From 1972 to 1992, a landmark study on heart disease was performed in Finland. The study reduced sodium or salt consumption while increasing potassium consumption.
The results were literally heard around the world—but then somehow forgotten.
During this 20-year study, when heart patients increased their ratio of potassium to sodium, the rate of death from stroke decreased by 62 percent in men and 63 percent in women. The rate of death from ischemic heart disease decreased by 55 percent in men and 68 percent in women. (1,2)
Volumes of follow-up research confirmed the link between low potassium and high sodium (salt) intake and cardiovascular concerns. (1,2)
Western diets are insidiously high in salt and low in potassium, and reversing these ratios requires a concerted effort to change the American diet.
According to the USDA, the average American consumes only 2640 mg of potassium per day, while the suggested dietary intake for adults is 4700 mg—making most Americans deficient in potassium. (3)
Sodium intake in America averages at 3330 mg/day, which is more than twice the suggested intake of 1500 mg/day. (4,5)
Compare that to our hunter-gatherer ancestors, who consumed a whopping 7000 milligrams of potassium per day, with less than 1000 daily milligrams of sodium. (5)
Vegetarians Naturally Eat More Potassium
Centenarian cultures around the world consume mostly plant-based diets with only 10 percent animal protein and daily servings of high-potassium and low-sodium fruits, vegetables, beans, whole grains, nuts, and seeds.
For more on the diets and lifestyles of centenarian cultures, watch my podcast with best-selling Blue Zone author, Dan Buettner.
Studies on groups of vegetarians such as the Trappist Monks, Seventh-Day Adventists, and vegetarian groups in Boston and Israel found that high blood pressure, heart disease and strokes were rare events in these communities. (2)
Another study showed that vegetarian diets are successfully used for the treatment of heart failure and cardiovascular disease. Potassium-rich, plant-based vegetarian diets have also been found to lower blood pressure, blood lipids, and reduce platelet counts while being beneficial in weight management and reducing the risk of developing metabolic syndrome and type 2 diabetes.
One study concluded that vegetarian diets have a hand in preventing and reversing atherosclerosis and decreasing cardiovascular disease risk—reducing the risk of dying from heart disease by 40 percent. (6)
Vegetarian diets, by definition, require followers to consume many more high-potassium fruits, vegetables, whole grains, beans, nuts, and seeds.
Studies that reported on people who ate red meat once a month, or were lacto-ovo vegetarians or pescatarians (all-high potassium, low-sodium diets) saw significant cardiovascular health rewards compared to non-vegetarians. (7,8)
Signs of Low Potassium (1,2,9,14)
Normal potassium serum levels are considered to be between 3.6 – 5.2 mmol/L. Levels lower than 3.6 mmol/L are considered to be mild hypokalemia which is associated with:
- Increased blood pressure
- Fatigue and tiredness
- Increased bone turnover
- Muscle cramps
- Increased risk of kidney stones
- Constipation
Moderate to severe hypokalemia is defined as less than 2.5 mmol/L and is considered potentially life-threatening. Signs include:
- Glucose intolerance
- Poor respiration
- Increased risk of cardiac arrhythmia
Overall, insufficient potassium intake is linked to multiple health risks, including increased risk of hypertension, stroke, and type 2 diabetes.
Reversing Low Potassium and High Sodium with Diet
Studies suggest that the best way to glean the benefits of adequate potassium in the diet is to eat more potassium-rich, plant-based foods and less salt.
Experts in this field, like Richard Moore MD, PhD, suggest a potassium ratio of 4:1, meaning that we should consume 4 times as many milligrams of potassium as we do milligrams of sodium.
Today, the normal range for potassium in a blood test is 3.6-5.2 mmol/L. Your suggested goal is to be at the upper end of this range at 6 mEq/L on your next blood test.
The key is to not only eat more high-potassium foods, but to also eat low-sodium (low-salt) foods as well. Some of my favorite foods in this category include:
- Whole grains are good, but oatmeal tops the list.
- All fruits are great, but avocado, banana, cantelope, dates, coconut, peaches, plantains, and strawberries top my list.
