— October 9, 2026 · FDA Lets Salt Substitutes Into 139 Standardized Foods

Table of Contents

1. At a Glance
2. What the Rule Does and When
3. Which Foods Are Covered
4. What the Label Must Show
5. How Salt Substitutes Work
6. How It Fits With Earlier Research
7. Potassium, Kidneys and Medicines
8. What the Agencies Said
9. What It Cannot Show and What Remains Unknown
10. Sources and Primary Documents
11. Key Research Papers
12. Connections

At a Glance

• The document — FDA final rule “Use of Salt Substitutes To Reduce the Sodium Content in Standardized Foods,” 91 FR 65040–65070, FR Doc. 2026-20848, Docket No. FDA-2022-N-2226, RIN 0910-AI72. Signed by Robert F. Kennedy, Jr., Secretary of Health and Human Services.
• Announced — October 9, 2026 (FDA Human Foods Program constituent update; filed for public inspection the same morning). Federal Register issue date: October 13, 2026.
• What changes — 80 standards of identity are amended directly to permit salt substitutes; 59 more that cross-reference them follow automatically, for 139 in total.
• The definition — a new section, 21 CFR 130.30, defines a salt substitute as a safe and suitable ingredient, or combination of them, that replaces some or all of the added salt, reduces sodium and “serves the functions of salt in the food.”
• Labels — no new requirements. Existing rules already require each substitute to be named in the ingredient list and potassium to be shown on the Nutrition Facts label when a serving holds 2% or more of the Daily Value.
• Dates — effective December 14, 2026; objections to the dairy amendments due by November 12, 2026. There is no compliance date because using a substitute is voluntary.
• History — proposed April 10, 2023 (88 FR 21148); more than 120 public comments.
• Estimated cost and benefit — $0 in quantified costs and $0 in quantified benefits; the FDA describes possible health benefits only in words, because it cannot predict how many foods will change.

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What the Rule Does and When

A standard of identity is a federal regulation that defines what a food sold under a common name must contain. In the FDA’s words, these standards “often describe in detail what a food must contain and what is optional and sometimes describe the amount or proportion of ingredients or components. Many SOIs also prescribe a method of production or formulation.” A product labelled “cheddar cheese” or “canned corn” has to follow its standard. Makers have long been free to use salt substitutes in foods with no standard, but most standards that mention salt did not allow one.

An older general provision (21 CFR 130.10) let makers of certain standardized foods use substitutes only if they cut sodium to the level of a formal sodium claim, which the FDA said “may be impracticable.” The October 9 announcement: “Before today’s final rule, 139 SOIs allowed or required the addition of salt, but did not permit the use of salt substitutes in these foods. This meant manufacturers had few options to lower the sodium content in these standardized foods.”

The rule works in two steps. First, it creates a new subpart in the general food-standards regulation, “Flexibility in Standardized Foods,” with one new section, 21 CFR 130.30. That section says that substitutes “must not change the basic nature and essential characteristics of the food,” and it defines the term:

“Salt substitute means a safe and suitable ingredient (or combination of safe and suitable ingredients) that is used to replace some or all of the added salt (sodium chloride), to reduce sodium in the food, and that serves the functions of salt in the food.”

Second, it edits 80 individual standards, often by changing a line that read “Salt” to “Salt or salt substitute.” Because 59 other standards borrow their ingredient lists from those 80, the change reaches 139 standards in all. The FDA made one change to the wording it proposed in 2023: the phrase in brackets now reads “combination of safe and suitable ingredients,” so that every ingredient in a blend has to meet that test.

Several limits are written into the rule or its explanation:

• No list of approved substitutes. The FDA declined requests to list them, so that future ingredients are covered without another rulemaking.
• No new ingredients in the food supply. The rule “does not permit the use of any ingredients or substances that are not already permitted in non-standardized foods.” Any substitute still has to be an approved food additive or generally recognized as safe (GRAS) for that use.
• No minimum reduction. The definition “does not require a minimum replacement level of salt or prescribe the sodium content” of the food; some salt has to be replaced, but how much is up to the maker.
• The substitute has to do salt’s job. “Safe and suitable” already means, under 21 CFR 130.3(d), that an ingredient does a proper job in the food, is used at no more than the level needed, and is not an unapproved additive.

