A simple change in the salt that Indians sprinkle on their food every day could prevent nearly four lakh deaths and more than fifteen lakh new cases of heart and kidney disease in the country each year, according to a major international study.
The research, published in the journal Nature Health, found that replacing some of the sodium chloride in regular table salt with potassium chloride could avert almost three million deaths and more than ten million new cases of cardiovascular and kidney disease worldwide every year.
The study was carried out by researchers from The George Institute for Global Health, who assessed the health benefits of switching the salt supply to potassium-enriched salt across 193 countries. Potassium-enriched salt is made by replacing a proportion of the sodium chloride that makes up regular table salt with potassium chloride. It looks, pours and tastes like ordinary salt, but its composition is different.
Where regular salt contains only sodium chloride, the low-sodium substitute typically replaces 25 to 30 per cent of that sodium with potassium chloride.
The numbers for India are striking. The researchers estimated that a complete switch of all salt to the potassium-enriched variety could prevent 399,884 deaths and 1,528,494 new cases of cardiovascular and chronic kidney disease in India every year, a total of nearly 19.3 lakh fatal and non-fatal events avoided annually.
Globally, the same switch could prevent 2.96 million deaths, 10.17 million new cases of disease and 69.43 million disability-adjusted life years lost to cardiovascular and kidney disease each year. Bruce Neal, senior professorial fellow at The George Institute for Global Health in Australia, said the health gains of switching to potassium-enriched salt would be widespread and could avert as many as one in ten cardiovascular deaths in most countries.
The study examined a range of hypothetical scenarios, from a full global switch of all salt to more targeted use among people with diagnosed and treated high blood pressure. Switching only regular table salt used at home to the potassium-enriched variety could prevent 18.5 lakh deaths and about 62 lakh cases of cardiovascular and chronic kidney disease worldwide. Switching salt only in processed and restaurant foods could prevent 15.6 lakh deaths and 54.6 lakh cases.
Switching both together could avert nearly thirty lakh deaths and more than one crore cases, the researchers estimated.
The findings matter enormously for India, where high blood pressure is one of the largest public health problems in the country. According to a 2023 study by the Indian Council of Medical Research, known as ICMR-INDIAB, 315 million people in India, or 35.5 per cent of the total population, suffer from hypertension. Consuming too much sodium and not enough potassium are the main drivers of high blood pressure.
Excess sodium makes the body retain water, raising blood pressure and increasing pressure on blood vessel walls, which in turn raises the risk of heart attack and stroke. At the same time, potassium intake among Indians sits at roughly 1,400 to 1,800 milligrams a day, less than half of the 3,500 milligrams recommended by the World Health Organization.
The evidence behind the idea has been building for years. In 2025, the World Health Organization endorsed the use of potassium-enriched salt as a strategy to reduce blood pressure and the risk of cardiovascular disease. A randomised controlled trial conducted in rural Telangana demonstrated that hypertensive adults who switched to the substitute reduced their systolic blood pressure by 4.6 millimetres of mercury.
A larger trial in China, involving about 21,000 participants over nearly five years, found even more striking results. Users of the salt substitute recorded 14 per cent fewer strokes, 13 per cent fewer major cardiovascular events and 12 per cent lower overall mortality. Analysis of the Chinese trial data showed that about 75 per cent of the blood pressure-lowering effect came from the potassium increase, not from the sodium reduction alone.
In April 2026, The George Institute for Global Health India and the organisation Resolve to Save Lives released a consensus statement backed by cardiologists, nephrologists, nutritionists and public health researchers from across India, urging a nationwide switch to low-sodium, potassium-enriched salt.
The statement called on the government to reduce the goods and services tax on the product and to introduce production subsidies to bring its cost down, so that the substitute becomes affordable for ordinary households.
Professor Vivekanand Jha, executive director of The George Institute for Global Health India, described the intervention as both proven and practical, noting that it could prevent hundreds of thousands of deaths from heart disease every year without asking people to change how their food tastes.
The researchers and doctors behind the push are careful to add a note of caution. People with advanced chronic kidney disease, in stages four and five, struggle to excrete potassium efficiently, and increased intake carries real risks for that group.
Nephrologist Professor Vivek Jha, senior professorial fellow at The George Institute in India, said people with serious kidney disease and those taking medicines that significantly increase blood potassium levels should take precautions before switching. The consensus statement does not recommend the substitute for everyone without qualification, and people with kidney problems should consult a doctor first.
The attraction of the idea for public health experts is that it requires no change in behaviour. Unlike advice to eat less salt, which depends on millions of people changing lifelong cooking habits, switching the salt itself works silently in the background. The substitute can be used in home cooking, in processed foods and in restaurant meals, and the modelling study suggests that the biggest gains come when all three are switched together.
The challenge is one of price and availability. Potassium-enriched salt costs more than ordinary salt, and it is not yet widely stocked in small shops and village markets where most Indians buy their daily provisions. That is why the April consensus statement focused on tax cuts and subsidies.
India's salt problem is part of a much larger global burden. Cardiovascular disease is the leading cause of death in the country, and kidney disease is rising fast alongside diabetes and hypertension. The new study puts a number on what a single, low-cost dietary change could achieve: nearly four lakh lives saved every year in India alone, and more than fifteen lakh cases of serious disease prevented.
If the government acts on the researchers' recommendations and makes potassium-enriched salt affordable and widely available, the humble salt shaker could become one of the most powerful tools in the country's fight against heart disease.
(Reporting based on NDTV and The George Institute for Global Health.)