# The Assessment of Availability, Formulation, Price and Its Risk Factors of Potassium-Enriched Low-Sodium Salt in China: Implications for Population-Level Salt Reduction

## TL;DR

This study examines the availability, formulation, and pricing of potassium-enriched low-sodium salt in China, finding significant gaps that could hinder population-level salt reduction efforts.

## Contribution

The study identifies critical gaps in formulation and pricing of potassium-enriched low-sodium salt in China, offering actionable insights for improving public health outcomes.

## Key findings

- Potassium-enriched low-sodium salt is less available in small supermarkets compared to large ones.
- Most potassium-enriched low-sodium salt products contain less than 15% potassium chloride.
- Potassium-enriched low-sodium salt is significantly more expensive than regular salt.

## Abstract

Background/objectives: Potassium-enriched lower-sodium salt substitutes (LSSS) offer consumers a practical way to increase potassium intake and decrease sodium intake, thereby reducing their risk of high blood pressure and cardiovascular disease. This risk reduction, however, depends on whether consumers can access affordable, evidence-based LSSS products. This study investigated the availability, formulation and price of LSSS in China. Methods: A cross-sectional salt survey was conducted across 195 supermarkets in 15 cities from 2023 to 2025 in China. Results: LSSS availability varied substantially by supermarket size: 90.9% of large (33), 88.9% of middle-sized (45), and only 53.0% of small supermarkets (117) stocked LSSS. Of 1861 total salt products surveyed, 310 were LSSS and 1551 were regular salt. A critical evidence–practice gap exists in product formulation: the mean potassium chloride (KCl) content among unique LSSS products was only 16.6%, with 53.4% of LSSS containing <15% KCl. LSSS products are also consistently more expensive than regular salt. The median LSSS price (11.7 yuan/kg) was significantly higher than regular salt (9.8 yuan/kg, p < 0.001). Price disparities were most pronounced at lower price points. Within-brand and within-supermarket comparisons revealed that the lowest-priced LSSS cost 2.0-fold and 2.2-fold more than the lowest-priced regular salt, respectively. Multiple regression analysis identified that LSSS price was significantly associated with KCl content, salt source, supermarket size and geographic region. Conclusions: Consumer access to affordable, effective LSSS products can be increased by expanding LSSS availability in small supermarkets, incentivizing higher-KCl formulations, and reducing price barriers to consumer adoption, which could substantially contribute to salt reduction at the population level.