSSS on DBP and SBP in children.


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“These small effects may be important when LSSS interventions are implemented at the population level,” the authors write.

Abstract/Full Text