The effectiveness, feasibility, and acceptability of low‐sodium salts worldwide: An environmental scan protocol

BACKGROUND Regular salt is about 100% sodium chloride (NaCl). Low-sodium salts have reduced sodium chloride content, most commonly through substitution with potassium chloride (KCl). Low-sodium salts have a potential role in reducing population sodium intake level and blood pressure, but its availability in global market was unknown. OBJECTIVE The aim of this study was to assess the availability, formulation, labelling, and price of low-sodium salts currently available to consumers around the world. METHODS Low-sodium salts were identified through a systematic literature review, Google search, online shopping sites search, and inquiry of key informants. The keywords of “salt substitute”, “low-sodium salt”, “potassium salt”, “mineral salt”, and “sodium reduced salt” in six official languages of the United Nations were used for search. Information about the brand, formula, labelling, and price was extracted and analysed. RESULTS Eighty-seven low-sodium salts were available in 47 out of 195 countries around the world (24%), including 28 high-income countries, 13 upper-middle-income countries, and six lower-middle-income countries. The proportion of sodium chloride varied from 0% (sodium-free) to 88% (as percent of weight, regular salt is 100% NaCl). Potassium chloride was the most frequent another component with levels ranging from 0% to 100% (potassium chloride salt). Forty-three (49%) had labels advising potential health risk, 33 (38%) labelling the advice of potential health benefits. The median price of low-sodium salts in high-income, upper-middle-income, lower-middle-income countries was USD 15.0/kg (IQR: 6.4 to 22.5), USD 2.7/kg (IQR: 1.7 to 5.5) and USD 2.9/kg (IQR: 0.50 to 22.2) respectively. The price of low-sodium salts was between 1.1 and 14.6 times that of regular salts. CONCLUSIONS Low-sodium salts are not widely available and are commonly more expensive than regular salts. Policies that promote the availability, affordability and labelling of low-sodium salts should enhance appropriate uptake for blood pressure lowering and cardiovascular prevention. CLINICALTRIAL N/A INTERNATIONAL REGISTERED REPORT RR2-10.1111/jch.14054

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Availability, Formulation, Labelling, and Price of Low-Sodium Salts Worldwide (Preprint)

JMIR Public Health and Surveillance ◽

10.2196/27423 ◽

2021 ◽

Author(s):

Xuejun Yin ◽

Hueiming Liu ◽

Jacqui Webster ◽

Kathy Trieu ◽

Mark D. Huffman ◽

...

Keyword(s):

Sodium Salts ◽

Low Sodium

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Fast and Direct Na and K Determination in Table, Marine, and Low-Sodium Salts by X-ray Fluorescence and Chemometrics

Journal of Agricultural and Food Chemistry ◽

10.1021/jf504941z ◽

2015 ◽

Vol 63 (9) ◽

pp. 2406-2412 ◽

Cited By ~ 10

Author(s):

José A. Da-Col ◽

Maria I. M. S. Bueno ◽

Fábio L. Melquiades

Keyword(s):

Sodium Salts ◽

X Ray ◽

Low Sodium

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Examination of Low-Sodium Salts for Radiation Education

Radiation Safety Management ◽

10.12950/rsm.200714 ◽

2021 ◽

Vol 20 (0) ◽

pp. 9-19

Author(s):

Takao KAWANO

Keyword(s):

Sodium Salts ◽

Low Sodium ◽

Radiation Education

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Expression of Concern: Normal-sodium diet compared with low-sodium diet in compensated congestive heart failure: is sodium an old enemy or a new friend?

Clinical Science ◽

10.1042/cs-20070193_eoc ◽

2020 ◽

Vol 134 (13) ◽

pp. 1841-1841

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Sodium Diet ◽

Low Sodium Diet ◽

Low Sodium

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Comparative Plasma Heparin Levels after Subcutaneous Sodium and Calcium Heparin

Thrombosis and Haemostasis ◽

10.1055/s-0038-1648673 ◽

1978 ◽

Vol 40 (02) ◽

pp. 397-406 ◽

Cited By ~ 8

Author(s):

Joyce Low ◽

J C Biggs

Keyword(s):

Peak Plasma ◽

Plasma Concentrations ◽

Factor Xa ◽

Normal Subjects ◽

Sodium Salts ◽

Sodium Heparin ◽

Significant Difference ◽

Heparin Plasma ◽

Calcium Heparin ◽

Plasma Heparin

SummaryComparative plasma heparin levels were measured in normal subjects injected subcutaneously with 5,000 units of the sodium and calcium salts of heparin. Plasma heparin levels were measured up to 7 hr post-injection by an anti-factor Xa assay (Denson and Bonnar 1973). Preliminary studies indicated that heparin levels were reproducible in subjects who received two injections of the same heparin. Peak plasma concentrations (Cmax) and the time at which peak concentration was reached (Tmax) varied greatly from subject to subject. In one group of subjects (15) two commonly used heparins, a sodium heparin (Evans) and a calcium heparin (Choay) were compared. Peak heparin concentrations were not significantly different. However the Tmax for the sodium heparin (1.5 hr) was significantly earlier than the Tmax for the calcium heparin (3 hr) and this was not due to a difference in the volume of the two heparin injections. No significant difference could be detected in the plasma clearance rate and the molecular weight distribution of the two heparins.In two other groups of subjects, sodium and calcium preparations from two manufacturers were compared. In general, the sodium salts gave rise to significantly higher plasma concentrations, which could be interpreted as a greater bioavailability of sodium salts. These results indicate that the salt of the heparin can influence the plasma concentration achieved after subcutaneous injection.

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BIOASSAY OF THYROID HORMONE USING HYPOTHYROID TADPOLES

Acta Endocrinologica ◽

10.1530/acta.0.0410143 ◽

1962 ◽

Vol 41 (1) ◽

pp. 143-153 ◽

Cited By ~ 2

Author(s):

U. Henriques

Keyword(s):

Thyroid Hormone ◽

Dose Response ◽

Developmental Rate ◽

Response Curves ◽

Sodium Salts ◽

Dose Response Curves

ABSTRACT A bioassay of thyroid hormone has been developed using Xenopus larvae made hypothyroid by the administration of thiourea. Only tadpoles of uniform developmental rate were used. Thiourea was given just before the metamorphotic climax in concentrations that produced neoteni in an early metamorphotic stage. During maintained thiourea neotoni, 1-thyroxine and 1-triiodothyronine were added as sodium salts to the water for three days and at the end of one week the stage of metamorphosis produced was determined. In this way identical dose-response curves were obtained for the two compounds. No qualitative differences between their effects were noted except that triiodothyronine seemed more toxic than thyroxine in equivalent doses. Triiodothyronine was found to be 7–12 times as active as thyroxine.

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