Dates. The rule takes effect on December 14, 2026, “except as to any provisions in the SOI for dairy products that may be stayed by the filing of proper objections.” Dairy standards (21 CFR parts 131 and 133) are amended under a section of the law that allows objections and requests for a hearing; those are due by November 12, 2026. Because no maker is required to do anything, the rule has no compliance date.

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Which Foods Are Covered

Table 1 of the rule lists the 80 standards it edits directly. Grouped by the rule’s own sections, they include:

• Milk and cream products — acidified milk, cultured milk, sour cream, acidified sour cream and eggnog.
• Cheeses — 41 cheese standards, among them cheddar, colby, cream cheese, dry curd cottage cheese, mozzarella, parmesan, provolone, swiss, and pasteurized process cheese and cheese spread.
• Bakery and grain foods — bread, rolls and buns; self-rising flour; self-rising white corn meal; macaroni products; and noodle products.
• Canned and frozen fruit and vegetables — canned applesauce, canned figs, fruit butter, canned green and wax beans, canned corn, canned peas, canned tomatoes, tomato concentrates, catsup, certain other canned vegetables, canned mushrooms, tomato juice and frozen peas.
• Fish and shellfish — canned oysters, canned Pacific salmon, canned wet-pack shrimp and canned tuna.
• Cacao products — chocolate liquor, breakfast cocoa, sweet chocolate, white chocolate and milk chocolate.
• Other foods — margarine; cane, maple, sorghum and table sirups; mayonnaise; and salad dressing.

Some fish standards were deliberately left alone. Fresh oysters may be shucked using saltwater of less than 0.75% salt, but salt is not an added ingredient there, and the FDA said a substitute could change how much water the oysters absorb or lose. The standards for frozen raw breaded shrimp (and lightly breaded shrimp) already allow any safe and suitable batter and breading ingredients (other than artificial flavours, sweeteners, colours and chemical preservatives), so the FDA said no amendment was needed.

The list describes which recipes may change, not which foods will. The FDA wrote that comments on the 2023 proposal “do not provide information about definitive plans to reformulate products,” and the agency declined to publish a list of foods likely to receive potassium-based substitutes because any such list “would be too speculative to be useful.”

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What the Label Must Show

The rule states plainly: “The final rule does not prescribe any new labeling requirements for ingredients used to replace salt in standardized foods.” What it relies on instead are labelling rules that already apply to every packaged food:

• Ingredient list. Each substitute has to be listed by its common or usual name (21 CFR 101.4). The rule defines “salt substitute” but does not make it a collective name, so a label cannot simply say “salt substitute.”
• Potassium chloride. It has to appear as “potassium chloride” or as “potassium salt,” the alternate name the FDA has accepted since a December 2020 guidance.
• Potassium on the Nutrition Facts label. A food that contains 2% or more of the Daily Value for potassium per serving has to declare its potassium content (21 CFR 101.9(c)(8)(ii) and (iii)).
• Monosodium glutamate. If MSG is used as a substitute, it has to be declared by the name “monosodium glutamate” (21 CFR 101.22(h)(5)).
• “Low sodium” claims. A food labelled “low sodium” still has to meet that claim’s existing sodium limit (21 CFR 101.61(b)(4)).

Some commenters asked for a front-of-pack notice of added potassium, or a warning for people at risk of hyperkalemia. The FDA declined, saying it disagreed that foods with potassium-based ingredients need to carry “a warning statement for individuals at risk for hyperkalemia.” Its stated reasons: potassium facts are already required on the label; so many foods contain potassium that warnings would be everywhere and lose their meaning; and they could put off people who need more potassium.

