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Taking salt substitutes may lower risk for heart disease, stroke

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Nutritionists and cardiovascular experts have warned against high sodium (salt) intake due to its ability to increase blood pressure, the danger it poses to cardiovascular health and its ability to predispose people to noncommunicable diseases.

They, however, recommend the consumption of potassium salt substitutes instead of dietary salt (sodium chloride) to reduce such risks.

According to them, sodium and chloride in salt can cause an expansion of the extracellular fluid volume, which over time, causes a rise in blood pressure that results in strokes, heart failure, heart attacks, and kidney disease.

While calling for the replacement of sodium chloride with salty-tasting potassium chloride, experts said decreasing dietary salt intake from the current global levels of 9–12 grams per day to the recommended level of less than 5 grams per day would have a major impact on blood pressure and cardiovascular disease.

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The professionals said that salt reduction strategies are best in the prevention of global noncommunicable diseases and can avert over yearly 2.5 million deaths from heart attacks and strokes.

According to the World Health Organisation, potassium salt substitutes are alternatives to regular salt both as an ingredient of pre-packaged foods and as salt added to food and beverages by consumers.

The WHO noted that the use of potassium salt substitutes also known as low-sodium salt substitutes is increasingly being considered as a potential blood pressure-lowering strategy by national health authorities and public health organisations.

“The amount of dietary salt consumed is an important determinant of blood pressure levels and of hypertension and overall cardiovascular risk. Annually, 17.5 million deaths are attributable to cardiovascular disease, which accounts for an estimated 31 per cent of deaths globally.

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“It is also estimated that one out of every 10 cardiovascular deaths are attributable to salt intake of more than 5g per day,” the United Nations agency added.

Speaking exclusively with PUNCH Healthwise a Registered Dietitian Nutritionist, Olusola Malomo said dietary salt is essential to the body, but its high intake can also raise blood pressure, which can damage the body in many ways.

He said high blood pressure has been linked to heart disease, stroke, kidney failure, and other health-related problems, adding that potassium salt substitute provides a seasoning alternative for manufacturers looking for how to reduce sodium.

He added, “Potassium has many important functions. It allows the nerves to respond to stimulation and muscles to contract, including those in the heart. It reduces the effect of sodium in table salt on blood pressure.

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“It helps to move nutrients into cells, and waste products out of cells. Salt substitutes made from potassium chloride alone look like regular salt and have a salty flavour, but have zero sodium.

“However, potassium doesn’t activate the same taste cells as sodium. That’s why people complain that these substitutes often leave a bitter or metallic aftertaste. Salt substitutes contain potassium chloride, either alone or mixed with regular salt.”

Malomo added that potassium salt is less processed than table salt and retains trace minerals, which add flavour and colour, insisting that sea salt is also available as fine grains or crystals and is often promoted as being healthier than table salt.

On its impact on cardiovascular health, a Consultant Cardiologist at the Lagos University Teaching Hospital, Idi-Araba, Dr Akinsanya Olusegun-Joseph, said the human body needs a small quantity of salt for optimal health and development but too much of it causes the body to retain water.

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“This increase in fluid in the body increases blood pressure, which puts a strain on blood vessels, the heart and kidneys. With this, people with high blood pressure have an increased risk of coming down with heart disease and stroke.

“It’s, therefore, safe to say that everyone should pay attention to and reduce their dietary salt intake. Potassium salt is available in Nigeria and we recommend it to some patients. A lot of people don’t know the quantity of salt they consume daily.

“Too much sodium and the accompanying fluid retention in the body can be very dangerous. But potassium has a way of dilating the vessels and by doing this, the blood pressure will be reduced. The spiral resistance reduces and blood pressure comes down.

“Sodium causes retention of fluid but potassium doesn’t. Potassium will reduce high blood pressure but sodium will increase it. So, potassium salt substitutes have a greater advantage when compared with sodium chloride.”

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Buttressing this position, a study published in the National Library of Medicine titled, ‘Potential use of salt substitutes to reduce blood pressure’,’ by Clare Farrand and her team, affirmed that higher intakes of potassium are associated with decreased blood pressure independent of sodium intake.

The study also suggested that increased consumption of potassium can mitigate the negative effects of high sodium consumption on blood pressure, indicating that the sodium‐potassium ratio of the diet is therefore a major determinant of blood pressure.

