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Nutrients
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The Role of Dietary Potassium in Human Health
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The Role of Dietary Potassium in Human Health

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Micronutrients and Human Health".

Deadline for manuscript submissions: closed (10 December 2021) | Viewed by 23768

Special Issue Editor

Dr. Rachael McLean

E-Mail Website
Guest Editor
Department of Preventive and Social Medicine, University of Otago, Dunedin 9054, New Zealand
Interests: diet; cardiovascular disease; dietary sodium and potassium; epidemiology; population health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Dietary potassium is associated with positive health outcomes, including lowered blood pressure and decreased risk of cardiovascular disease (particularly, stroke and myocardial infarction). Despite the diffusion of remarkably consistent dietary recommendations around the world, many populations consume less potassium than is advised. Fruit and vegetables are important sources of dietary potassium, besides providing other healthy factors such as dietary fibre.  Research to determine the dietary potassium intake in individuals and populations and interventions to increase potassium and fruit and vegetable intakes are needed, as is further research on the relationship between potassium and sodium intakes and a variety of health- and disease-related outcomes. This Special Issue on “Dietary Potassium and Human Health” aims to further our understanding of this important issue and welcomes a range of submissions, from mechanistic studies to those focussing on population-level interventions.

Dr. Rachael McLean
Guest Editor

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Potassium
  • Salt
  • Sodium
  • Blood Pressure
  • Cardiovascular Disease
  • Nutrition
  • Prevention
  • Population
  • Dietary Assessment

Published Papers (7 papers)

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Editorial

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3 pages, 196 KiB  
Editorial
Salt Substitutes—An Important Tool to Increase Potassium and Reduce Sodium Intakes?
by Rachael Mira McLean
Nutrients 2023, 15(12), 2647; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15122647 - 06 Jun 2023
Cited by 2 | Viewed by 1137
Abstract
Potassium is an essential mineral and is the main cation in intracellular fluid [...] Full article
(This article belongs to the Special Issue The Role of Dietary Potassium in Human Health)

