Get­ting enough potas­sium re­quires more than a sup­ple­ment

The Saline Courier Weekend - - NEWS - D . GLAZIER

Dear Doctor:

Your re­cent col­umn about how potas­sium can help lower blood pres­sure was quite help­ful, but when I looked into sup­ple­ments, they turned out to be al­most use­less. Why is that? What foods should I be eat­ing?

Dear Reader: Potas­sium is a min­eral that plays a key role in the optimal func­tion­ing of nerves, mus­cles, fluid bal­ance, and, as we wrote about re­cently, the reg­u­la­tion of blood pres­sure. Al­though it’s found in a wide range of whole foods, Americans’ on­go­ing love af­fair with highly pro­cessed and fast foods has led to di­ets that fall short of ad­e­quate potas­sium.

The most re­cent guide­lines for daily potas­sium in­take were re­leased last March by the Na­tional Acad­e­mies of Sci­ence, En­gi­neer­ing and Medicine.

They rec­om­mend a min­i­mum of 2,300 mil­ligrams per day for healthy women, and 3,400 mg per day for healthy men. These new­est rec­om­men­da­tions are lower than those pre­vi­ously es­tab­lished in 2005.

Un­for­tu­nately, ac­cord­ing to the Na­tional In­sti­tutes of Health, the ma­jor­ity of Americans get less than half the amount of the min­eral that they need. It seems log­i­cal that, since you can boost your in­take of just about any vi­ta­min or min­eral with a sup­ple­ment, you should be able to do the same with potas­sium. How­ever, it’s not that simple. Potas­sium has the po­ten­tial to in­ter­act with a va­ri­ety of med­i­ca­tions, in­clud­ing blood pres­sure meds, di­uret­ics and some com­mon pain med­i­ca­tions. De­pend­ing on the spe­cific medication, it can re­sult in potas­sium lev­els that are dan­ger­ously high or dan­ger­ously low. Too much or too lit­tle potas­sium can lead to mus­cle cramp­ing, nerve prob­lems, prob­lems with cognition and po­ten­tially life-threat­en­ing heart ar­rhyth­mias. As a re­sult, the U.S. Food and Drug Ad­min­is­tra­tion re­quires over-the-counter potas­sium sup­ple­ments, in­clud­ing mul­ti­vi­ta­mins, to con­tain less than 100 mg, which is a frac­tion of the rec­om­mended daily in­take.

The good news is that by eat­ing a diet that draws from a wide va­ri­ety of whole and fresh foods, you can meet your daily potas­sium needs. Foods that con­tain high or mod­er­ate lev­els of potas­sium in­clude fish like salmon, tuna, cod and snap­per; most red meats; leafy greens like spinach and chard; black beans, pinto beans and white beans; avo­ca­dos; ba­nanas; apri­cots; pota­toes; to­mato sauce and to­mato paste; water­melon; lentils; can­taloupe; yo­gurt; and co­conut wa­ter. One quick and easy way to give a meal a potas­sium boost is with frozen spinach, which can eas­ily be added to soups and stews and used as a side dish. Beans, beets and avo­ca­dos make great ad­di­tions to sal­ads. Try swap­ping out sweet or salty ul­tra-pro­cessed snacks for can­taloupe or water­melon.

While you’re busy revving up your potas­sium in­take, don’t for­get to con­tinue to be vig­i­lant about salt. The Amer­i­can Heart As­so­ci­a­tion wants adults to eat no more than 2,300 mg of sodium per day, and rec­om­mends we stick closer to a limit of 1,500 mg per day -or less. This is par­tic­u­larly im­por­tant for peo­ple deal­ing with high blood pres­sure, or those who are at risk of car­dio­vas­cu­lar dis­ease.

Al­though get­ting enough potas­sium with­out the help of sup­ple­ments may seem daunt­ing at first, de­lib­er­ate food choices and just a bit of ad­vance plan­ning will get you into the zone.•••

Eve Glazier, M.D., MBA, is an in­ternist and as­so­ciate pro­fes­sor of medicine at UCLA Health. El­iz­a­beth Ko, M.D., is an in­ternist and as­sis­tant pro­fes­sor of medicine at UCLA Health.

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