Skip to main content
Have a personal or library account? Click to login
WHO’s Salt Substitution Guidelines for Population-Wide Impact: Act on Strong Evidence, Monitor for the Long Term Cover

WHO’s Salt Substitution Guidelines for Population-Wide Impact: Act on Strong Evidence, Monitor for the Long Term

Open Access
|Mar 2025

References

  1. United Nations Human Rights Office of the High Commissioner. About the right to food and human rights [Internet]. OHCHR; [cited 2025 March 1]. Available from: https://www.ohchr.org/en/special-procedures/sr-food/about-right-food-and-human-rights.
  2. Mocumbi AO. Cardiovascular health care in low- and middle-income countries. Circulation. 2024;149(8):557559. DOI: 10.1161/CIRCULATIONAHA.123.065717
  3. Boushey C, Ard J, Bazzano L, Heymsfield S, Mayer-Davis E, Sabaté J, et al. Dietary patterns and risk of cardiovascular disease: A systematic review. Alexandria (USA): USDA; 2020. DOI: 10.52570/NESR.DGAC2020.SR0102
  4. GBD 2017 Diet Collaborators. Health effects of dietary risks in 195 countries, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019;393(10184):19581972. DOI: 10.1016/S0140-6736(19)30041-8
  5. World Heart Federation. World Heart report 2023: Confronting the world’s number one killer. Geneva: World Heart Federation; 2023.
  6. Cobb LK, Frieden TR, Appel LJ. No u-turn on sodium reduction. Journal of Clinical Hypertension. 2020;22(11):21562160. DOI: 10.1111/jch.14021
  7. World Health Organization. Use of lower-sodium salt substitutes: WHO guideline. Geneva: World Health Organization; 2025.
  8. Rose G. Sick individuals and sick populations. International Journal of Epidemiology. 1985;14(1):3238. DOI: 10.1093/ije/14.1.32
  9. Stuckler D, Siegel K, De Vogli R, Basu S. Sick individuals, sick populations: The societal determinants of chronic diseases. In: Stuckler D, Siegel K, editors. Sick Societies: Responding to the global challenge of chronic disease. Oxford: Oxford University Press; 2011. pp. 2662. DOI: 10.1093/acprof:oso/9780199574407.003.0027
  10. Chater N, Loewenstein G. The i-frame and the s-frame: How focusing on individual-level solutions has led behavioral public policy astray. Behavioral and Brain Sciences. 2022;46:e147. DOI: 10.1017/S0140525X22002023
  11. Usman MS, Van Spall HGC, Greene SJ, Pandey A, McGuire DK, Ali ZA, et al. The need for increased pragmatism in cardiovascular clinical trials. Nature Reviews Cardiology. 2022;19:737750. DOI: 10.1038/s41569-022-00705-w
  12. Jeemon P, Séverin T, Amodeo C, Balabanova D, Campbell NRC, Gaita D, et al. World Heart Federation roadmap for hypertension - A 2021 update. Global Heart. 2021;16(1):63. DOI: 10.5334/gh.1066
  13. McEvoy JW, McCarthy CP, Bruno RM, Brouwers S, Canavan MD, Ceconi C, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. European Heart Journal. 2024;45(38):39124018. DOI: 10.1093/eurheartj/ehae178
  14. Barroso WKS, Rodrigues CIS, Bortolotto LA, Mota-Gomes MA, Brandão AA, Feitosa AD de M, et al. Diretrizes brasileiras de hipertensão arterial –2020. Arquivos Brasileiros de Cardiologia. 2021;116(3):516658. DOI: 10.36660/abc.20201238
  15. Human Foods Program. FDA to propose to permit salt substitutes to reduce sodium in standardized foods [Internet]. US Food and Drug Administration; 2024 [cited 2025 March 1]. Available from: https://www.fda.gov/food/hfp-constituent-updates/fda-propose-permit-salt-substitutes-reduce-sodium-standardized-foods.
  16. Little R, Ellison DH. Modifying dietary sodium and potassium intake: An end to the “Salt Wars”? Hypertension. 2024;81(3):415425. DOI: 10.1161/HYPERTENSIONAHA.123.19487
  17. Sanzo KM, Bhojani NS. Salt-shaking it up: FDA issues proposed rule to allow salt substitutes in standardized foods [Internet]. Well Done: Your Source on Food Litigation and Regulation; 2023 [cited 2025 March 1]. Available from: https://www.morganlewis.com/blogs/welldone/2023/06/salt-shaking-it-up-fda-issues-proposed-rule-to-allow-salt-substitutes-in-standardized-foods.
  18. Bernabe-Ortiz A, Sal Y Rosas VG, Ponce-Lucero V, Cárdenas MK, Carrillo-Larco RM, Diez-Canseco F, et al. Effect of salt substitution on community-wide blood pressure and hypertension incidence. Nature Medicine. 2020;26:374378. DOI: 10.1038/s41591-020-0754-2
  19. Neal B, Wu Y, Feng X, Zhang R, Zhang Y, Shi J, et al. Effect of salt substitution on cardiovascular events and death. New England Journal of Medicine. 2021;385(12):10671077. DOI: 10.1056/NEJMoa2105675
  20. Independent Group of Scientists appointed by the Secretary-General. Global Sustainable Development Report 2023: Times of crisis, times of change: Science for accelerating transformations to sustainable development. New York: United Nations; 2023.
  21. National Science Foundation. People are disrupting natural “salt cycle” on a global scale, new study shows [Internet]. National Science Foundation; 2024 [cited 2025 March 4]. Available from: https://www.nsf.gov/news/people-are-disrupting-natural-salt-cycle-globa.
  22. World Sustainability Organization. Sustainable salt [Internet]. World Sustainability Organization; 2019 [cited 2025 March 4]. Available from: https://friendofthesea.org/sustainable-standards-and-certifications/sustainable-salt/.
  23. Miranda JJ, Anderson CAM, Trieu K. A salty odyssey: A potassium-enriched journey inspired by don quijote. Annals of Internal Medicine. 2024;177(5):682683. DOI: 10.7326/M24-0860
  24. Yuan Y, Jin A, Neal B, Feng X, Qiao Q, Wang H, et al. Salt substitution and salt-supply restriction for lowering blood pressure in elderly care facilities: a cluster-randomized trial. Nature Medicine. 2023;29(4):973981. DOI: 10.1038/s41591-023-02286-8
  25. McLean RM. Benefits of salt substitution in care facilities for the elderly. Nature Medicine. 2023;29:789790. DOI: 10.1038/s41591-023-02279-7
DOI: https://doi.org/10.5334/gh.1419 | Journal eISSN: 2211-8179
Language: English
Submitted on: Mar 5, 2025
Accepted on: Mar 7, 2025
Published on: Mar 26, 2025
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2025 J. Jaime Miranda, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.