Research

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12 pages, 606 KiB  
Article
Urinary Potassium Excretion, Fibroblast Growth Factor 23, and Incident Hypertension in the General Population-Based PREVEND Cohort
by Stanley M. H. Yeung, Ewout J. Hoorn, Joris I. Rotmans, Ron T. Gansevoort, Stephan J. L. Bakker, Liffert Vogt and Martin H. de Borst
Nutrients 2021, 13(12), 4532; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13124532 - 17 Dec 2021
Cited by 2 | Viewed by 2466
Abstract
High plasma fibroblast growth factor 23 (FGF23) and low potassium intake have each been associated with incident hypertension. We recently demonstrated that potassium supplementation reduces FGF23 levels in pre-hypertensive individuals. The aim of the current study was to address whether 24-h urinary potassium [...] Read more.
High plasma fibroblast growth factor 23 (FGF23) and low potassium intake have each been associated with incident hypertension. We recently demonstrated that potassium supplementation reduces FGF23 levels in pre-hypertensive individuals. The aim of the current study was to address whether 24-h urinary potassium excretion, reflecting dietary potassium intake, is associated with FGF23, and whether FGF23 mediates the association between urinary potassium excretion and incident hypertension in the general population. At baseline, 4194 community-dwelling individuals without hypertension were included. Mean urinary potassium excretion was 76 (23) mmol/24 h in men, and 64 (20) mmol/24 h in women. Plasma C-terminal FGF23 was 64.5 (54.2–77.8) RU/mL in men, and 70.3 (56.5–89.5) RU/mL in women. Urinary potassium excretion was inversely associated with FGF23, independent of age, sex, urinary sodium excretion, bone and mineral parameters, inflammation, and iron status (St. β −0.02, p < 0.05). The lowest sex-specific urinary potassium excretion tertile (HR 1.18 (95% CI 1.01–1.37)), and the highest sex-specific tertile of FGF23 (HR 1.17 (95% CI 1.01–1.37)) were each associated with incident hypertension, compared with the reference tertile. FGF23 did not mediate the association between urinary potassium excretion and incident hypertension. Increasing potassium intake, and reducing plasma FGF23 could be independent targets to reduce the risk of hypertension in the general population. Full article
(This article belongs to the Special Issue The Role of Dietary Potassium in Human Health)
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18 pages, 485 KiB  
Article
Feasibility of Low-Sodium, High-Potassium Processed Foods and Their Effect on Blood Pressure in Free-Living Japanese Men: A Randomized, Double-Blind Controlled Trial
by Yoko Umeki, Hitomi Hayabuchi, Hisashi Adachi and Masanori Ohta
Nutrients 2021, 13(10), 3497; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13103497 - 03 Oct 2021
Cited by 5 | Viewed by 3047
Abstract
We aimed to verify the effect of new low-sodium high-potassium seasonings and processed foods containing poly-γ-glutamic acid on blood pressure in free-living settings. To this end, we conducted a randomized, double-blind controlled trial on 187 Japanese men, aged 35–67 years, who did not [...] Read more.
We aimed to verify the effect of new low-sodium high-potassium seasonings and processed foods containing poly-γ-glutamic acid on blood pressure in free-living settings. To this end, we conducted a randomized, double-blind controlled trial on 187 Japanese men, aged 35–67 years, who did not use antihypertensives. Participants were randomly allocated to an intervention (n = 93) or a control group (n = 94). They were given a boxed lunch and miso soup (average Na and K content for the intervention group: 1175 and 1476 mg; for the control group: 2243 and 703 mg, respectively). Blood pressure was measured three times every morning for 1 week immediately before and during the final week of the trial. On the day before and the final day of the intervention period, 24 h urine samples were collected. After intervention, the intervention group showed a significantly stronger decrease in the urinary sodium-to-potassium ratio than the control group (p < 0.001). The mean difference in systolic blood pressure change after adjustment for baseline values between the two groups was −2.1 (95% CI: −3.6, −0.6) mmHg. Compliance between the groups was similar, suggesting successful blinding. In conclusion, the use of new seasonings and processed foods aimed at lowering blood pressure in free-living settings may be feasible and effective. Full article
(This article belongs to the Special Issue The Role of Dietary Potassium in Human Health)
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13 pages, 1324 KiB  
Article
Randomized Trial on the Effects of Dietary Potassium on Blood Pressure and Serum Potassium Levels in Adults with Chronic Kidney Disease
by Sharon Turban, Stephen P. Juraschek, Edgar R. Miller III, Cheryl A. M. Anderson, Karen White, Jeanne Charleston and Lawrence J. Appel
Nutrients 2021, 13(8), 2678; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13082678 - 31 Jul 2021
Cited by 29 | Viewed by 4918
Abstract
In the general population, an increased potassium (K) intake lowers blood pressure (BP). The effects of K have not been well-studied in individuals with chronic kidney disease (CKD). This randomized feeding trial with a 2-period crossover design compared the effects of diets containing [...] Read more.
In the general population, an increased potassium (K) intake lowers blood pressure (BP). The effects of K have not been well-studied in individuals with chronic kidney disease (CKD). This randomized feeding trial with a 2-period crossover design compared the effects of diets containing 100 and 40 mmol K/day on BP in 29 adults with stage 3 CKD and treated or untreated systolic BP (SBP) 120–159 mmHg and diastolic BP (DBP) <100 mmHg. The primary outcome was 24 h ambulatory systolic BP. The higher-versus lower-K diet had no significant effect on 24 h SBP (−2.12 mm Hg; p = 0.16) and DBP (−0.70 mm Hg; p = 0.44). Corresponding differences in clinic BP were −4.21 mm Hg for SBP (p = 0.054) and −0.08 mm Hg for DBP (p = 0.94). On the higher-K diet, mean serum K increased by 0.21 mmol/L (p = 0.003) compared to the lower-K diet; two participants had confirmed hyperkalemia (serum K ≥ 5.5 mmol/L). In conclusion, a higher dietary intake of K did not lower 24 h SBP, while clinic SBP reduction was of borderline statistical significance. Additional trials are warranted to understand the health effects of increased K intake in individuals with CKD. Full article
(This article belongs to the Special Issue The Role of Dietary Potassium in Human Health)
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10 pages, 253 KiB  
Article
Dietary Modelling to Explore the Impact of Potassium Chloride Replacement for Sodium in Bread for Adults with Chronic Kidney Disease
by Rebecca Morrison, Jordan Stanford and Kelly Lambert
Nutrients 2021, 13(7), 2472; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13072472 - 20 Jul 2021
Cited by 4 | Viewed by 2562
Abstract
Food manufacturers are increasingly substituting potassium chloride (KCl) in food products so as to reduce the sodium chloride content. Bread and bread products are common staple foods in many Western households and are a target for recipe reformulation using KCl. Given that chronic [...] Read more.
Food manufacturers are increasingly substituting potassium chloride (KCl) in food products so as to reduce the sodium chloride content. Bread and bread products are common staple foods in many Western households and are a target for recipe reformulation using KCl. Given that chronic kidney disease (CKD) is a medical condition of global importance that requires dietary potassium restriction in the later stages, we sought to evaluate the impact and safety of varying levels of KCl substitution in bread products. We undertook a secondary analysis of dietary data from the National Nutrition and Physical Activity Survey 2011–2012 for 12,152 participants (154 participants with CKD). The sodium chloride content in bread and bread-based products was substituted with 20%, 30%, and 40% of KCl. The contribution of these alterations in the dietary potassium intake to the total daily potassium intake were then examined. The replacement of sodium in bread with varying amounts of KCl (20%, 30%, and 40%) resulted in one third of people with CKD exceeding the safe limits for dietary potassium consumption (31.8%, 32.6%, and 33%, respectively). KCl substitution in staple foods such as bread and bread products have serious and potentially fatal consequences for people who need to restrict dietary potassium. Improved food labelling is required for consumers to avoid excessive consumption. Full article
(This article belongs to the Special Issue The Role of Dietary Potassium in Human Health)
13 pages, 5361 KiB  
Article
Global Trends (1961–2017) in Human Dietary Potassium Supplies
by Diriba B. Kumssa, Edward J. M. Joy and Martin R. Broadley
Nutrients 2021, 13(4), 1369; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13041369 - 19 Apr 2021
Cited by 19 | Viewed by 3142
Abstract
Background: Potassium (K) is an essential mineral and major intracellular electrolyte involved in the regulation of blood pressure, muscle contraction and nerve transmission in humans. Major dietary sources of K include fruits and vegetables, starchy roots and tubers, and whole grains. The aim [...] Read more.
Background: Potassium (K) is an essential mineral and major intracellular electrolyte involved in the regulation of blood pressure, muscle contraction and nerve transmission in humans. Major dietary sources of K include fruits and vegetables, starchy roots and tubers, and whole grains. The aim of this study was to assess and report: (i) the sufficiency of K in national food systems globally, (ii) to quantify the contribution from food groups, and (iii) to explore spatial and temporal trends in the period of 1961–2017. Methods: Food supply and demography (1961–2017), K composition and K requirement data were combined to estimate per capita human dietary supplies of potassium (DSK), adequate intake of K (AIK) and K sufficiency ratio (KSR) at national, regional, continental and global levels. Results and Discussion: Globally, the mean ± SD. DSK (mg capita−1 d−1) increased from 2984 ± 915 in 1961 to 3796 ± 1161 in 2017. There was a wide range in DSK between geographical regions and across years, with particularly large increases in east Asia, where DSK increased from <3000 to >5000 mg capita−1 day−1. Roots and tubers contributed the largest dietary source of K, providing up to 80% of DSK in most regions. At the global level, throughout the 57-year period, the population-weighted KSR was <1 based on the 2006 Institute of Medicine AIK recommendation, while it was >1 based on the 2019 National Academies of Science and the 2016 European Union AIK recommendation. While KSR ≥ 1 shows sufficiency of DSK, KSR < 1 does not indicate K deficiency risk. Conclusion: Due to the absence of a Recommended Daily Allowance (RDA) for K, this study used the ratio of DSK:AIK (i.e., KSR) to assess dietary K sufficiency. Estimates of dietary K sufficiency are, therefore, highly sensitive to the AIK reference value used and this varied greatly based on different institutions and years. To quantify the risk of dietary K deficiency, bridging the data gap to establish an RDA for K should be a global research priority. Full article
(This article belongs to the Special Issue The Role of Dietary Potassium in Human Health)
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Review