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How Salt Substitutes Work

Salt does more in food than make it taste salty. Comments summarised in the rule describe salt’s roles in microbial safety and shelf stability, including control of moisture and of fermentation. That is why the rule’s definition requires a substitute to serve “the functions of salt in the food,” and why the FDA wrote that “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, including functions related to safety and quality.”

The FDA gave a worked example. Self-rising flour is dry and canned corn is heat-sterilised, so in neither does salt prevent spoilage. If cutting salt in those foods loses flavour, a flavour ingredient that meets the definition may stand in; an ingredient that only preserves would not qualify, because preserving is not a job salt does there.

The best-known substitute is potassium chloride, a close chemical relative of table salt in which potassium takes the place of sodium alongside chloride. It tastes salty but becomes bitter or metallic at higher levels; the FDA cited taste research and said it expects potassium chloride use to be “self-limiting because of its inherent bitter and metallic taste characteristics.” The rule does not limit substitutes to potassium. It lists yeast extracts, MSG, amino acids and dairy extracts as other ingredients discussed in the scientific literature, and says flavours, flavour enhancers and mineral salts may qualify if they meet the definition.

Potassium-enriched salt works in two directions at once. A 2020 review in Hypertension described the idea as a way “to reduce sodium intake, increase potassium intake, and thereby lower blood pressure.” The same review notes the risk: the body clears extra potassium through the kidneys, so conditions “that impair potassium excretion such as chronic kidney disease” raise the chance that blood potassium climbs too high. The site’s animated explainer on how the body controls blood pressure shows the kidney hormone system involved.

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How It Fits With Earlier Research

Where the sodium comes from. The rule states that “more than 70 percent of Americans’ sodium intake comes from foods where sodium is added during food manufacturing and commercial food preparation.” A study the rule cites, of 450 adults in three US regions, found that sodium added outside the home made up 70.9% of intake and salt added in home cooking and at the table only 5.6% and 4.9% (Harnack et al., 2017). Average US intake is about 3,400 mg of sodium a day, against a limit of less than 2,300 mg a day for people aged 14 and over in the Dietary Guidelines that the rule cites.

The FDA’s voluntary sodium targets. Phase I of the FDA’s voluntary goals for industry, announced on October 14, 2021 (86 FR 57156), set 2.5-year targets “intended to support an average sodium intake reduction to 3,000 milligrams/day.” Phase II, a draft announced on August 16, 2024 (89 FR 66727), proposes 3-year targets across 163 food categories that, if met, would bring average intake to about 2,750 mg a day; the FDA says Phase I and Phase II together would cut average intake by about 20% from earlier levels. In 2022 data, about 40% of the Phase I targets had been reached or were within 10%, the FDA reports.

Sodium and blood pressure. The rule’s health rationale rests on the link between sodium and high blood pressure. A 2020 Cochrane review the rule cites found that, in white participants with hypertension, cutting sodium lowered systolic pressure by 5.71 mmHg (95% CI 4.74 to 6.67) and diastolic by 2.87 mmHg; in people with normal blood pressure the systolic drop was 1.14 mmHg. The same review recorded rises in renin, aldosterone, cholesterol and triglycerides (Graudal et al., 2020). A cited modelling study projected 280,000 to 500,000 deaths averted over 10 years from a gradual 40% cut in US sodium — a projection, not an observed result (Coxson et al., 2013). The site’s pages on salt excess and blood pressure and potassium and blood pressure cover more.

The Salt Substitute and Stroke Study (SSaSS). The largest trial, published in the New England Journal of Medicine in 2021, randomly assigned 600 villages in rural China to a substitute of 75% sodium chloride and 25% potassium chloride or to regular salt. The 20,995 participants had a history of stroke or were 60 or older with high blood pressure; their mean age was 65.4, and they were followed for a mean of 4.74 years. Compared with regular salt, the substitute group had fewer strokes (29.14 vs 33.65 per 1,000 person-years; rate ratio 0.86, 95% CI 0.77 to 0.96), fewer major cardiovascular events (rate ratio 0.87, 0.80 to 0.94) and fewer deaths (rate ratio 0.88, 0.82 to 0.95). Serious adverse events attributed to hyperkalemia were not significantly different (3.35 vs 3.30 per 1,000 person-years; rate ratio 1.04, 0.80 to 1.37). The trial was funded by Australia’s National Health and Medical Research Council (Neal et al., 2021). See also stroke and salt and stroke risk.

