NEW DELHI: How much salt are you consuming every day? Well, most Indians on average consume daily 8-11 grams of salt, almost twice the recommendations by WHO and ICMR-National Institute of Nutrition (NIN).
High salt intake in India is the key driver behind the rise in hypertension and heart diseases and has led to 1,75,000 deaths annually in India.
Leading experts, including from AIIMS, here on Friday released a consensus statement recommending potassium-enriched low-sodium salt substitutes (LSSS) as an effective intervention to reduce hypertension and cardiovascular disease in India.
Prof. Ambuj Roy, Department of Cardiology, AIIMS, New Delhi, said, "While we have enough scientific data supporting the benefits of Low-Sodium Salt Substitutes, the evidence-to-action gap must be closed by treating LSSS as a ' dietary vaccine' to treat hypertension.”
“It is the 'low-hanging fruit' of cardiology, a passive intervention that provides 24/7 cardiovascular protection without requiring patients to actually sacrifice the taste of their traditional diet," he said at a conference organised by The George Institute for Global Health India, in collaboration with Resolve to Save Lives.
With nearly 80% of sodium intake in India coming from salt added during cooking at the household level, experts emphasised that interventions focused on reducing salt use at home can have the greatest impact.
Dr. Sandeep Mahajan, Professor, Nephrology, AIIMS, New Delhi, said, “The potential risks of low-sodium salt substitutes are often overstated relative to their population-level benefits. While a small subset of patients—particularly those with advanced kidney disease or on specific medications—require caution, this group is clearly identifiable and can be guided through simple screening and labelling measures.”
“With clear advisories and better awareness, nearly 90% of the population can safely benefit from this intervention. What we need to address now is therapeutic inertia—both among clinicians and the public—to enable wider adoption of this effective strategy for reducing cardiovascular risk.”
Prof. Vivekanand Jha, Executive Director of The George Institute for Global Health India, said low-sodium salt substitutes address both—cutting sodium and restoring potassium, which is key to lowering blood pressure.
“With no change in taste and appropriate safeguards, this is a safe, scalable solution for India’s NCD prevention strategy.”
Dr. Syed Imran Farooq, Executive Director, Resolve to Save Lives, India, said, “Reducing excess sodium intake is one of the most impactful and achievable steps India can take to prevent hypertension and cardiovascular disease at scale.
Evidence shows potassium - enriched low-sodium salt substitutes are a practical, effective, and scalable solution, and this consensus marks an important shift from evidence to action, aligned with the government’s commitment to reduce population-level salt intake, experts added.
Dr Sailesh Mohan, Deputy Director, Centre for Chronic Disease Control, Delhi, said, “We also recommend that governments should support public procurement for school mid-day meals, ICDS, PDS rations, hospital kitchens, railways, and large institutional canteens to build volume and normalise use. Food industry reformulation policies should require partial replacement of sodium chloride with potassium salts in packaged foods and restaurant meals, especially in high-salt categories such as snacks, instant mixes, and condiments."
Noting that despite strong evidence and top-tier guideline recommendations, low-sodium salt substitutes remain underutilised in practice, said Dr. Sachdev Meenakshi, Dietician, Tamil Nadu Govt. Multi Super Speciality Hospital, Chennai.
“With hypertension affecting a significant proportion of India’s population, we need an ‘all hands-on deck’ approach to bridge this gap. This means moving beyond awareness to active prescription, wider clinical adoption, and integration into medical and dietetic training, public programmes, and early health education. It’s a simple, effective intervention—we now need to ensure it reaches people at scale.”
Given that approximately three-fourths of sodium intake in India comes from discretionary salt used in home cooking, the experts recommend that LSSS primarily target household consumption. This differs from high-income countries, where processed foods account for most sodium intake.
Experts said that low-sodium salt substitutes, composed of approximately 70–75% sodium chloride and 25–30% potassium chloride, reduce sodium intake while increasing potassium consumption, thereby helping to lower blood pressure and reduce cardiovascular risk. "“It can thus be a major cost-saving intervention in the direction of prevention, control, and management of hypertension and other CVDs in developing countries like India,” according to the white paper, released at the occasion.
Experts said as there is a high population burden of hypertension (affecting 28% of adults in India and contributing to 10% of all deaths), LSSS be integrated into national NCD prevention strategies.
They also suggested that the national NCD and hypertension guidelines should recommend routine use of LSSS in place of regular salt for the general adult population, with well-defined contraindications (advanced CKD, potassium-sparing drugs, potassium supplements, known hyperkalemia).
It was also highlighted that health professionals to be educated so that LSSS becomes a routine part of hypertension counselling, with simple screening questions to identify those who should avoid potassium-enriched products and clear instructions for everyone else to switch all household salt to LSSS.
They recommended governments to support public procurement for school mid-day meals, ICDS, PDS rations, hospital kitchens, railways, and large institutional canteens to build volume and normalise use.
High salt intake India has committed to a global goal of reducing the average population level sodium intake by 30% by 2030 to help prevent and control non-communicable diseases (NCDs) like diabetes, cancer, cardiovascular diseases, and chronic kidney disease.
The WHO has also released guidelines that propose replacing regular table salt with potassium-enriched low-sodium salt substitutes (LSSS) for adults without renal comorbidities.