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14 pages, 308 KiB  
Review
Core Strategies to Increase the Uptake and Use of Potassium-Enriched Low-Sodium Salt
by Adefunke Ajenikoko, Nicole Ide, Roopa Shivashankar, Zeng Ge, Matti Marklund, Cheryl Anderson, Amy Atun, Alexander Thomson, Megan E. Henry and Laura K. Cobb
Nutrients 2021, 13(9), 3203; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13093203 - 15 Sep 2021
Cited by 8 | Viewed by 4729
Abstract
Excess sodium consumption and insufficient potassium intake contribute to high blood pressure and thus increase the risk of heart disease and stroke. In low-sodium salt, a portion of the sodium in salt (the amount varies, typically ranging from 10 to 50%) is replaced [...] Read more.
Excess sodium consumption and insufficient potassium intake contribute to high blood pressure and thus increase the risk of heart disease and stroke. In low-sodium salt, a portion of the sodium in salt (the amount varies, typically ranging from 10 to 50%) is replaced with minerals such as potassium chloride. Low-sodium salt may be an effective, scalable, and sustainable approach to reduce sodium and therefore reduce blood pressure and cardiovascular disease at the population level. Low-sodium salt programs have not been widely scaled up, although they have the potential to both reduce dietary sodium intake and increase dietary potassium intake. This article proposes a framework for a successful scale-up of low-sodium salt use in the home through four core strategies: availability, awareness and promotion, affordability, and advocacy. This framework identifies challenges and potential solutions within the core strategies to begin to understand the pathway to successful program implementation and evaluation of low-sodium salt use. Full article
(This article belongs to the Special Issue The Role of Dietary Potassium in Human Health)
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