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Potassium/Sodium Balance

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Updated about 4 hours ago
Created August 09, 2011 at 12:37 AM

What is the ideal ratio of potassium to sodium?

1a98a40ba8ffdc5aa28d1324d01c6c9f
20353 · June 02, 2012 at 2:49 AM

Thanks CaveMan!

7fc82eebafd44badc73c520f44660150
3280 · June 02, 2012 at 12:25 AM

Great post @eric!!!

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18671 · August 09, 2011 at 2:31 PM

Hey, by the way, I just looked up ground beef on nutritiondata.com. It claims that 2 lbs of that gives the RDA of potassium. I eat about 2 lbs of meat a day, so maybe I'm not as low as presumed.

100fd85230060e754fc13394eee6d6f1
18671 · August 09, 2011 at 2:20 PM

So, would you consider it a good hypothesis that on a VLC diet, potassium supplementation would have to be very high before it would start being excreted in large amounts?

1a98a40ba8ffdc5aa28d1324d01c6c9f
20353 · August 09, 2011 at 2:19 PM

my heart goes into affib (irregulat beat). Paleo and high potasium ratio helps a ton and keeps me off drugs.

100fd85230060e754fc13394eee6d6f1
18671 · August 09, 2011 at 2:16 PM

Well, it just seems to me that if the blood has a need, that will obviously be prioritized over both bone and organs, and if the bones have enough as well, it's possible the organs do, too. I don't have a sense of whether the bones are prioritized over the organs or not.

100fd85230060e754fc13394eee6d6f1
18671 · August 09, 2011 at 2:13 PM

Exactly. It's not clear, and I think it's a leap to say that it means a LC diet should be HP.

Eecc48184707bc26bce631485b5b7e34
4764 · August 09, 2011 at 1:50 PM

Oh and ambi, the diet need not be VLC to increase bone mineralization - it just needs to contain animal products afaict. But what's bone mineralization got to do with this particular issue? We're not really talking about bones but rather intracellular levels throughout tissue. Blood levels will still be 'in range' even if organs are attempting to function (eventually poorly) and carry out cellular functions (eventually poorly) with insufficient potassium.

Eecc48184707bc26bce631485b5b7e34
4764 · August 09, 2011 at 1:49 PM

Thank you! So why are you shooting for 4:1 K:Na? I shoot for 4:1 K:kcal and very often exceed it. But sometimes I fall very short - ie when eating out a lot. I

Eecc48184707bc26bce631485b5b7e34
4764 · August 09, 2011 at 1:47 PM

I only read the whole article quite quickly yesterday but my take away was that potassium uptake appears to improve in the presence of higher insulin levels. It's not clear though what that means.

Eecc48184707bc26bce631485b5b7e34
4764 · August 09, 2011 at 1:44 PM

Oh and ambi, the diet need not be VLC to increase bone mineralization - it just needs to contain animal products afaict. I'm not sure what you mean by stating that bone mineralization is better...we're not really talking about bones but rather intracellular levels throughout tissue. Blood levels will still be 'in range' even if organs are attempting to function (eventually poorly) and carry out cellular functions (eventually poorly) with insufficient potassium.

Eecc48184707bc26bce631485b5b7e34
4764 · August 09, 2011 at 1:40 PM

Saiklon, from the analyses that have been done, it appears that the RDI for sodium is high. I don't have the sources handy nor the time to look them up, but when I read them some time ago, I think it indicated that the ratio was 8-12:1 K:Na

Eecc48184707bc26bce631485b5b7e34
4764 · August 09, 2011 at 1:40 PM

@Ambimorph, it's still not enough to account for the massive difference. On a VLC/all or nearly all meat diet, it's pretty hard to get beyond 2-3:1 K:Na ratio

Eecc48184707bc26bce631485b5b7e34
4764 · August 09, 2011 at 1:39 PM

Saiklon, from the analyses that have been done, it appears that the RDI for sodium is high. I don't have the sources handy nor the time to look them up, but when I read them some time ago, I think it indicated that the ratio was 8-12:1 K:Mg.

