Salt replacements could be deadly, say renal specialists

By Caroline Scott-Thomas

- Last updated on GMT

Related tags Potassium chloride Potassium Hypertension

Renal specialists have called for clear labeling on products that use potassium chloride as a salt replacer because it could pose a hidden risk for dialysis patients.

It has been claimed that Americans get up to 80 percent of their sodium intake from packaged foods, so manufacturers have been under pressure to reduce salt content in their products. However, this presents challenges in terms of consumer acceptability, as well as in replicating the functionality of salt as a preservative or stabilizer.

Potassium chloride has been seen as a potential candidate for salt replacement because it is as salty as salt, and although it does not have salt’s functionality, it has not been connected to the health problems associated with salt.

A recent article published on this website provoked a number of responses from renal dietitians across the United States who were concerned that dialysis patients – who must avoid eating too much potassium as well as too much sodium – could end up inadvertently choosing potassium-containing foods.

Bonnie Malinowski, a dietitian for dialysis patients and certified specialist for renal nutrition, told “My concern with this [for food companies] is not so much that they eliminate it but that they label it. I think that putting potassium on the label might attract some people to those foods anyway, as potassium is heart healthy for most people.”

Malinowski suggested that products that use the salt substitute could be labeled ‘low in sodium (or salt)’ and ‘good source of potassium’.

Avoiding potassium

She explained that it is often difficult for renal patients to avoid potassium, which their kidneys are unable to filter, because it is found at high levels in many common foods, including bananas, tomatoes and potatoes.

“There are some foods that dialysis patients should avoid. Potassium is particularly one of those nutrients. When levels get really high it can cause irregular heartbeats and even heart attacks. People could die from foods they think are healthy. Nobody can totally avoid it but you can cut back,”​ she said.

FEMA standards

The article she was responding to discussed a new salt replacement technology based on potassium chloride from Bell Flavors and Fragrances.

Vice president of R&D Flavors at Bell Simon Poppelsdorf said that he felt he lacked the authority to comment on a medical issue, but pointed out that the company does comply with FEMA standards for the use of potassium chloride in foods.

FEMA did not respond to questions regarding these standards.

However, it appears that potassium chloride can be a good choice for the general public, as Malinowski commented. A recent study published in the journal Hypertension Research​ found that consuming a salt substitute containing potassium chloride lowered blood pressure for adults considered to be at risk of poor heart health.

The health impacts of excessive salt consumption have been well-researched, including its contribution to high blood pressure and stroke. Despite this, Americans currently consume about 10 grams of salt per person each day – or around two-thirds more than the maximum of 6 grams recommended under US government guidelines.

Other companies that have also launched potassium-chloride based salt replacement products include Redpoint Bio Corporation, Wild, and Jungbunzlauer.

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