“Both sodium and chloride in salt lead to an increase in blood pressure and then cause strokes, heart failure, and heart attacks, as well as kidney disease,” the study stated.

The authors recommended a reduction in sodium use in food manufacturing and processing, and to explore the use of potassium‐based sodium replacers.

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“Further consideration may need to be given to how best to label salt substitutes (namely potassium) in processed foods to ensure that people who may be adversely impacted are aware,” the study recommended.

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SAD! Lassa Fever Claims 127 Lives Across 18 States in Nigeria(List)

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The Nigeria Centre for Disease Control and Prevention (NCDC) has reported a sharp rise in Lassa fever cases, with 127 deaths confirmed across 18 states as of April 6, 2025.

According to the agency’s latest situation report, 674 people have tested positive for the virus out of 4,025 suspected cases recorded between January and early April.

The current Case Fatality Rate (CFR) stands at 18.8%, slightly higher than the 18.5% recorded during the same period in 2024, indicating a worrying upward trend.

The most affected states include Taraba (31 deaths), Ondo (26), Edo (17), Bauchi (12), and Ebonyi (11). Other states with reported fatalities are Gombe (7), Kogi (4), Benue (4), Nasarawa (4), Plateau (5), Kaduna (2), and one death each in Enugu, Delta, Cross River, and Ogun.

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The report also highlights that 71% of confirmed cases were concentrated in Ondo (30%), Bauchi (25%), and Edo (16%), with the remaining 29% spread across 15 other states. The virus has now reached 93 local government areas nationwide.

Lassa fever is a viral haemorrhagic illness transmitted mainly through exposure to food or household items contaminated by infected rodents, particularly the multimammate rat. It can also spread through direct contact with the blood, urine, feces, or other bodily secretions of an infected person.

The disease predominantly affects people between the ages of 21 and 30, with a male-to-female ratio of 1:0.8, according to NCDC data.

In response to the outbreak, the NCDC has activated the National Lassa Fever Multi-Partner, Multi-sectoral Incident Management System to strengthen surveillance, case management, risk communication, and coordination efforts at all levels.

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As the country continues to battle the spread of the virus, the NCDC is urging citizens to maintain proper hygiene, store food in rodent-proof containers, and seek immediate medical attention if symptoms such as fever, headache, sore throat, chest pain, or vomiting occur

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FG identifies 1,277 persons for monitoring as Lassa fever kills 122

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The Nigeria Centre for Disease Control and Prevention has listed 1,277 persons for follow-up over the possibility of being infected with Lassa fever. This follows the centre recording 659 confirmed cases out of 3,779 suspected cases and 122 deaths in 13 weeks (from January to March 30, 2025).

A report obtained from the NCDC on Friday indicated that no fewer than 18 states across the country have recorded Lassa fever cases, with Ondo, Bauchi, and Edo being the most affected.

The report partly reads, “Cumulatively, in week 13 of 2025, 122 deaths have been reported, with a Case Fatality Rate of 18.5%, which is lower than the CFR for the same period in 2024 (18.7%).

“In total for 2025, 18 states have recorded at least one confirmed case across 93 Local Government Areas. Seventy-one per cent of all confirmed Lassa fever cases were reported from these three states (Ondo, Bauchi, and Edo), while 29% were reported from 15 other states with confirmed Lassa fever cases. Of the 71% of confirmed cases, Ondo reported 30%, Bauchi 25%, and Edo 16%.

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“The predominant age group affected is 21-30 years (Range: 1 to 94 years, Median Age: 30 years). The male-to-female ratio for confirmed cases is 1:0.8. The number of suspected cases increased compared to that reported for the same period in 2024. No new healthcare worker was affected in week 13. The National Lassa fever multi-partner, multi-sectoral Incident Management System (IMS) was activated to coordinate the response activities at all levels.”

The report shows that the contacts under follow-up number 1,277, while the contacts that have completed follow-up total 1,448.

According to the NCDC, the disease has affected 20 healthcare workers in eight states so far this year.

Lassa fever is an acute viral haemorrhagic fever caused by the Lassa virus. The natural reservoir for the virus is the multimammate rat (also known as the African rat), although other rodents can also act as carriers.

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The public health institute stated that Lassa fever cases occur year-round, with peak transmission periods typically from October to May.