33907fee54e98865a1988e5eef59147e
480 · August 09, 2011 at 4:14 AM

great question. Ive been thinking about this lately. Lots of paleo protein and fat sources seem to be relatively high sodium. Can anyone comment on how much potassium is in meat products?

100fd85230060e754fc13394eee6d6f1
18671 · August 09, 2011 at 4:05 AM

That's an interesting point, that potassium is so necessary in the blood, that blood levels may not reflect the body's status. On the other hand, LC/high protein diets are associated with increased bone mineralization, which contradicts the idea that the blood is getting all available potassium at the expense of the rest.

5b69a02dadcae753771921d913909215
1457 · August 09, 2011 at 1:51 AM

Oh yeah, but +1 for the rest of the info!

5b69a02dadcae753771921d913909215
1457 · August 09, 2011 at 1:49 AM

"... could very* well..."

5b69a02dadcae753771921d913909215
1457 · August 09, 2011 at 1:47 AM

For the 8:1 ratio you are suggesting that the RDI is wrong for potassium but correct for sodium? I think the RDIs are based on sedentary people in poor health. H-Gs would have spent much time outdoors sweating most of the time, especially in the warmer climates. I have sweated for hours hunting/hiking in 5 degree weather in the mountains... Moreover, in places like FL, for most of the year, when you are outdoors you are probably sweating even when you are asleep at night when its coldest. My point is that the RDI for sodium could vary well be wrong too...

1d0497f8781845ab371b479455bfee8e
11152 · August 09, 2011 at 1:32 AM

"those with the highest potassium-sodium intake ratio (about 2:1) had only half the risk of cardiovascular disease death as compared to those with the lowest ratio (about 1:4). According to the study's findings, the said ratio actually mattered more than the actual quantities eaten. http://www.naturalnews.com/025820_sodium_potassium_health.html Unfortunately the study they cited has been archived and only the abstract is available. http://archinte.ama-assn.org/cgi/content/short/171/13/1183 Unfortunately there really isn't a conclusive study on the ideal ratio of K to Na. Minimum is 2:1.

E5c7f14800c5992831f5c70fa746dc5c
12847 · August 09, 2011 at 12:55 AM

source?????????

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5 Answers

Eecc48184707bc26bce631485b5b7e34
3
4764 · August 09, 2011 at 1:09 AM

Pretty high actually. 8:1? More? Our chronic deficiency of potassium may have significant consequences for declining energy levels and hypertension.

Assuming a 2000 kcal diet, the current RDI for sodium is 2300 mg and 4700mg for potassium.

http://www.seminarsinnephrology.org/...143-4/abstract Volume 26, Issue 6, Pages 447-453 (November 2006)

The Evolution-Informed Optimal Dietary Potassium Intake of Human Beings Greatly Exceeds Current and Recommended Intakes

Anthony Sebastian, Lynda A. Frassetto, Deborah E. Sellmeyer, R. Curtis Morris JrAn organism best fits the environment described by its genes, an environment that prevailed during the time period (millions of years) when evolution naturally selected the genes of its ancestors???those who survived to pass on their genes. When an organism???s current environment differs from its ancestral one, the environment???s mismatch with the organism???s genome may result in functional disadvantages for the organism. The genetically conditioned nutritional requirements of human beings established themselves over millions of years in which ancestral hominins, living as hunter-gatherers, ate a diet markedly different from that of agriculturally dependent contemporary human beings. In that context, we sought to quantify the ancestral-contemporary dietary difference with respect to the supply of one of the body???s major mineral nutrients: potassium. In 159 retrojected Stone Age diets, human potassium intake averaged 400 ?? 125 mEq/d, which exceeds current and recommended intakes by more than a factor of 4. We accounted for the transition to the relatively potassium-poor modern diet by the fact that the modern diet has substantially replaced Stone Age amounts of potassium-rich plant foods (especially fruits, leafy greens, vegetable fruits, roots, and tubers), with energy-dense nutrient-poor foods (separated fats, oils, refined sugars, and refined grains), and with potassium-poor energy-rich plant foods (especially cereal grains) introduced by agriculture (circa 10,000 years ago). Given the fundamental physiologic importance of potassium, such a large magnitude of change in potassium intake invites the consideration in human beings of whether the quantitative values of potassium-influenced physiologic phenomena (eg, blood pressure, insulin and aldosterone secretion rates, and intracellular pH) currently viewed as normal, in fact disaccord with genetically conditioned norms. We discuss the potential implications of our findings in respect to human health and disease.