Other trials and pooled analyses. In DECIDE-Salt, 48 elderly care homes in China with 1,612 residents aged 55 or older were randomised for two years; a substitute of 62.5% sodium chloride and 25% potassium chloride lowered systolic pressure by 7.1 mmHg (95% CI 3.8 to 10.5) and cut cardiovascular events (hazard ratio 0.60, 0.38 to 0.96), with no significant effect on total deaths (hazard ratio 0.84, 0.63 to 1.13); simply restricting the salt supply had no effect (Yuan et al., 2023). A 2022 meta-analysis of 21 trials and 31,949 participants found an average systolic drop of 4.61 mmHg and lower total mortality (risk ratio 0.89, 0.85 to 0.94) with salt substitutes (Yin et al., 2022).

The WHO guideline. On January 27, 2025, the World Health Organization issued a guideline based on a Cochrane review of 26 randomised trials in 34,961 adults (Brand et al., 2022). WHO reported, with moderate certainty, a mean systolic reduction of 4.76 mmHg and diastolic reduction of 2.43 mmHg, and “little to no difference in hyperkalaemia.” Its conditional recommendation reads: “If choosing to use table salt, WHO suggests replacing regular table salt with lower-sodium salt substitutes that contain potassium.” WHO’s recommendation covers table salt only and, in its own words, “does not apply to … non-discretionary salt already present in manufactured foods” — the very salt the FDA rule addresses. WHO also notes that “most trials assessed discretionary use” — salt added in cooking or at the table — and that there “was not enough evidence on the non-discretionary consumption of LSSS (e.g. from manufactured foods)” to include it. One trial it describes, of bread made with a substitute and given to children, showed little to no effect on blood pressure (very low certainty evidence).

What reformulation does to potassium intake. A modelling study the rule cites, by researchers at a food manufacturer using Dutch survey data from 2,106 people, estimated that replacing 20% of the sodium chloride in each food with potassium chloride would raise median potassium intake by 453 mg a day from a baseline of 3,334 mg; replacing 50% raised it by 674 mg and 100% by 733 mg. Bread, processed fruit and vegetables, snacks and processed meat accounted for most of the change (van Buren et al., 2016).

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Potassium, Kidneys and Medicines

Much of the debate over the proposal concerned potassium. As the rule summarises them, commenters said potassium-based substitutes could affect people with chronic kidney disease, heart failure or certain medicines “because of an increased risk of hyperkalemia,” which the rule defines as “a condition where there is too much potassium in the blood.” Some said people may not know they have kidney disease or may not read labels, making such potassium “hidden”; others said the evidence may not show that substitutes cause hyperkalemia, or that more research is needed.

The FDA’s responses, in the rule’s own terms:

• It “recognize[s] the need for certain individuals to monitor potassium intake” and points to the Nutrition Facts label and ingredient list as the source of that information.
• It cannot say how much potassium the rule will add to the food supply: “we cannot determine the extent to which the final rule may affect the amount of potassium in the food supply.”
• It plans “to monitor relevant data and scientific publications for changes in U.S. consumption patterns in potassium intake.”
• It notes that standards of identity “do not address dietary restrictions related to individuals’ specific disease conditions or their use of certain medications.”

The research raises a specific concern for people whose kidneys cannot clear potassium well. The 2020 review in Hypertension lists the risks of potassium-enriched substitutes as “a possible increased risk of hyperkalemia and its principal adverse consequences: arrhythmias and sudden cardiac death, especially in people with conditions that impair potassium excretion such as chronic kidney disease,” and adds that “there is insufficient evidence regarding the effects of potassium-enriched salt substitutes on the occurrence of hyperkalemia” (Greer et al., 2020). See the site’s page on hyperkalemia.

