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It is plausible that most people consume an unhealthy amount of salt. The 2019 Global Burden of Disease report estimates that diets high in sodium kill 1.9 million people a year. However, there is a fair bit of disagreement on this topic, and some researchers claim that standard salt consumption is fine.

Potassium chloride is a substance that can replace salt (sodium chloride). Unlike salt, which is potentially harmful, potassium chloride is probably quite beneficial as many people are deficient in potassium. In my opinion, it tastes pretty similar to salt, but opinions were mixed among my friends who have tried it. One alternative to completely switching to potassium chloride is to use a mixture of potassium chloride and sodium chloride.

It seems possible to change laws or norms around what type of salt is sold. Iodised salt is a great example of this happening.

Does anyone have any thoughts on how effective encouraging the use of potassium chloride would be as a health intervention? If salt is as bad as the GBD report suggests, this seems like it could be pretty effective. Are there any reasons why this wouldn't work or would be a bad idea?

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Thanks for the tag, Mathias and Spencer!

Hi Oscar, CEARCH recently put out a report on hypertension as a cause area: https://forum.effectivealtruism.org/posts/k7NjuGEKdRSrrJHmZ/deep-report-on-hypertension 

(1) TLDR: We expect advocacy for top sodium control policies (particularly regulating food manufacturers to reduce the sodium content on processed food), so as to reduce the disease burden of hypertension/high blood pressure, to be at least 10x GiveWell cost-effectiveness.

(2) The scientific evidence on more salt = worse health outcomes (heart attacks, strokes etc) is rock solid. There was a controversy some years back on the "J-Curve" hypothesis, which was the idea that at low levels of sodium consumption, maybe it's bad to further reduce sodium intake because that actually worsens health outcomes (hence a J-curve with sodium consumption on the X-axis and adverse health events on the Y-axis). However, the current scientific consensus is that the initial studies purportedly showing this were faulty, with poor methodology (particularly in relying on imperfect measures of sodium levels, rather than like 24-hour urine samples). All the meta-analysis we've read in full (e.g. Aburto et al, Ettehad et al, Strazzullo et al) or checked the abstracts of basically back the idea of a sodium-blood pressure-cardiovascular disease relationship.

(3) On potassium replacement - it's definitely promising (in fact, since writing the report, I have been persuaded to use salt with like 33% potassium chloride when cooking). The issue is cost - it's just more expensive, and it's not as if you can force consumers to pay more. Which brings us back to the need for regulatory interventions (e.g. aforementioned reformulation of food) or fiscal interventions (e.g. taxing salt), paired with consumer education (e.g. nutrition labelling and mass media campaigns) and  just governments changing the menus in public schools, hospitals and workplaces.

Thanks so much, this is super informative. 

Do you know if the price premium for potassium chloride is due to some fundamental thing? Or is it just because it is a smaller market and could have the potential to significantly decline in price if it became more popular?

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Joel Tan
8mo
I undersrand that it's fundamentally just harder to produce potassium than sodium, though economies of scale should see the price difference fall somewhat as demand for potassium chloride grow over time as a result of health consumers.
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