Keywords: dietary potassium, human evolution, diet net acid load

Your body will maintain tight control of serum potassium no matter what until your potassium is so low that it is medical emergency Blood levels are one thing - sufficient potassium for optimal intracellular levels ad all bodily functions that require potassium is another thing entirely.

http://en.wikipedia.org/wiki/Hypokalemia "Normal serum potassium levels are between 3.5 to 5.0 mEq/L1; at least 95% of the body's potassium is found inside cells, with the remainder in the blood. This concentration gradient is maintained principally by the Na+/K+ pump."

http://www.krispin.com/potassm.html

http://www.umm.edu/altmed/articles/potassium-000320.htm

http://en.citizendium.org/wiki/Potas...ase_and_Stroke

100fd85230060e754fc13394eee6d6f1
18671 · August 09, 2011 at 2:31 PM

Hey, by the way, I just looked up ground beef on nutritiondata.com. It claims that 2 lbs of that gives the RDA of potassium. I eat about 2 lbs of meat a day, so maybe I'm not as low as presumed.

100fd85230060e754fc13394eee6d6f1
18671 · August 09, 2011 at 2:20 PM

So, would you consider it a good hypothesis that on a VLC diet, potassium supplementation would have to be very high before it would start being excreted in large amounts?

100fd85230060e754fc13394eee6d6f1
18671 · August 09, 2011 at 2:16 PM

Well, it just seems to me that if the blood has a need, that will obviously be prioritized over both bone and organs, and if the bones have enough as well, it's possible the organs do, too. I don't have a sense of whether the bones are prioritized over the organs or not.

Eecc48184707bc26bce631485b5b7e34
4764 · August 09, 2011 at 1:50 PM

Oh and ambi, the diet need not be VLC to increase bone mineralization - it just needs to contain animal products afaict. But what's bone mineralization got to do with this particular issue? We're not really talking about bones but rather intracellular levels throughout tissue. Blood levels will still be 'in range' even if organs are attempting to function (eventually poorly) and carry out cellular functions (eventually poorly) with insufficient potassium.

Eecc48184707bc26bce631485b5b7e34
4764 · August 09, 2011 at 1:44 PM

Oh and ambi, the diet need not be VLC to increase bone mineralization - it just needs to contain animal products afaict. I'm not sure what you mean by stating that bone mineralization is better...we're not really talking about bones but rather intracellular levels throughout tissue. Blood levels will still be 'in range' even if organs are attempting to function (eventually poorly) and carry out cellular functions (eventually poorly) with insufficient potassium.

Eecc48184707bc26bce631485b5b7e34
4764 · August 09, 2011 at 1:40 PM

Saiklon, from the analyses that have been done, it appears that the RDI for sodium is high. I don't have the sources handy nor the time to look them up, but when I read them some time ago, I think it indicated that the ratio was 8-12:1 K:Na

Eecc48184707bc26bce631485b5b7e34
4764 · August 09, 2011 at 1:40 PM

@Ambimorph, it's still not enough to account for the massive difference. On a VLC/all or nearly all meat diet, it's pretty hard to get beyond 2-3:1 K:Na ratio

Eecc48184707bc26bce631485b5b7e34
4764 · August 09, 2011 at 1:39 PM

Saiklon, from the analyses that have been done, it appears that the RDI for sodium is high. I don't have the sources handy nor the time to look them up, but when I read them some time ago, I think it indicated that the ratio was 8-12:1 K:Mg.

100fd85230060e754fc13394eee6d6f1
18671 · August 09, 2011 at 4:05 AM

That's an interesting point, that potassium is so necessary in the blood, that blood levels may not reflect the body's status. On the other hand, LC/high protein diets are associated with increased bone mineralization, which contradicts the idea that the blood is getting all available potassium at the expense of the rest.

