Photo by Donna Turner Ruhlman

Yesterday the NYTimes covered an important health ratio: the amount of potassium relative to the amount salt you consume. While the article by long time health reporter, Jane Brody, leads with the obvious (excessive salt has proven to be a health risk, according to yet another major study), and the headline writer reinforce the obvious (“Sodium-Saturated Diet is a Threat for All”), the article recognizes that everything is about balance and notes the important role potassium-rich foods play in countering salt’s negative effects.

“The researchers found that while a diet hight in sodium—salt is the main source—increases your risk,” Brody writes, “even more important is the ratio of sodium (harmful) to potassium (protective) in one’s diet.”

This was pointed out to me this summer by Mark Bitterman, author of a great book called Salted, and owner of the specialty store The Meadow (in Portland and Manhattan) via this Seattle P.I. blog post. And I’m glad to see the weighty Times take note.

Even more interesting is Brody’s suggestion that one if potassium’s benefits is that it “activates nitric oxide, and thus reduces pressure in the arteries, lowering the risk of hypertension.” I’m not a nutritionist or chemist but my guess is that this nitric oxide is possible because of the high quantities of nitrates in the vegetables we eat; it certainly makes sense, since nitrates convert to nitrites which convert to nitric oxide. I’d be grateful for any experts to weigh in here as to why potassium is so important and how it works. (See my related post on the “no-nitrates-added” hoax used to market bacon.)

The article goes over what any literate American should know: that most of the salt we consume (75% according to Brody) comes from processed food. My contention has always been and remains that if you cook your own food, you can salt it to pleasurable levels and not live in terror of salt.

But now, you charcutepaloozians, dry-curers and bacon lovers can, in addition to cooking your own food, be sure to eat plenty of potassium-rich foods: bananas, canteloupe, oranges, grapes, grapefruit, blackberries, legumes, leafy greens (which are also nitrate-rich), potatoes and sweet potatoes. You should eat these foods anyway.  And listen to your body.

Perhaps this is why I start every morning with a glass of grapefruit juice and red grapes with my coffee. I never knew why I craved these things. Now I think I do.

If you liked this post on Salt, check out these other links:

© 2011 Michael Ruhlman. Photo © 2011 Donna Turner-Ruhlman. All rights reserved

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21 Wonderful responses to “The Potassium Effect: Important Ratio”

  • Carolyn Z

    I am a sodium sensitive person; this is hereditary. I try not to eat processed foods, and now I can use a small amount of salts to season meals. The taste is wonderful. I’ve missed it all these years. Nice to have an article that talks about the balance of sodium to potassium in a healthy diet for the layperson.

  • Wilma de Soto

    In Spanish the phrase “estás salado” means unlucky. It’s lucky you’ve listed the potassium rich foods in this post because I cannot live without salt.

  • Linda Langness

    Every once in a while I eat potato chips, but not many;otherwise, I do not eat fast food, nor do I eat processed foods. I cook almost all my own food (I do not make cheese), including, after this past year’s participation in Charcutepalooza, my own sausage, pates, smoked food, etc. If someone spent an hour in the grocery store looking at the labels of their favorite foods, they would discover that most food is full of sodium, corn syrup, un-pronounceable chemicals, more corn, e.g., guar gum, and un-identified body parts (animal by-products), and, they wouldn’t eat it. If they figured it was okay because the government said so, and ate it anyway, I’d guess they just voted to shorten their own lives.

  • JaySeeDub

    I think that should be “nitric oxide,” and not “nitrous oxide.”

    Simply, potassium has been seen to correlate with NO uptake and response outside of cells. The more there are, the more NO that a cell can take in. Your body makes NO, if it’s vascular (heart related), it’s in the endothelium and made by an enzyme called endothelial NOS (eNOS). Potassium channels, possibly, open up. NO is detected on the vascular tissue, which opens up the NO receptors on those tissues and the NO receptors on nearby smooth muscle tissues. Both sets of tissue absorb NO, which is a signal for the tissues to relax.

    • ruhlman

      many thanks for catching the nitrous/nitric error, now fixed. and thanks for taking the time to explain the effects, though it remains kind of complicated and unclear. my fault, not yours!

  • Dorothy

    Does using lite salt (sodium chloride and potassium chloride) help with potassium intake?

  • JaySeeDub

    Dorothy
    Does using lite salt (sodium chloride and potassium chloride) help with potassium intake?

    As a source of potassium? Yes. As a substitute for the flavor enhancing and bitter reducing qualities of sodium? No. Potassium has the opposite effect of sodium when it comes to taste. Where sodium can open up flavor receptors, potassium seems to only open up “bitter” receptors. Which is why lite salt has such off taste.

  • Elisabeth

    As long as you don’t already have heart disease, I don’t think there’s any reason to curtail salt. Processed food causes heart disease and cancer independently of the salt content, I believe, because of the high levels of white flour, sugar and HFCS it contains.

  • Chris Mower

    I agree with you about the processed food. For me, processed food always tastes too salty to begin with (especially canned soups and broths). In general, I find much more pleasure in cooking my own food, salting to taste, and avoiding the processed goods.

    On another note—and somewhat unrelated—I’ve recently learned that having too much salt can cause you to experience vertigo. As NaCl travels through the body and finds its ways to the ears, it attracts extra H20 to the vestibular labyrinth, causing it to swell.

  • allen

    The joke’s are common about the dreadful mother in law and I often cringe failing to find the humor as I dearly love my mother in law. She’s a wonderful person and every Christmas she bakes me a mince meat pie from a very old recipe, with a delicious flaky crust.
    This year I found the perfect beverage to pair it with: two year old eggnog with fresh grated nutmeg from an old posting on this blog.

