Low-sodium alternatives can lead to major health gains in Indonesia

Excess sodium intake and a lack of potassium are major contributing factors towards high blood pressure in Indonesia, prompting calls for low-sodium potassium-rich salt substitutes (LSSS) to be readily available to improve health and curb health costs.

New Griffith University research has looked at the impact of switching out current table salt (100 per cent sodium chloride) with a low-sodium alternative in Indonesia.

Lead author Dr Leopold Aminde from the School of Medicine and Dentistry said the World Health Organisation has recommended a population-wide reduction in sodium consumption to tackle the burden of high blood pressure and non-communicable diseases.

“LSSS look similar to table salt and research shows they have a similar taste with some consumers unable to differentiate between the two options,” Dr Aminde said.

“The research shows that making LSSS available would have a positive impact on the Indonesian health system by reducing blood pressure, and preventing heart attacks, strokes, and kidney disease.

“Ultimately it would reduce health expenditure by up to US$2 billion [IDR 27.7 trillion] over 10 years, providing a much-needed cost-saving measure.”

Dr. Wahyu Nugraheni, co-author and Head of the Research Centre for Public Health and Nutrition at the National Research and Innovation Agency in Jakarta said: “Indonesians consume more sodium than is physiologically required.”

“LSSS are an excellent option to help people effortlessly reduce the sodium in their diet,” Dr Nugraheni said.

Over the first 10 years of implementation, LSSS could prevent up to 1.5 million non-fatal cardiovascular disease events and more than 640,000 new cases of chronic kidney disease.

“The greatest health benefits will likely be seen in the low-income bracket of the population,” Dr Aminde said.

The research team is hoping the findings will prompt the government in Indonesia, and other countries globally, to consider reformulation of regular salt to LSSS alternatives, or facilitate supply chains to expand their availability and affordability.

The research findings will inform the upcoming WHO guidelines on the evidence gaps related to implementation costs, cost-effectiveness, and the possible impacts on health inequalities.

The paper ‘Cost-effectiveness analysis of low-sodium potassium-rich salt substitutes in Indonesia: an equity modelling study’ has been published in The Lancet Regional Health – Southeast Asia.