5b69a02dadcae753771921d913909215
1457 · August 09, 2011 at 1:51 AM

Oh yeah, but +1 for the rest of the info!

5b69a02dadcae753771921d913909215
1457 · August 09, 2011 at 1:49 AM

"... could very* well..."

5b69a02dadcae753771921d913909215
1457 · August 09, 2011 at 1:47 AM

For the 8:1 ratio you are suggesting that the RDI is wrong for potassium but correct for sodium? I think the RDIs are based on sedentary people in poor health. H-Gs would have spent much time outdoors sweating most of the time, especially in the warmer climates. I have sweated for hours hunting/hiking in 5 degree weather in the mountains... Moreover, in places like FL, for most of the year, when you are outdoors you are probably sweating even when you are asleep at night when its coldest. My point is that the RDI for sodium could vary well be wrong too...

1a98a40ba8ffdc5aa28d1324d01c6c9f
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20353 · August 09, 2011 at 1:56 AM

I am going to say 4:1

That is what I shoot for.

EDIT:

Richard D. Moore, MD, PhD (8) goes into great detail about the function of the sodium/potassium pump (Na/K pump) and what he calls the K Factor. (K for potassium; Na for sodium).

Early man???s consumption of sodium and potassium worked out to about 11,000 mg daily of potassium and only 690 of sodium. A ratio of about 16:1. (Moore) Other sources say the potassium was around 6,000 mg with 600 mg sodium. Salt was not a big factor in early man???s diet.

Dr. Moore says: ???The low ratio of potassium to sodium in the typical American diet is one of the biggest - perhaps even the biggest -cause of bad health in our country.???

cellular biophysics tells us that one of several dozen energy-consuming mechanisms in living cells uses about 25% of the total energy of that cell and therefore is of vital importance to that cell. This mechanism is the Na-K pump and it???s the key to survival for every cell in our body. Not only does this specialized pump keep potassium levels in the cell high and sodium levels low, but it makes an electrical current which is carried by positive sodium ions that the cell uses for itself, but also serves to regulate acid and calcium levels inside the cell. Dr. Moore says: ???When a living cell is exposed to a substance that specifically inhibits the Na-K pump and without affecting any other mechanism???that cells dies. So this pump is of vital importance to everyone

video simulation of How the Sodium-Potassium Pump Works. http://tinyurl.com/yutaw4

Quote from Principles of Biochemistry, 1992: The activity of this Na/K-ATPase in extruding Na+ and accumulating K+ is an essential cell function. About 25% of the energy-yielding metabolism of a human at rest goes to support the Na/K-ATPase. 25%!! Think about it! If we don???t have these pumps working, imagine how this affects heart tissue, especially. Dr. Moore says the ideal ratio of dietary intake will be between 2 and 4 parts potassium to one part sodium. In his book, he emphasizes 4:1.

His message: ???The sum of intracellular K+ Na is a constant??? meaning you can???t raise IC potassium unless you lower IC sodium.???

Moore) (8) Chapter 4, p. 78: The Key Problem: An Imbalance in the Ratio of Potassium to Sodium (The K-factor)

"For purely physical reasons (connected with the law of osmotic equilibrium), inside the cell the sum of sodium plus potassium must be constant. This means that sodium can go up only if potassium goes down. Likewise, if potassium goes up, sodium must go down. So potassium and sodium are unalterably linked together like two children on a teeter-totter. You can't change one without changing the other." POTASSIUM AND THE REFRACTORY PERIOD. Potassium prolongs the refractory period???or the time when the heart is resting between beats. At this time, heart cells can???t be stimulated to contract. Supporting biochemistry: In the resting state, cardiac muscle cells are polarized due to gradients established by the active inward transport of potassium ions and the outward transport of sodium ions. Various stimuliincluding drug-induced effects-can cause shifts in these gradients, producing a decrease in the internal negative membrane potential. This process is known as depolarization.(9) Adverse effects or clinical consequences of potassium depletion predominantly affect the cardiovascular and neuromuscular systems. Both respond to the associated hyperpolarization of electrical tissue. The presence of hypokalemia (potassium depletion), decreased membrane permeability to potassium (which prolongs action potentials), shortens refractory periods and increases the incidence of spontaneous and early depolarizations.

