Potassium-Enriched Salt Study: Nature Health Model Finds Swap Could Prevent Nearly 3 Million Deaths a Year

A new Nature Health modeling study finds that switching from regular table salt to potassium-enriched salt could prevent close to 3 million deaths and more than 10 million cases of heart disease, stroke and kidney disease every year worldwide. The research, led by The George Institute for Global Health, is the most comprehensive estimate yet of what a global potassium-enriched salt switch could mean for public health — and it arrives as governments weigh how to act on the World Health Organization’s 2025 endorsement of salt substitutes.

Below, we break down what the researchers did, what they found, who stands to benefit, who needs to be careful, and what the study cannot tell us.

Potassium-Enriched Salt Study: The Key Findings

Verified facts (study and institutional releases):

• Paper: “Global health outcomes from replacing dietary sodium chloride with potassium-enriched salt,” Nature Health, DOI 10.1038/s44360-026-00216-9. Publication date listed as November 4, 2026 (EurekAlert!).
• Who did it: Researchers at The George Institute for Global Health and UNSW Sydney, including Professor Bruce Neal and nephrologist Professor Vivek Jha. Liping (Polly) Huang, PhD, of the George Institute’s Food Policy Division, is a lead author.
• Scope: 193 countries, covering an estimated 4.6 billion adults.
• Headline result: If potassium-enriched salt replaced regular salt both at home and in processed and restaurant foods, the model estimates about 2.96 million deaths and 10.17 million new cases of cardiovascular disease (CVD) and chronic kidney disease (CKD) could be averted each year.

Estimated annual global impact by scenario

Source: The George Institute / UNSW release and EurekAlert! summary of the Nature Health paper. All figures are model estimates.

Selected countries (full-switch scenario)

How the Study Worked: Methodology

This is a computational modeling study, not a clinical trial. According to the UNSW release and Healthline’s report:

• Researchers began with existing blood-pressure data by sex, age and country.
• They modeled how replacing regular salt with a blend of about 75% sodium chloride and 25% potassium chloride would change sodium and potassium intake, blood pressure and, in turn, disease risk.
• They ran hypothetical scenarios — home salt only, processed and restaurant food only, both, and targeted uptake among people with hypertension.
• They weighed projected benefits against the risk of hyperkalemia (dangerously high blood potassium) in vulnerable groups.

The approach builds on clinical evidence such as the 2021 Salt Substitute and Stroke Study (SSaSS), a roughly 21,000-person trial in rural northern China published in the New England Journal of Medicine, which found lower rates of stroke, major cardiovascular events and death among people using a salt substitute.

Who Is Affected

• People with high blood pressure: About 1.4 billion adults — roughly one in three people aged 30–79 — have hypertension, according to WHO figures cited by UNSW.
• China and India: The model projects the largest gains in these two countries, where much of the salt people eat is added at home during cooking.
• Europe and North America: More than 70% of salt in these regions comes from processed and restaurant food, so the researchers say the food industry would need to take part for large gains.
• People with advanced kidney disease or on potassium-raising medications: This group faces the greatest risk of hyperkalemia and needs medical guidance before switching (see safety section below).

Implications for Policy and Industry

Researcher statements (as reported): Professor Neal described a full global shift as “aspirational,” according to UNSW, and the team calls for country-specific strategies rather than a single global approach. The authors also point to the need to scale up potassium chloride production and to engage food manufacturers and restaurants, building on the WHO’s 2025 guidance endorsing potassium-enriched salt substitutes.

Analysis: Because the targeted scenario (80% of people with diagnosed hypertension switching at home) still averts an estimated 590,000 deaths a year, the study suggests that public-health programs do not need universal adoption to have a measurable effect. Cost and supply remain practical hurdles; Healthline reports the study notes potassium-enriched salt costs roughly twice as much as regular salt.

Safety: Kidney Disease and Hyperkalemia

Potassium is normally cleared by the kidneys, so people with advanced chronic kidney disease, or those taking medicines that raise potassium levels, can be at risk of hyperkalemia.

• Researcher view (UNSW, Euronews): The modeling found the population-level benefits outweighed the risks, even when people with advanced CKD were included. Professor Jha said the risks can be managed through patient education, product labelling and clinical oversight.
• Researcher view (Healthline): Co-lead author Huang told Healthline that some patients with advanced CKD should avoid potassium-enriched salt, and the team estimated about 750,000 deaths prevented in people with stage 3–5 CKD against roughly 100,000 hyperkalemia deaths per year.
• Bottom line for readers: Anyone with kidney disease, or who takes blood-pressure or heart medicines, should talk with a clinician before switching. The American Heart Association gives the same advice, according to Healthline.

Limitations

• Modeled, not observed: The death and disease figures are projections, not outcomes measured in people.
• Older inputs and assumptions: The authors acknowledged to Healthline that some data are from a few years ago and that the model relies on many assumptions.
• Time to scale: A large-scale switch would take years, and the scenarios assume levels of uptake that do not exist today.
• Not fully reviewed here: Vanderbiltreport.com reviewed the institutional releases and press coverage; the full paper’s supplementary methods were not independently examined for this article.
• Disclosures: The EurekAlert! listing reports that some authors received research support from Resolve to Save Lives and one reported WHO funding.

Independent Perspective

Expert commentary: Dr. Cheng-Han Chen, an interventional cardiologist at MemorialCare Saddleback Medical Center who was not involved in the study, told Healthline that cutting sodium helps blood pressure, which can begin to improve within about a week.

What Happens Next

• Governments and health agencies will consider whether to fold potassium-enriched salt into national salt-reduction strategies.
• Researchers say more work is needed on production capacity, pricing and labelling.
• Food companies in high-processed-food markets face pressure to test reformulation with potassium-enriched salt.

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Sources

• Nature Health — Global health outcomes from replacing dietary sodium chloride with potassium-enriched salt (DOI 10.1038/s44360-026-00216-9)
• UNSW Sydney newsroom release
• EurekAlert! — The George Institute release
• Euronews coverage
• Healthline coverage with independent comment
• NEJM — Salt Substitute and Stroke Study (2021)

This article is for general information and is not medical advice. Talk with a healthcare professional before changing your diet, especially if you have kidney disease or take prescription medicines.

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