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WHO calls for countries to address disruptions to TB services

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In the wake of massive cuts in US funding, the World Health Organization (WHO) today called on global health leaders, donors, and policymakers to protect and maintain tuberculosis (TB) care and support services around the world.

In a statement issued ahead of World Tuberculosis Day (March 24), the WHO said the “drastic and abrupt” cuts to global health funding threaten to reverse gains made in global efforts to combat TB, which remains the world’s deadliest infectious disease. Those efforts have saved an estimated 79 million lives worldwide since 2000, the organization said.

“The huge gains the world has made against TB over the past 20 years are now at risk as cuts to funding start to disrupt access to services for prevention, screening, and treatment for people with TB,” said WHO Director-General Tedros Adhanom Ghebreyesus, PhD. “But we cannot give up on the concrete commitments that world leaders made at the UN General Assembly just 18 months ago to accelerate work to end TB. WHO is committed to working with all donors, partners and affected countries to mitigate the impact of funding cuts and find innovative solutions.”

USAID cuts have crippled TB control efforts

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While the statement does not specifically mention the US Agency for International Development (USAID), the Trump administration’s freeze of USAID funding, and the subsequent canceling of thousands of contracts issued by the agency, have left a gaping hole in funding for TB prevention, screening, and treatment services. The US government has been the leading bilateral donor to global TB control efforts, contributing $200 million to $250 million annually—roughly one quarter of international donor funding for the disease.

The WHO said 27 countries are facing crippling breakdowns in their TB response, with the biggest impact seen in high-TB burden countries in Africa, Southeast Asia, and the Western Pacific. Among the services that have been disrupted are diagnosis, active case finding, screening, and contact tracing, and those disruptions are resulting in delayed detection and treatment and increased transmission risk. Drug supply chains, laboratory services, and data and surveillance systems have also been undermined.

A recent update from StopTB Partnership, which works on TB response with more than 2,000 partners in 100 countries, provides some detail on the services affected by the USAID funding cuts. In Cambodia, active case finding has halted in half the country, resulting in 100,000 people missing TB screening and 10,000 cases of drug-susceptible (DS)-TB going undetected. In Kenya, sputum sample transport once supported by USAID has halted, affecting the diagnosis of DS- and drug-resistant (DR)-TB. In India, USAID-funded TB screening projects in vulnerable groups have stopped.

The huge gains the world has made against TB over the past 20 years are now at risk as cuts to funding start to disrupt access to services for prevention, screening, and treatment for people with TB.

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Those are just three of dozens of examples. In a news release today, StopTB Partnership Executive Director Lucica Ditiu, MD, echoed Tedros’s call for action.

“People with TB need us,” Ditiu said. “We have to remain strong, and we can never ever give up the fight. Through innovative, global and national efforts and standing together, we will be able to achieve these targets of ensuring TB prevention, treatment, and care are accessible to all.”

TB was responsible for an estimated 1.25 million deaths in 2023, according to the WHO’s most recent annual report. An estimated 8.2 million people were newly diagnosed with the disease—the most cases in a year recorded by the WHO since it began global TB monitoring in 1995. High-burden TB countries have only recently begun to recover from the disruptions caused by the COVID-19 pandemic, which the WHO estimates resulted in 700,000 excess TB deaths.

Cuts exacerbate funding shortfalls

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As the WHO notes, the funding cuts come amid what was already a shortfall in funding for global TB control efforts. In 2023, $5.7 billion was available for TB prevention, diagnostic, and treatment services in low- and middle-income countries, but that’s only 26% of the 2027 target goal of $22 billion. TB research is receiving just one fifth of its 2022 target of $5 billion. Cuts to US funding are only going to exacerbate the problem.

In a joint statement issued earlier this week, Tedros and the Civil Society Task Force on Tuberculosis called on countries to take urgent action to prevent any disruption to TB services, ensure domestic resources to sustain equitable and essential TB care, and safeguard essential TB drugs, diagnostics, care, and social protection coverage for TB patients. They also urged the establishment of national partner platforms that would bring together public and private sectors, civil society, nongovernmental organizations, professional societies, and donors to maintain momentum against TB in affected countries.

“This urgent call is timely and underscores the necessity of swift, decisive action to sustain global TB progress and prevent setbacks that could cost lives,” said Tereza Kasaeva, PhD, director of WHO’s Global Programme on TB and Lung Health, in today’s WHO news release.

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