High blood pressure, or hypertension, affects more than 1.28 billion adults worldwide and is a leading risk factor for cardiovascular disease. Public health guidelines underscore sodium reduction as the best way to reduce hypertension and cardiovascular disease risk.
In the peer-reviewed report, “Rethinking the impact of dietary sodium and potassium on blood pressure to advance public health,” published August 1 in the American Journal of Clinical Nutrition, a team of physicians and health experts propose that dietary impact on hypertension will be greater with a complementary strategy of increasing intake of potassium, which can serve as a salt substitute. This new understanding of potassium’s critical role and efficacy in reducing blood pressure calls for a paradigm shift to consider sodium and potassium together when developing public health recommendations.
“It is time to view dietary interventions holistically because food components interact and physiology is integrative across systems,” said Naomi Fukagawa, M.D., Ph.D., professor of medicine emerita at the Robert Larner, M.D. College of Medicine at the University of Vermont and first author on the report. “Growing evidence shows that increasing dietary potassium as well as reducing sodium intake work together to better manage hypertension.” Dr. Fukagawa formerly served as director of the USDA Beltsville Human Nutrition Center in Maryland.
“Growing evidence shows that increasing dietary potassium as well as reducing sodium intake work together to better manage hypertension.” — Naomi Fukagawa, M.D., Ph.D.
The report examines the basis for current intake recommendations for sodium and potassium, the strategies for sodium reduction and potassium enhancement, implementation challenges, and future directions for research and policy to accelerate public health progress. This work was supported by the Institute for the Advancement of Food and Nutrition Sciences (IAFNS) Sodium in Food and Health Implications Committee, a nonprofit organization that mobilizes members from government, industry, and academia to drive, fund, and lead actionable science in support of public health.
Excessive sodium intake and insufficient potassium consumption are major modifiable contributors to elevated blood pressure. While average sodium intake remains above recommendations, potassium consumption is often “far below optimal levels in both developed and developing nations,” according to the authors.
Potassium intake enhances sodium excretion, modulates vascular tone, and reduces blood pressure. High-potassium diets have consistently been associated with improved cardiovascular outcomes in population studies. Potassium-rich foods include fruits, vegetables, legumes, and dairy. Because there is a maximum level at which potassium salts can be added to foods before a metallic flavor is detected, food makers must carefully approach the balance of sodium and potassium in their products.
The authors conclude that “dietary sodium reduction is a foundational strategy for hypertension prevention and management. However, new evidence supports a broadening of the current approach that focuses solely on sodium reduction and provides equal emphasis on increasing potassium intake.”
Read the report in the American Journal of Clinical Nutrition
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