    Of course the first glass is a toast the father of a fine son, Mr. Rip Ruhlman, wishing you and your family a warm, loving, prosperous and wonderful new year and to all of the followers of this blog I wish you the same,
    If I could share a glass with you it would not be enough. This is liquid gold and the taste is amazing. One glass is a teasing taunt to the palate and by no means enough to satisfy. It has everything that you crave and satisfies the soul adding cheer and wish for more.
    If you haven’t already made some aged eggnog be sure and make a double large batch for next year. You’ll need a double batch so you can share the goods with special loved ones and friends.
    Happy holidays and best wishes for the coming new year!

  • karen downie makley

    Not too long ago, I read a book that indicated that people who are subject to high levels of stress actually NEED an above-average amount of salt to regulate the function of their adrenal glands, which is why tightly-wound types crave chips, pretzels, and other salty fare. This explained a lot, and helped me understand why I crave and consume a goodly amount of salt and yet maintain lower-than-average blood pressure (thereby exempting me from having to be a lemming to the “OMG! OMG! THROW YOUR SALT SHAKER AWAY RIGHT NOW!!!” mentality that is out there, thank God) Your awesome article explains why I almost always reach for an orange or grapefruit at breakfast. Thanks!

  • Susie

    Happy and healthy 2012 to all. And huge thanks, Michael, for the informative article.

  • Dan

    I’m not buying this hypothesis. Sodium-potassium homeostasis is under exquisite control in normal physiological conditions. You can’t simply eat your way into/out of an imbalance. If you could, a salty snack might instantly cause a seizure (normal neural and muscular electrophysiological activity can occur because of this homeostatic balance). Likewise, we could inhibit seizure activity in seizure-prone children simply by feeding them bananas, but alas, it doesn’t work. I still contend that for most people salt consumption is simply a non-issue. There likely exists a subpopulation of people who are indeed “salt-sensitive,” and this is likely the result of harboring a non-deleterious genetic variant (or handful of said variants). The money currently going in to developing public policy by the anti-salt contingent would better be served in the hands of genetics scientists who could perform GWAS studies on patients to elucidate these underlying variants.

    I also think that the idea that a high salt diet as a recent phenomenon due to the influx of processed foods into our diet is also likely untrue. Go back two to three generations to when we regularly processed foods at home for long-term storage (pickling, charcuterie, etc.) and look at the recipes used. You find salt concentrations that seem unreal by today’s standards. Nor is a high salt diet a particularly American phenomenon as frequently purported. I live in Japan, and the average person here consumes far more salt than a typical American.

    Also, although nitrates can be reduced into NO in animals (as well as be a product of the mitochondrial electron transport chain), I believe most NO in humans is actually synthesized from the conditionally nonessential amino acid L-arginine. My biochemistry is a bit rusty, but I believe it goes something like this: L-arginine + 3/2 NADPH + H+ + 2 O2 = citrulline + nitric oxide + 3/2 NADP+.

  • Rachel

    This post inspired me to break out my biochemistry book from college. According to the text, nitric oxide (NO) is made from the amino acid arginine and an oxygen molecule by the enzyme nitric oxide synthase. Since the reaction does not involve nitrates, these compounds from plants wouldn’t have any effect on NO production in the body. It is more likely the potassium in the plants that enhances NO production. As for how potassium does this, I don’t know the details but would love an explanation. Hope this helps!

  • Chuck McLean

    An 8 oz. glass of low-sodium V8 juice has just 140 mg of sodium and 820 mg of potassium.

  • JW

    Michael,

    I believe we touched on this issue in a previous post, but to expand, the relation between nitric oxide & potassium likely involves separate mechanisms. One of my collaborators, Dr. Jennifer Pollock, is a world expert in nitric oxide and knows of no such link.

    Nitric oxide is produced by healthy vascular endothelium and when released causes vasodilation (relaxation). As others have pointed out, NO is produced by the enzyme nitric oxide synthase from the precursor amino acid l-arginine. There are many possibilities to improve NO production, including ingestion of substances high in arginine, certain drugs termed NO donors (mostly vasoactive nitrates and a specific beta-blocker called nebivilol aka Bystolic), and antioxidants.

    As for potassium, it is the ratio of potassium to sodium that is important. There are several mechanisms that likely explain low potassium intake and the link to hypertension. Potassium is the major intercellular cation. Sodium is the major extracellular cation. Potassium deficiency likely leads to intercellular “cation” deficiency causing an increase in intercellular sodium (and global sodium retention) in order to maintain cellular osmolality. On the flip side, adequate potassium hyperpolarizes endothelial cell membranes which is transmitted to vascular smooth muscle cells which leads to decreased intercellular calcium and promotes vascular relaxation. (wordy).

    High sodium negates many of the positive effects of dietary potassium and actually contributes to urinary losses of potassium.

    Sorry for the wordiness…I’m not a writer.

    JW

  • NJ

    Those of us with Addison’s Disease are all too aware of the importance of the sodium-potassium ratio. When we become aware we have this disease, it is usually after the ratio has tilted in favor of the potassium and we have an Addisonian Crisis, (kind of like flu symptoms) and end up in the hospital. Consequently, it is OK for me to like salt.

  • Jon

    I don’t know if anyone has pointed you to a paper that discusses your idea about nitrates and nitric oxide production, but you’ll be interested in this paper:

    http://www.ajcn.org/content/90/1/1.full.pdf+html

    Not only do they discuss the roles of dietary nitrates and nitrites in nitric oxide production, but they also list the concentrations of nitrates and nitrites in various vegetables, fruits, and cured/processed meat produces.

    It’s a pretty great reference.

    • Michael Ruhlman

      i read Hord’s paper from July 2009, but not this. was this just published?

      thank you!

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