# Stakeholder perspectives on scaling up potassium-enriched salt to reduce cardiovascular disease in Australia: a qualitative study

## TL;DR

This study explores why potassium-enriched salt, a promising way to reduce heart disease, is not widely used in Australia and what can be done to promote its adoption.

## Contribution

The study provides new insights into stakeholder perspectives on scaling up potassium-enriched salt in Australia.

## Key findings

- Low awareness and knowledge of potassium-enriched salt among stakeholders was a major barrier.
- Industry and consumers lacked incentives to adopt potassium-enriched salt products.
- Government hesitancy due to concerns about health risks like hyperkalaemia was identified as a key challenge.

## Abstract

Cardiovascular disease, the world’s leading cause of death, could be significantly reduced through sodium reduction strategies; however, the implementation of such strategies has had limited impact in Australia and globally. Switching to potassium-enriched salt is a highly promising intervention, but uptake by the food industry and consumers remains limited. This study investigated the barriers and enablers for scaling up potassium-enriched salt use in Australia.

A qualitative, theory-informed study design was used to conduct 24 semi-structured interviews with representatives from civil society, government, and industry. Interviewees discussed scaling up potassium-enriched salt in relation to their interests, ideas, existing policies and guidelines, and perceived challenges and opportunities within the Australian context. Data were analysed using thematic analysis.

Minimal knowledge and awareness of potassium-enriched salt among all stakeholder groups was the most prominent finding. The key perceived barriers were low consumer demand for potassium-enriched salt products and little incentive for industry to invest in supply. Further, government stakeholders expressed hesitancy to implement policies due to perceived health risks such as hyperkalaemia. Interviewees identified increased awareness, support for industry research and development, and leveraging current policies and initiatives (such as the Australian Health Star Rating system) as potential enablers.

Improving stakeholder understanding of the benefit of switching to potassium-enriched salt in Australia may require a coordinated advocacy strategy that disseminates the evidence and addresses misconceptions. Efforts to drive increased supply and demand could be advanced using a multi-sectoral approach that focuses on supporting industry uptake, encouraging consumer demand, and informing policy implementation.

The online version contains supplementary material available at 10.1186/s12889-025-23717-w.