Key facts from the evidence base:

• The trials left out the people most at risk. WHO reports that all 26 trials in its review “specifically excluded participants in whom an increased intake of potassium could cause harm – for example, people with kidney disease, impaired renal function or those using potassium-sparing medications or potassium supplements.” Its recommendation therefore excludes “individuals with kidney impairments or with other circumstances or conditions that might compromise potassium excretion,” and does not apply to children or pregnant women.
• Blood potassium rises a little on average. Across those trials, potassium in the blood rose by 0.12 mmol/L on average (95% CI 0.07 to 0.18). In DECIDE-Salt, the substitute raised mean serum potassium and led to more frequent hyperkalemia on blood tests, which the authors report was not associated with adverse clinical outcomes.
• A modelling estimate of the trade-off. A 2020 BMJ modelling study estimated that replacing salt added at the table or in cooking across China with potassium-enriched substitute could prevent about 461,000 cardiovascular deaths a year, while causing an estimated 11,000 (6,422 to 16,562) extra hyperkalemia-related deaths among the roughly 17 million people with chronic kidney disease; it still projected a net benefit of about 21,000 fewer deaths in that group (Marklund et al., 2020). These are model outputs, not counted deaths, for a different country and a different use of salt.
• Medicines. Case reports describe severe hyperkalemia in two people with high blood pressure treated with ACE inhibitors who also used a potassium-based salt substitute; their potassium returned to normal after the substitute was stopped (Ray et al., 1999). WHO’s exclusions name potassium-sparing medicines and potassium supplements.

The irregular heartbeat that very high potassium can cause is covered on the site’s page on hyperkalemia and heart rhythm.

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What the Agencies Said

The FDA’s announcement (October 9, 2026) named no individual official. It said: “Americans consume too much sodium. Excess sodium increases the risk of high blood pressure, a leading cause of heart disease and stroke.” It said the rule supports the Make America Healthy Again initiative and the FDA’s multi-phase voluntary sodium goals, and that “later this year, the agency will issue a report evaluating progress against the Phase I targets; a preliminary assessment issued in 2024 showed encouraging signs of progress.”

The rule itself states that “reducing sodium consumption may help reduce the risk of hypertension, a major risk factor for heart disease and stroke.” The FDA agreed with commenters that tastes “may adapt and adjust over time” to gradual sodium cuts, while noting that “the amount of sodium that can be removed without substitution may be limited, particularly in standardized foods for which salt is a required ingredient.”

On safety of individual substitutes, the FDA treated questions about specific ingredients as outside this rule and said it has “instituted a post-market review process to review substances more systematically for continued safety” (see the site’s page on GRAS and post-market review).

On cost, the FDA calls the rule a deregulatory action under Executive Order 14192 and records $0 in quantified costs and benefits, because “due to the voluntary nature of the rule, no changes in costs of production or increase in consumer satisfaction can be quantified.”

The World Health Organization, in its January 2025 guideline, called its recommendation for potassium-containing salt substitutes a conditional one, based on evidence it rated low certainty overall when all outcomes were considered.

A press claim that does not match the documents. One trade-press report on October 9 said the FDA’s Phase I targets aim to reduce sodium intake by 20%. The FDA’s own documents give Phase I a goal of 3,000 mg a day (from about 3,400) and say the roughly 20% figure applies to Phase I and Phase II together.

