South Africans love biltong, boerewors, and a good braai! But with a love of food comes a love of salt, and South Africa has one of the highest salt intakes globally. This World Salt Awareness Week, observed from the 11th to the 17th of May, the Heart and Stroke Foundation South Africa (HSFSA) is joining the global World Action on Salt, Sugar and Health (WASSH) movement to #SaltItOut, highlighting healthier alternatives to excessive salt.
Research has established a clear link between high salt intake and increased risk of elevated blood pressure. What’s more, South Africans underestimate their salt intake – and their blood pressure shows it. Recent data from HSFSA reveals a dangerous disconnect: while most South Africans think their salt intake is “normal,” the numbers tell a different story. Over 1 in 3 South Africans are walking around with high blood pressure, with 1,570 out of 4,510 participants having elevated blood pressure. Yet when asked about their diets, the majority self-reported normal salt consumption. This gap suggests many of us are unaware of how much salt we’re actually eating. Hidden sources like bread, processed meats, sauces, soups, and ready meals can increase sodium levels without us even realising it.
HSFSA’s campaign, “The Salt Shift”, raises awareness about potassium salt substitutes, a lesser-known option for managing blood pressure. This initiative encourages individuals and the industry to make a conscious shift from traditional salt to potassium salt substitutes, a simple yet effective way to support healthier blood pressure levels.
The World Health Organisation (WHO) recommends limiting sodium consumption to less than 2g per day (equivalent to 5g of salt) to reduce health risks. A high salt intake is estimated to account for 1.65 to 1.8 million deaths worldwide, or about 1 in 10 of all cardiovascular deaths, each year. South African research indicates that in the 18-49-year age group, the average salt intake is around 8 g/day, ranging from 5 to 12g. The South African government has taken proactive measures to address excessive salt intake by implementing legislation that establishes maximum sodium levels for various categories of processed foods. This initiative has yielded positive results, with research indicating a corresponding decrease in salt consumption, specifically an overall reduction of 1.15g/day in salt intake.
A recent study co-authored by our CEO, Prof Pamela Naidoo of the HSFSA, highlights important progress as well as ongoing challenges in reducing salt intake in South Africa. The research found that while approximately 75% of packaged food products comply with national sodium reduction targets, certain commonly consumed categories, particularly bread, savoury powders, and processed meats, still exceed recommended limits, with processed meats showing the lowest compliance. These findings reinforce the positive impact of existing salt reduction legislation while emphasising the need for continued food reformulation, stronger monitoring, and effective enforcement. The HSFSA encourages consumers to make informed choices by referring to the Salt Chart booklet available on our website. The booklet provides practical examples of the salt content in commonly consumed food categories, such as breads, processed meats, snacks, and sauces, without focusing on specific brands, helping consumers identify high-salt foods and make healthier dietary choices.
Building on this momentum, further reductions could be achieved by increasing access to potassium salt, a healthier alternative, and educating the public about its benefits. According to the University of Cape Town, the largest source of dietary salt comes from processed foods, which account for approximately 55% of a typical Western diet, with much of this intake coming from “hidden salt” that is not immediately visible to consumers, making it easy to exceed recommended levels without realising it. By making potassium salt more accessible and promoting its use through awareness campaigns, South Africans can take another significant step towards reducing their salt intake and mitigating the risks of hypertension and cardiovascular disease, aligning with WHO-recommended strategies that include public education, food reformulation, and clear labelling. Prof Pamela Naidoo, CEO of HSFSA, says, “At the moment, the increased cost of salt substitutes is a barrier to market introduction, limiting accessibility for consumers looking to reduce their sodium intake. However, growing demand and advances in food technology could help drive prices down. One potential solution is incentivising local production of potassium salt blends in South Africa, which could reduce costs and make healthier alternatives more affordable for consumers.”
Many South Africans are unaware that potassium salts are available locally and miss out on their science-backed benefits. Potassium salt is a type of salt substitute that replaces some or all of the sodium chloride (table salt) with potassium chloride. A recent systematic review found that using salt substitutes lowers blood pressure, reduces sodium intake, and cuts the risk of death from any cause by 12%. This simple change can be an effective way to manage blood pressure and reduce the risk of heart disease. Another study found that replacing sodium chloride with potassium-enriched salt substitutes lowers systolic blood pressure by an average of 5.58 mm Hg and diastolic blood pressure by 2.88 mm Hg. If you’re worried about taste, don’t worry! A study by WITS University found that South Africans actually liked the taste of 50% potassium salt (a mix of potassium chloride and sodium chloride). Almost half (45%) of participants said it tasted fantastic or really good, and 62% liked it and would use it, saying it tasted like regular salt. However, those with kidney disease, heart problems, or who are on certain medications should consult their healthcare provider first. Excessive potassium intake can be harmful.
The hype around “natural salts” like coarse sea salt or pink Himalayan salt often leads people to believe they’re a healthier choice. Yes, these salts do contain minerals like magnesium, calcium, and potassium – but let’s put this into perspective. The amounts are typically tiny compared to other dietary sources, so for most people, the mineral boost is negligible. Mostly, they contain the same amount of sodium as regular salt. Nutrition Science Team Lead at HSFSA, Ms Shonisani Nephalama, warns that “Many South Africans don’t know how to read food labels, so they’re missing the sodium content of foods and are unknowingly putting their blood pressure at risk.”
This shift toward healthier salt choices is part of a broader public health journey. Once a vital tool in combating iodine deficiency, iodised salt has played a crucial role in enhancing global nutrition. South Africa’s adoption of mandatory salt iodisation in 1995 has been highly effective, with 89% of households now benefiting from adequately iodised salt. Today, we face a new challenge: excessive salt intake, often hidden in processed foods, contributes to hypertension and increased stroke risk. Encouragingly, evidence shows that reducing sodium intake, including through the use of potassium-enriched salts, does not compromise iodine status. This presents an opportunity to make informed choices. Exploring healthier salt options, such as potassium salt, can support cardiovascular health while maintaining essential iodine intake. Ms Cari Erasmus, Registered Dietitian at HSFSA, urges South Africans to create environments that support healthy eating: “We should advocate for further regulations, such as removing saltshakers from tables.”
By making informed choices about the salt we consume, we can take a significant step towards managing our blood pressure and reducing our risk of heart disease and stroke.
Interviews will be conducted with our CEO, Prof Pamela Naidoo and our Healthcare Professional Teams. To coordinate and confirm interview dates you are welcome to contact Mr. Themba Mzondi, our PR and Communications Officer on 021 422 1586 / 078 113 5216 or email themba.mzondi@heartfoundation.co.za
About the Heart and Stroke Foundation SA
The Heart and Stroke Foundation South Africa (HSFSA) plays a leading role in the fight against preventable heart disease and stroke, with the aim of seeing fewer people in South Africa suffer premature deaths and disabilities. The HSFSA, established in 1980, is a non-governmental, non-profit organization which relies on external funding to sustain the work it carries out.
The HSFSA aims to reduce the cardiovascular disease (CVD) burden in South Africa and ultimately on the health care system of South Africa. Our mission is to empower people in South Africa to adopt healthy lifestyles, make healthy choices easier, seek appropriate care and encourage prevention.
For more information visit www.heartfoundation.co.za. You can also find us on www.facebook.com/HeartStrokeSA, www.x.com/SAHeartStroke and www.instagram.com/heartstrokesa_