• Faxuan Wang, Yangyang Pi, Yi Zhao, Yuhong Zhang, Bo Zhou, Zhifang Li, Jixin Sun, Yan Yu, Maoyi Tian, Minghui Yang, Liping Huang, Hongyi Song, Bruce Neal, and Katrina R Kissock.
• School of Public Health, Ningxia Medical University, Yinchuan, Ningxia, China.
• Bmc Med. 2024 Sep 4; 22 (1): 366366.

BackgroundAssociations of dietary sodium and potassium intake with fracture risk are inconsistent and the effects of salt substitute on fracture incidence are unknown. We assessed the effect of salt substitute compared to regular salt intake on fracture incidence using data from the Salt Substitute and Stroke Study (SSaSS).MethodsSSaSS was a cluster-randomized controlled trial conducted in 600 villages in northern China. Villages were randomly allocated into intervention and control groups in a 1:1 ratio. Salt substitute was provided to intervention villages and control villages continued regular salt use for 5 years. The primary outcome for this secondary analysis was the incidence of all fractures. Secondary outcomes included incidence of vertebral fracture, non-vertebral fracture, and fracture of unknown or non-specific location.Results20,995 participants were included in this study, and 821 fractures occurred during follow-up. Intention-to-treat analyses showed no differences between the salt substitute and regular salt groups in the incidence of all fractures (rate ratio (RR) 0.96; 95% CI 0.81 to 1.14), vertebral fracture (RR 0.82; 95% CI 0.53 to 1.26), non-vertebral fracture (RR 1.05; 95% CI 0.86 to 1.29), or fracture of unknown or non-specific location (RR 0.80; 95% CI 0.54 to 1.18).ConclusionsUse of salt substitute compared to regular salt had no detectable effect on the incidence of fracture in a population at high risk of cardiovascular disease and fracture.Trial RegistrationClinicalTrials.gov, NCT02092090. Registered on March 12, 2014.© 2024. The Author(s).

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