- Almonds, walnuts, and pecans have great potassium to sodium ratios, as do all nuts.
- All beans are great, but black beans and kidney beans top the list, as do garbanzo beans and lentils.
- All vegetables have high potassium-to-sodium ratios, but white potato with the skins are extremely high.
A Cautionary Note
The takeaway here is NOT to avoid salt/sodium and to only eat potassium rich-low sodium foods. Both are electrolytes needed to drive the sodium-potassium pump, mitochondrial energy, muscle contractions, and healthy lymphatic flow.
Avoid high-sodium foods by avoiding packaged foods. It turns out that whenever humans get a hold of a whole food, they package it and preserve it with salt, so avoid packaged foods—no wrappers!
Potassium and Magnesium Deficiencies Linked
A 2006 survey reported that almost half (48%) of the American population was deficient in magnesium. Magnesium is linked to many of the health concerns seen with potassium deficiencies. (13) If potassium levels are low, magnesium levels will also be low.
In one study in an elderly population, 20% of those tested were found to be deficient in both potassium and magnesium. (10)
Magnesium and potassium are closely linked, as magnesium protects the cells from losing potassium. In one study, 42% of those who were deficient in magnesium were also deficient in potassium.
This information suggests that these two minerals should always be taken together—because they are depleted together. (11)
These two minerals are involved in thousands of chemical processes in the body linked to numerous health concerns. In addition to bone, heart, circulatory, blood sugar, kidney, and metabolic health, they may play a leading role in the healthy contractions of muscles leading to weakness, cramping, and loss of muscle mass. They play a critical role in cardiovascular health, as the heart and arteries depend on magnesium and potassium for healthy muscular contractions. (11,12,)
Learn more about safe Potassium-Magnesium supplementation
Disclaimer: Certain medications for high blood pressure and hypertension are contraindicated with potassium supplementation. People with kidney disease, diabetes, heart disease, Addison’s disease, stomach ulcers, or other health problems should never take potassium supplements without talking to a doctor first.
Signs of a potassium overdose include muscle weakness or paralysis, irregular heartbeat, confusion, tingling sensation in the limbs, low blood pressure, and coma. Get emergency medical help immediately.
Hello Dr Douillard..
I wanted to ask about the cautionary note you made in practical measures for optimal Lymphatic flow.. Is there a metric for the balance of salt/ potassium in terms of how to know how many grams of salt per day or per meal, or per serving… given that you are eating otherwise a low salt high potassium diet already.. I am pretty much 75-85% plant- 25/35 meat/ fish/dairy, basically a plant based omnivore.. I eat meat and dairy.. the occasional carb in the winter, no sugar other than whole fruits…Living in California makes it very easy.. How would I gauge how much salt would be for optimal Lymphatic flow?
not worried about the Fukushima radioactive waste or you just watch cnn? take sea salt or Himalayan, from what I read it contains over 40 minerals, and salt is needed anyway for good digestion!
Lysine Arginine ratio is thru the roof with dense nuts, so wary of that recourse because flesh can be eaten, v being sustained… high vata mid fifties…
Recently… every 4 out of seven days AM baked potato in oven then stuff n it when bell goes off, then eat in twenty or so… all in an effort to fuel run in the am, because more than one doc says i got to zone II in the AM moreso than at 16:40 fav run time…
N o w I read about “All vegetables have high potassium-to-sodium ratios, but white potato with the skins are extremely high.”
Yippee!!! :♥) S c o r e !!!
Why is sea salt always recommended? Isn’t the sodium in a inorganic rock form instead of a plant form (which is for humans to consume)? Or do we get enough sodium in the plants and fruit we eat, if we eat them enough daily?
In my blood tests over the years, my potassium has always been higher than normal – I am on a good track I wonder?
Great article, thanks! re-affirming to a whole plant, whole food diet with quality protein….I did get a chuckle out of your suggested fruits in the article above: avocado, dates, and….antelope! OK, had that once in an eclectic organic restaurant! and I do love cantelope too. Thanks again for all your great research and sharing of the info in an accessible way. Beautiful!