FDA Considers Allowing Salt Substitutes in More Foods—But What Are They?

The U.S. food supply may be about to get a salt makeover.

In a March 2023 news release, the FDA announced proposed changes to the standards of identity (SOIs) of foods that use salt, permitting them to use “safe and suitable” substitutes that contain less sodium. (Currently, most SOIs do not permit the use of salt substitutes.)

A wide range of foods could be affected by these new guidelines, including canned goods, condiments, and breads.

The proposed changes are motivated by the fact that about 90% of Americans consume higher than recommended amounts of sodium—a dietary pattern that can have serious consequences for health.

“Reducing sodium may help reduce the risk of high blood pressure, a leading cause of heart disease and stroke,” a spokesperson for the FDA said in an interview with Health. “Most people in the U.S. consume too much sodium, and the majority of sodium comes from processed, packaged and prepared foods, not from table salt added to food when cooking or eating.” 

In fact, since October 2021, the FDA has been encouraging restaurants and food manufacturers to voluntarily reduce sodium in over 160 categories of foods. “If finalized, the proposed rule may help manufacturers to meet these voluntary targets,” the FDA said.

Here’s what these potential changes might mean for your daily eating—and, ultimately, for your health.  

What Are Salt Substitutes?

A salt substitute is any product that reduces the sodium content of food by creating a similar savory flavor.

For home cooking, you may already be familiar with branded salt substitutes from manufacturers like Morton’s and Nu-Salt, which use potassium chloride to mimic salt’s taste, or salt-free blends such as Mrs. Dash, which contain a variety of herbs and spices.

At the moment, it’s not clear which salt substitutes would be permitted in packaged and processed foods if the FDA’s proposed changes are put into place. “The proposed rule does not list permitted salt substitutes, but defines them as safe and suitable ingredients used to replace some or all of the added sodium chloride (‘salt’) and that serve the functions of salt in food,” the FDA told Health. 

That said, the pre-publication draft of the proposed ruling mentions several examples of alternatives to table salt, including potassium chloride, monosodium glutamate, yeast extracts, amino acids, and dairy extracts.

If the changes are approved, consumers can rest assured that any new ingredients will be clearly labeled.

“Our labeling regulations require ingredients used in food, including salt substitutes, to be declared on the label’s ingredient list by their specific common or usual name,” the FDA said. “The name ‘salt’ specifically refers to sodium chloride. Therefore, salt substitutes cannot be labeled simply as ‘salt.’”

How Salt Substitutes in Foods Could Affect Public Health

The potential new ruling on salt substitutes is part of the Biden-Harris administration’s National Strategy on Hunger, Nutrition, and Health, which intends to reduce diet-related diseases by 2030. Specifically, these changes take aim at sodium-driven cardiovascular disease.

“Excess salt intake, in the form of sodium chloride, causes excess fluid retention within blood vessels, and triggers hormonally-mediated remodeling in blood vessel walls that lead to high pressure,” Bibhu D. Mohanty, MD, assistant professor of cardiovascular sciences and director of the Neuro-Cardiac Program at the University of South Florida, explained in an interview with Health. “Conversely, reducing salt intake, yields the opposite effect, and pressure falls.” 

According to Dr. Mohanty, reducing sodium in the American diet is a large-scale change that may take more than relying on salt substitutes in certain foods. Still, he sees promise for salt substitutes’ positive effects on public health.

“It is too early to tell whether fundamentally replacing sodium in our food can overcome [excess sodium consumption],” Dr. Mohanty said. “But given the extent of data we have on the deleterious effects of sodium on cardiovascular health outcomes, perhaps taking the onus off the individual will prove to be a superior overall strategy.”

A large 2022 study, for example, found that replacing salt with low-sodium substitutes reduced sodium intake by up to 77%. Researchers concluded that this intervention “probably” reduced blood pressure, non-fatal cardiovascular events, and cardiovascular mortality slightly in adults.

Another upside may occur if potassium chloride is used as a primary salt substitute. (This alternative is one of the most commonly used for providing a similar taste to salt with zero sodium.) “This can provide individuals with more potassium, a nutrient that Americans are not eating enough of,” cardiac dietitian Veronica Rouse, MAN, RD, CDE told Health. “Eating more potassium can help lower blood pressure, thereby reducing the risk of heart disease.”

Potential Drawbacks of Salt Substitutes

While scaling back on salt could have benefits for heart disease risk, some of the so-called “salternatives” have drawbacks, especially for certain groups of people.

“Potassium chloride can be harmful to people with kidney disease or individuals with heart disease that take certain medications like diuretics, as it could cause hyperkalemia (too much potassium in the blood),” Rouse said. Some people might also experience reactions like a metallic taste or even side effects like headaches or stomach cramps, she stated.

Meanwhile, salt is often fortified with iodine, serving as an important source of this essential mineral for many people. Rouse pointed out that iodine deficiency was more common prior to its addition to salt in the 1920s, and that consuming less iodine could increase the risk of thyroid dysfunction.

Finally—and importantly, given the role of flavor in food choice—there could be significant trial and error before manufacturers can formulate recipes that mimic much-loved flavors in foods like ketchup, milk chocolate, and salad dressing.

In addition to taste, other culinary and even safety factors also have to be considered. “We recognize that salt can serve various functions in standardized foods. For example, depending on the type of food, salt may be important for taste, microbial safety, and other functions,” the FDA said. “The extent to which salt can be replaced depends on the ability of the salt substitute to replicate the functions of salt in the food without compromising the food’s safety and nutritional quality.”

How to Reduce Sodium on Your Own

Only time will tell if the FDA’s proposed rules on salt substitutes receive approval—but that doesn’t mean you can’t take steps to lower your personal sodium consumption in the meantime.

Mohanty encourages starting by simply avoiding adding extra salt to meals and being mindful of salt content in common culprits like snack foods and restaurant meals. Rouse recommends choosing minimally processed foods (like fruits, vegetables, and whole grains) as often as possible, rinsing canned foods like beans prior to use, and reading nutrition labels to identify high-sodium items. Seeking out “no salt added” or “low sodium” products can also be helpful.  

If you’d like to experiment with salt substitutes in your own cooking, that’s an option, too. Garlic, lemon juice, black pepper, and onion powder are common possibilities for adding flavor without adding sodium. Or consider a sprinkle of potassium chloride or monosodium glutamate for extra savoriness. (Despite MSG’s longtime reputation for triggering health problems, the FDA considers it “generally recognized as safe.”)

“I think it reasonable to consider salt substitutes in everyday cooking as there has been no real signal of harm, though a clear reduction in salt intake,” Dr. Mohanty said. Just be sure to read labels, even on products intended to slash sodium. “It is important to note that there is still some salt in most substitutes, so moderation is still advised.”