Health Talk | New WHO guidelines aim to cut excess sodium consumption

Last week, the World Health Organisation (WHO) issued new guidelines aimed at protecting people from one of the biggest culprits on our dining tables—table salt. Adding extra salt to a dish after it’s served is one of the worst dietary habits, as it can contribute to chronic health conditions in the long run.

The WHO guidelines provide evidence-based recommendations on using lower-sodium salt substitutes (LSSS) that contain potassium.

“To reduce blood pressure and the risk of cardiovascular diseases, WHO recommends reducing sodium intake to less than 2 g/day (strong recommendation). In this context, using less regular table salt is an important part of an overall sodium reduction strategy. If choosing to use table salt, WHO suggests replacing regular table salt with lower-sodium salt substitutes that contain potassium (conditional recommendation),” the guidelines state.

So, what evidence did WHO use to formulate these recommendations?

According to the WHO statement, studies show that adults who switched to LSSS instead of regular salt experienced reductions in both diastolic and systolic blood pressure over follow-up periods ranging from 56 days to five years. The mean reductions were 2.43 mmHg for diastolic blood pressure (DBP) and 4.76 mmHg for systolic blood pressure (SBP), based on moderate-certainty evidence.

Additionally, using LSSS instead of regular salt was associated with a lower risk of non-fatal stroke, non-fatal acute coronary syndrome, and cardiovascular death. However, it showed little to no difference in the prevalence of hypertension.

Despite these benefits, WHO experts included a note of caution. The recommendation applies to adults in the general population but excludes individuals with kidney impairments or other conditions that may compromise potassium excretion. It also does not apply to children or pregnant women.

Why is reducing salt intake so crucial?

In its first-ever global report on sodium intake reduction, published in 2023, WHO found that the world was off track to meet its goal of cutting sodium consumption by 30% by 2025.

While sodium is an essential nutrient, excessive intake increases the risk of heart disease, stroke, and premature death. The primary source of sodium is table salt (sodium chloride), but it is also found in other condiments such as sodium glutamate. The report revealed that only 3% of the global population is covered by mandatory sodium reduction policies, while 73% of WHO member states have yet to fully implement such measures.

WHO noted that adopting cost-effective sodium reduction policies could save an estimated seven million lives globally by 2030.

As WHO Director-General Tedros Adhanom Ghebreyesus put it, “Unhealthy diets are a leading cause of death and disease globally, and excessive sodium intake is one of the main culprits.”

There’s little to argue with there.