Background/Objectives: High sodium consumption increases the risk of hypertension and cardiovascular disease. Although food remains the primary source of intake, elevated sodium levels in drinking water can further contribute to excessive intake, particularly in populations already exceeding recommendations. This review examines the extent to which national drinking water standards account for sodium-related health risks and aims to inform discussion on the need for enforceable, health-based sodium limits. Methods: National standards for unbottled drinking water in 197 countries were searched for using the WHO 2021 review of drinking water guidelines, the FAOLEX database, and targeted internet and AI searches. For each country, data were extracted for the document name, year, regulatory body, regulation type, sodium limit (if stated), and rationale. Socio-geographic data were sourced from World Bank Open Data. A descriptive analysis was conducted using Microsoft Excel. Results: Standards were identified for 164 countries. Of these, 20% (n = 32), representing 30% of the global population, had no sodium limit. Among the 132 countries with a sodium limit, 92% (n = 121) adopted the WHO’s palatability-based guideline of 200 mg/L. Upper limits ranged from 50 to 400 mg/L. Only twelve countries (9%) cited health as a rationale. Three countries—Australia, Canada, and the United States—provided a separate recommendation for at-risk populations to consume water with sodium levels below 20 mg/L. Conclusions: Globally, drinking water standards give inadequate attention to sodium’s health risks. Most either lack sodium limits or rely on palatability thresholds that are too high to protect health. Updating national and international standards to reflect current evidence is essential to support sodium reduction efforts. Health-based sodium limits would empower communities to better advocate for safe water. Amid rising water salinity, such reforms must be part of a broader global strategy to ensure universal and equitable access to safe, affordable drinking water as a basic human right.

Background: 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. Methods: 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. Results: 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. Conclusion: 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.

Background : Switching to potassium‐enriched salt in food manufacturing and preparation is expected to lower blood pressure and improve stroke and cardiovascular disease outcomes. However, it is not well understood how the Australian salt supply chain would support increased use of potassium‐enriched salt. Objective : To explore food industry insights and perspectives on (1) how the salt supply chain operates in Australia and (2) technical considerations for switching to potassium‐enriched salt in food manufacturing and preparation. Methods : Twelve interviews with food industry stakeholders (including food, salt, and potassium‐salt manufacturers) were conducted between March and July 2023, transcribed, and thematically analysed using a template analysis method in NVivo. Results : The regular sodium chloride salt supply chain in Australia was described as well‐established, relatively simple, and mostly local, whereas the potassium‐enriched salt supply chain was less established, separate from the sodium chloride supply chain, and reliant on imported ingredients. Most stakeholders, except potassium‐enriched salt manufacturers, perceived cost, taste, and functionality as barriers to increased uptake of potassium‐enriched salt as a food ingredient. Potential enablers included strengthening the potassium‐enriched salt supply chain in Australia to withstand international changes, research and development, and retail promotion of potassium‐enriched salt. Conclusions : Opportunities exist to strengthen food industry support for switching to potassium‐enriched salt in Australia. Addressing feasibility and acceptability concerns through coordinated support from other sectors, along with incentives for industry adoption, is required. Industry uptake of potassium‐enriched salt use in packaged food is essential to realising the full potential of this promising public health strategy.

Background: Consideration of sex and gender in nutrition research is needed to inform best practice interventions and policy. It is unknown how nutrition and dietetic journals comply with sex and gender reporting guidelines. Objective: To determine if female representation and adherence to sex and gender guidelines across the leading nutrition and dietetic journals have changed between 2012 and 2022. Design: Quantitative analysis of articles published in 10 nutrition and dietetic journals was conducted. We screened a random sample of at least 100 articles per journal and year, aiming to include 50 randomly selected articles published in 2012 and 50 published in 2022 per journal. Articles were included if they were original research, conducted in humans, and focused on nutrition. Review articles and those focused on sex-specific conditions were excluded. Methods: Data were compiled on the proportion of female participants in published studies and compliance with the International Committee of Medical Journal Editors (ICMJE) guidelines relating to sex and gender. Changes in compliance with ICMJE guidelines between 2012 and 2022 were assessed using chi-square tests. Results: A total of 812 articles (402 in 2012, 410 in 2022) were included. Female representation was 56% in both years. Increases in adherence to ICMJE guidelines included reporting of sex and/or gender (90% in 2012 to 94% in 2022, p = 0.03), statistical comparison by sex and/or gender (38% in 2012 to 48% in 2022, p = 0.02), and definition of sex and/or gender terminology (0% in 2012 to 2% in 2022, p = 0.002). There was no evidence of a change in single-sex study justification, stratification of results by sex and/or gender, justification if not stratified, and discussion of sex and/or gender-related factors between time points. Conclusion: Greater inclusion of sex and gender considerations in nutrition research is required to inform best practice interventions.

Switching from regular salt to potassium-enriched salt lowers blood pressure and cardiovascular risk, but this intervention is underutilised by healthcare professionals. We assessed Australian healthcare professionals’ knowledge, attitudes and practices (KAP) regarding regular salt and potassium-enriched salt for hypertension management. We used mixed-methods research including surveys to quantify KAP towards regular salt and potassium-enriched salt and semi-structured interviews to gather in-depth information about knowledge, attitudes and the barriers and opportunities for recommending potassium-enriched salt use in clinical practice. Participants were general practitioners, medical specialists and allied health professionals working in Australia and caring for individuals with hypertension. Ninety-nine participants completed the survey, and thirty-six participants completed interviews. Survey participants generally had high knowledge related to regular salt; most were aware of potassium-enriched salt (94 %), but only 49 % reported familiarity with it. Of those aware, 73 % considered it safe to use and 66 % knew of the blood pressure-lowering benefits. Only 14 % had recommended it in the previous 12 months, though most interview participants were willing to recommend it in the future. Key barriers to recommendation were limited knowledge about potassium-enriched salt, insufficient time to discuss use with patients and concerns about taste, availability and affordability. The key opportunity identified was incorporating recommendations and information about potassium-enriched salt into existing resources supporting hypertension management by clinicians. Healthcare professionals are mostly aware and supportive of recommending potassium-enriched salt but lack in-depth knowledge. Advice about using potassium-enriched salt needs incorporation into clinical education programmes and hypertension management systems.