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What It Cannot Show and What Remains Unknown

• Whether any food changes. The rule allows reformulation; it does not require it. The FDA had no information on which makers plan to use it, for which foods, or with which ingredients.
• How much sodium falls. No minimum reduction is required, so a product could swap a small share of its salt. The rule sets no sodium target for any standardized food.
• Which substitute is used. Potassium chloride is the best-studied, but the rule also covers yeast extracts, MSG, amino acids, dairy extracts, flavours and other mineral salts that meet the definition. The health trials tested potassium-enriched salt only.
• Whether the trial results carry over. SSaSS and DECIDE-Salt tested salt used in home or care-home cooking by older adults in China, and WHO says most trials in its review assessed salt added in cooking or at the table. None tested reformulated standardized foods in the United States, and WHO’s recommendation explicitly does not cover salt in manufactured foods.
• The effect on people with kidney disease. The trials in WHO’s review excluded people with kidney disease and people on potassium-sparing medicines, so they cannot show how added potassium in everyday foods affects those groups. The FDA says it will watch data on US potassium intake; the rule does not say how or when it will report.
• Whether dairy provisions are stayed. Objections to the cheese and milk-product amendments, due November 12, 2026, could delay those parts of the rule.
• The Phase I verdict. The FDA’s full report on progress against its 2021 sodium targets was still pending on October 9; the agency said it would come “later this year.” Phase II remained a draft in the rule’s account, as did the January 2025 front-of-package nutrition labelling proposal (90 FR 5426), which the rule mentions and which the site covers on its front-of-package label page.

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Sources and Primary Documents

Statements about the rule come from its Federal Register full text, read in full and checked against the Federal Register’s records; sodium-goal figures from the FDA notices and web page; WHO figures from the guideline PDF; trial figures from the PubMed abstracts below.

1. Food and Drug Administration, HHS (October 13, 2026). Use of Salt Substitutes To Reduce the Sodium Content in Standardized Foods. Final rule. 91 FR 65040–65070; FR Doc. 2026-20848; Docket No. FDA-2022-N-2226; RIN 0910-AI72; filed for public inspection October 9, 2026. — Federal Register: 91 FR 65040 · GovInfo PDF
2. Federal Register public inspection, FR Doc. 2026-20848, filed October 9, 2026, 8:45 a.m. — Public inspection document 2026-20848
3. FDA Human Foods Program (October 9, 2026). FDA Issues Final Rule on Salt Substitutes in Standardized Foods. Constituent update. — FDA constituent update
4. Food and Drug Administration, HHS (April 10, 2023). Use of Salt Substitutes To Reduce the Sodium Content in Standardized Foods. Proposed rule. 88 FR 21148–21171; FR Doc. 2023-06456; Docket No. FDA-2022-N-2226; comments closed August 8, 2023. — Federal Register: 88 FR 21148
5. Food and Drug Administration, HHS (October 14, 2021). Voluntary Sodium Reduction Goals: Target Mean and Upper Bound Concentrations for Sodium in Commercially Processed, Packaged, and Prepared Foods; Guidance for Industry; Availability. 86 FR 57156; Docket No. FDA-2014-D-0055. — Federal Register: 86 FR 57156
6. Food and Drug Administration, HHS (August 16, 2024). Voluntary Sodium Reduction Goals … Draft Guidance for Industry (Edition 2); Availability. 89 FR 66727; Docket No. FDA-2014-D-0055. — Federal Register: 89 FR 66727
7. FDA. Sodium Reduction in the Food Supply (agency web page, Phase I progress and draft Phase II targets). — FDA sodium reduction page
8. World Health Organization (January 27, 2025). Use of lower-sodium salt substitutes: WHO guideline. Geneva: WHO. ISBN 978-92-4-010559-1. — WHO guideline page
9. Trade coverage: Food Safety Magazine (October 9, 2026), used only to check press claims against the documents. — Food Safety Magazine report

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Key Research Papers

Background papers on salt substitutes, sodium and potassium. Each entry was checked against its PubMed record and Crossref before it was written down; figures quoted in this article come from the abstracts.