Dr. Moore (8) Chapter 19, Information for the Physician, p. 323, Drugs That May Make the K Factor Dangerous It's not simply the amount of potassium that's important, it's the dietary and IC potassium-to-sodium ratio, which needs to be at least 4:1

1a98a40ba8ffdc5aa28d1324d01c6c9f
20353 · June 02, 2012 at 2:49 AM

Thanks CaveMan!

7fc82eebafd44badc73c520f44660150
3280 · June 02, 2012 at 12:25 AM

Great post @eric!!!

1a98a40ba8ffdc5aa28d1324d01c6c9f
20353 · August 09, 2011 at 2:19 PM

my heart goes into affib (irregulat beat). Paleo and high potasium ratio helps a ton and keeps me off drugs.

Eecc48184707bc26bce631485b5b7e34
4764 · August 09, 2011 at 1:49 PM

Thank you! So why are you shooting for 4:1 K:Na? I shoot for 4:1 K:kcal and very often exceed it. But sometimes I fall very short - ie when eating out a lot. I

100fd85230060e754fc13394eee6d6f1
1
18671 · August 09, 2011 at 4:02 AM

On a related note, Ned Kock just blogged about potassium and LC diets.

It is often pointed out, at least anecdotally, that potassium deficiency is common among low carbohydrate dieters. Potassium deficiency can lead to a number of unpleasant symptoms and health problems. This micronutrient is present in small quantities in meat and seafood; main sources are plant foods.

A while ago this has gotten me thinking and asking myself: what about isolated hunter-gatherers that seem to have thrived consuming mostly carnivorous diets with little potassium, such as various Native American tribes?

Another thought came to mind, which is that animal protein seems to be associated with increased bone mineralization, even when calcium intake is low. That seems to be due to animal protein being associated with increased absorption of calcium and other minerals that make up bone tissue.

Maybe animal protein intake is also associated with increased potassium absorption. If this is true, what could be the possible mechanism?

I find his next speculations odd, though, as he suggests that higher protein diets may aid potassium absorption via insulin, and therefore that higher protein is healthier in the absence of carbs, whereas higher fat would need to be accompanied by higher carb intake. This just doesn't seem to jibe with what we know.

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18671 · August 09, 2011 at 2:13 PM

Exactly. It's not clear, and I think it's a leap to say that it means a LC diet should be HP.

Eecc48184707bc26bce631485b5b7e34
4764 · August 09, 2011 at 1:47 PM

I only read the whole article quite quickly yesterday but my take away was that potassium uptake appears to improve in the presence of higher insulin levels. It's not clear though what that means.

1d0497f8781845ab371b479455bfee8e
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11152 · August 09, 2011 at 12:51 AM

Ideal ratio should be 2:1

1d0497f8781845ab371b479455bfee8e
11152 · August 09, 2011 at 1:32 AM

"those with the highest potassium-sodium intake ratio (about 2:1) had only half the risk of cardiovascular disease death as compared to those with the lowest ratio (about 1:4). According to the study's findings, the said ratio actually mattered more than the actual quantities eaten. http://www.naturalnews.com/025820_sodium_potassium_health.html Unfortunately the study they cited has been archived and only the abstract is available. http://archinte.ama-assn.org/cgi/content/short/171/13/1183 Unfortunately there really isn't a conclusive study on the ideal ratio of K to Na. Minimum is 2:1.

E5c7f14800c5992831f5c70fa746dc5c
12847 · August 09, 2011 at 12:55 AM

source?????????

C472c23f19591ab00038c34e20bd57a7
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0 · February 05, 2013 at 4:08 PM

http://www.webmd.com/hw-popup/rehydration-drinks?navbar=hw86827 States that electrolyte replacement drinks should have a 1.5:1 table salt to potassium salt ratio (by weight) for optimal absorption.

I don't think we can get the cellular ion pump to drive more potassium into our cells by eating more potassium, absent medical crisis. That pump evolved pre-paleo.

BTW, the longest living, healthiest people on the planet are from okinawa, japan, and only 6% of their calories come from animal protein. WIKI the Okinawa diet.

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