According to global data, the average daily sodium intake exceeded the World Health Organization’s (WHO) recommended limit of 2,000 mg per day. The high intake of sodium is often attributed to processed foods and added salt, particularly in areas where climate change and increasing water salinity compromise water quality.
High sodium levels in drinking water have been linked to severe conditions, including high blood pressure (BP), preeclampsia, low cognitive function, and high infant mortality rates. The WHO’s current Guidelines for Drinking Water Quality (GDWQ) do not provide health-based recommendations to suggest a non-binding palatability threshold of 200 mg/L. Around 1.9 million fatalities annually were observed with cardiovascular disease caused by high sodium intake. As per a 2023 study, a total of 29 research papers on the relationship between BP and water salinity found that only 15 studies reported a positive correlation.
The increase in sea levels has been negatively reported in South and Southeast Asian coastal ecosystems, according to the Intergovernmental Panel on Climate Change (IPCC). The study aims to analyse and identify national drinking water salt restrictions across the world with respect to more robust and universal health-based limitations. Official drinking water standards from 197 nations were evaluated in a desk-based study conducted between September 2024 and May 2025.
In 2021, the WHO used the Food and Agriculture Organization (FAOLEX) database and supplemented it with focused internet searches powered by AI programs, including Google and Microsoft Copilot, as major sources. Suppose the documents mentioned specific limits for substances in water or included official standards with proof of the body responsible. Specified limits in scholarly literature without citing the source, by consumer or health organizations, were excluded. The online World Bank Database was used to collect sociodemographic information, including population, geographic location, GDP, and income status.
There were no official papers regarding drinking water available for the 33 countries, which collectively represent 5% of the global population. The United States, Canada, and Australia are the only nations that have set a recommended sodium intake limit of 20 mg/L for those who are controlling their sodium intake. Australia’s guidelines further state that if the sodium levels in drinking water exceed 20 mg/L, patients with congestive heart failure or severe hypertension should be informed about this situation.
Data were not present for many nations except in America (n=10) and Africa (n=15). Only 9% of drinking water regulations in 12 countries mentioned health and safety considerations to establish increased salt levels. Europe is the most uniform country, while almost all countries have regulated the 200 mg/L limit as per European Union (EU) guidelines.
Conversely, Asian countries, along with America, reported the highest percentage of countries lacking sodium restrictions in their drinking water standards. Most drinking water guidelines lack health-based salt limitations, which is considered a serious public health failure. Modelling studies have shown that salt levels trends are particularly relevant in climate-vulnerable regions, reinforcing the need for targeted action. Ensuring a low sodium amount in drinking water is vital for health equality and chronic disease prevention, particularly as climate change and unsustainable water use continue to increase salinity levels worldwide.
Reference: Crowther J, Palu A, Dunning A, et al. Global drinking water standards lack clear health-based limits for sodium. Nutrients. 2025;17(13):2190. doi:10.3390/nu17132190