1. Neal B, Wu Y, Feng X, Zhang R, Zhang Y, Shi J, et al. (2021). Effect of Salt Substitution on Cardiovascular Events and Death. New England Journal of Medicine 385(12):1067-1077. — PubMed PMID: 34459569
2. Neal B, Tian M, Li N, Elliott P, Yan LL, Labarthe DR, et al. (2017). Rationale, design, and baseline characteristics of the Salt Substitute and Stroke Study (SSaSS)—A large-scale cluster randomized controlled trial. American Heart Journal 188:109-117. — PubMed PMID: 28577665
3. Yuan Y, Jin A, Neal B, Feng X, Qiao Q, Wang H, et al. (2023). Salt substitution and salt-supply restriction for lowering blood pressure in elderly care facilities: a cluster-randomized trial. Nature Medicine 29(4):973-981. — PubMed PMID: 37055566
4. Yin X, Rodgers A, Perkovic A, Huang L, Li KC, Yu J, et al. (2022). Effects of salt substitutes on clinical outcomes: a systematic review and meta-analysis. Heart 108(20):1608-1615. — PubMed PMID: 35945000
5. Brand A, Visser ME, Schoonees A, Naude CE (2022). Replacing salt with low-sodium salt substitutes (LSSS) for cardiovascular health in adults, children and pregnant women. Cochrane Database of Systematic Reviews 8(8):CD015207. — PubMed PMID: 35944931
6. Greer RC, Marklund M, Anderson CAM, Cobb LK, Dalcin AT, Henry M, Appel LJ (2020). Potassium-Enriched Salt Substitutes as a Means to Lower Blood Pressure: Benefits and Risks. Hypertension 75(2):266-274. — PubMed PMID: 31838902
7. Marklund M, Singh G, Greer R, Cudhea F, Matsushita K, Micha R, et al. (2020). Estimated population wide benefits and risks in China of lowering sodium through potassium enriched salt substitution: modelling study. BMJ 369:m824. — PubMed PMID: 32321724
8. Graudal NA, Hubeck-Graudal T, Jurgens G (2020). Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Cochrane Database of Systematic Reviews 12(12):CD004022. — PubMed PMID: 33314019
9. Harnack LJ, Cogswell ME, Shikany JM, Gardner CD, Gillespie C, Loria CM, et al. (2017). Sources of Sodium in US Adults From 3 Geographic Regions. Circulation 135(19):1775-1783. — PubMed PMID: 28483828
10. Coxson PG, Cook NR, Joffres M, Hong Y, Orenstein D, Schmidt SM, Bibbins-Domingo K (2013). Mortality benefits from US population-wide reduction in sodium consumption: projections from 3 modeling approaches. Hypertension 61(3):564-570. — PubMed PMID: 23399718
11. van Buren L, Dötsch-Klerk M, Seewi G, Newson RS (2016). Dietary Impact of Adding Potassium Chloride to Foods as a Sodium Reduction Technique. Nutrients 8(4):235. — PubMed PMID: 27110818
12. Ray K, Dorman S, Watson R (1999). Severe hyperkalaemia due to the concomitant use of salt substitutes and ACE inhibitors in hypertension: a potentially life threatening interaction. Journal of Human Hypertension 13(10):717-720. — PubMed PMID: 10516744

PubMed Topic Searches

1. PubMed: Salt substitutes, stroke and cardiovascular events
2. PubMed: Potassium-enriched salt and hyperkalemia
3. PubMed: Salt substitutes and chronic kidney disease
4. PubMed: Potassium chloride in food reformulation
5. PubMed: Sodium reduction in processed foods and blood pressure

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Connections

• News Archive
• FDA and Regulation — the site’s section on regulatory actions
• Sodium — the essential electrolyte most people get too much of
• Potassium — the mineral in most salt substitutes
• Salt Excess and High Blood Pressure — how excess sodium raises pressure
• Salt Excess and Stroke Risk — the stroke research behind sodium limits
• Potassium for Blood Pressure — the evidence on potassium intake
• Hyperkalemia (High Potassium) — symptoms, causes and risks
• Hypertension — high blood pressure, causes and research
• Stroke — the primary outcome of the SSaSS trial
• Kidney Disease — the condition at the centre of the potassium concerns
• How Your Body Controls Blood Pressure — animated explainer
• Front-of-Package Nutrition Label Proposal — the 2025 FDA labelling proposal the rule mentions
• GRAS and Post-Market Review — the FDA’s separate ingredient-safety process

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