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Potassium and Human Health

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A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (15 March 2016) | Viewed by 80927

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Prof. Dr. Peter Clifton

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Guest Editor

1. Division of Health Sciences, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
2. Alliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide, SA, Australia
Interests: obesity; lipids; diabetes; heart disease
Special Issues, Collections and Topics in MDPI journals

Dr. Jennifer Keogh

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Guest Editor

Fellow South Australian Cardiovascular Research Development Program, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia 5000, Australia
Interests: prevention and management of chronic disease using dietary change to achieve health benefits in obesity, diabetes and cardiovascular disease; diet and endothelial function, including sodium, potassium and saturated fat; intermittent energy restriction as a strategy for weight loss in people with and without diabetes
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Dietary potassium intake is positively associated with a number of health benefits in blood pressure, cardiovascular disease, endothelial function and bone health. Some researchers argue that the current dietary intake of potassium is inadequate. A higher intake of processed foods leads to a lower intake of potassium than a diet replete in vegetables, fruit and wholegrains. Recent surveys of dietary intake in Australia show that adult dietary potassium intake is approximately 3000 mg in men and 2500 mg in women. In Australia the adequate intake for potassium is 3800 mg/day for men and 2800 mg for women whereas in the United States it is 4700 mg/day. The reason for these differences is unclear.

The purpose of this special issue is to review the recent evidence for the effects of dietary potassium intake on human health with an emphasis on randomised controlled trials or meta-analyses of data from published studies.

Dr. Jennifer Keogh
Prof. Dr. Peter Clifton
Guest Editors

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Keywords

Potassium and health outcomes
Potassium and endothelial function
Potassium and markers of cardiovascular disease risk
Potassium and bone health
Dietary intake of potassium
Dietary quality and health outcomes.

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Published Papers (6 papers)

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Research

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12 pages, 239 KiB

Open AccessArticle

Urinary Sodium and Potassium Excretion and Carotid Atherosclerosis in Chinese Men and Women

by Xiao-Wei Dai, Cheng Wang, Ying Xu, Ke Guan, Yi-Xiang Su and Yu-Ming Chen

Nutrients 2016, 8(10), 612; https://doi.org/10.3390/nu8100612 - 1 Oct 2016

Cited by 11 | Viewed by 4963

Abstract

Limited studies have examined the association between sodium (Na) and potassium (K) levels and the risk of atherosclerosis. This study examined whether higher Na and Na/K levels and low K levels were independent risk factors for atherosclerosis. This community-based cross-sectional study included 3290 subjects (1067 men and 2223 women) 40 to 75 years of age in Guangzhou, China, between 2011 and 2013. Urinary excretion of Na and K were measured from the first morning void, and creatinine-adjusted values were used. The intima-media thickness (IMT) of the carotid common artery and the carotid bifurcation was measured with high-resolution B-mode ultrasonography. Dietary K and Na intake and other covariates were obtained by face-to-face interviews. A significant positive association was seen between urinary Na excretion and carotid atherosclerosis after adjustment for age, sex, and other lifestyle covariates. The odds ratios (OR) and 95% confidence interval (CI) of the highest (vs. lowest) quartile of urinary Na were 1.32 (1.04–1.66) for carotid plaques, 1.48 (1.18–1.87) for increased common carotid artery IMT, and 1.55 (1.23–1.96) for increased carotid bifurcation IMT (all p-trend < 0.01). A similar positive association was observed between urinary Na/K levels and carotid plaque and increased IMT, and between dietary Na intake and increased bifurcation IMT. Regarding potassium data, we only found a significantly lower presence of carotid plaque (OR 0.72, 95% CI 0.57–0.91) for quartile 2 (vs. 1) of urinary K. Our findings suggest that higher levels of urinary excretion Na and Na/K are significantly associated with greater presence of carotid atherosclerosis in Chinese adults. Full article

(This article belongs to the Special Issue Potassium and Human Health)

13 pages, 242 KiB

Open AccessArticle

Dietary Intake and Sources of Potassium and the Relationship to Dietary Sodium in a Sample of Australian Pre-School Children

by Siobhan A. O’Halloran, Carley A. Grimes, Kathleen E. Lacy, Karen J. Campbell and Caryl A. Nowson

Nutrients 2016, 8(8), 496; https://doi.org/10.3390/nu8080496 - 13 Aug 2016

Cited by 20 | Viewed by 7000

Abstract

The aim of this study was to determine the intake and food sources of potassium and the molar sodium:potassium (Na:K) ratio in a sample of Australian pre-school children. Mothers provided dietary recalls of their 3.5 years old children (previous participants of Melbourne Infant Feeding Activity and Nutrition Trial). The average daily potassium intake, the contribution of food groups to daily potassium intake, the Na:K ratio, and daily serves of fruit, dairy, and vegetables, were assessed via three unscheduled 24 h dietary recalls. The sample included 251 Australian children (125 male), mean age 3.5 (0.19) (SD) years. Mean potassium intake was 1618 (267) mg/day, the Na:K ratio was 1.47 (0.5) and 54% of children did not meet the Australian recommended adequate intake (AI) of 2000 mg/day for potassium. Main food sources of potassium were milk (27%), fruit (19%), and vegetable (14%) products/dishes. Food groups with the highest Na:K ratio were processed meats (7.8), white bread/rolls (6.0), and savoury sauces and condiments (5.4). Children had a mean intake of 1.4 (0.75) serves of fruit, 1.4 (0.72) dairy, and 0.52 (0.32) serves of vegetables per day. The majority of children had potassium intakes below the recommended AI. The Na:K ratio exceeded the recommended level of 1 and the average intake of vegetables was 2 serves/day below the recommended 2.5 serves/day and only 20% of recommended intake. An increase in vegetable consumption in pre-school children is recommended to increase dietary potassium and has the potential to decrease the Na:K ratio which is likely to have long-term health benefits. Full article

(This article belongs to the Special Issue Potassium and Human Health)

13 pages, 1671 KiB

Open AccessArticle

Dietary Impact of Adding Potassium Chloride to Foods as a Sodium Reduction Technique

by Leo Van Buren, Mariska Dötsch-Klerk, Gila Seewi and Rachel S. Newson

Nutrients 2016, 8(4), 235; https://doi.org/10.3390/nu8040235 - 21 Apr 2016

Cited by 57 | Viewed by 13748

Abstract

Potassium chloride is a leading reformulation technology for reducing sodium in food products. As, globally, sodium intake exceeds guidelines, this technology is beneficial; however, its potential impact on potassium intake is unknown. Therefore, a modeling study was conducted using Dutch National Food Survey data to examine the dietary impact of reformulation (n = 2106). Product-specific sodium criteria, to enable a maximum daily sodium chloride intake of 5 grams/day, were applied to all foods consumed in the survey. The impact of replacing 20%, 50% and 100% of sodium chloride from each product with potassium chloride was modeled. At baseline median, potassium intake was 3334 mg/day. An increase in the median intake of potassium of 453 mg/day was seen when a 20% replacement was applied, 674 mg/day with a 50% replacement scenario and 733 mg/day with a 100% replacement scenario. Reformulation had the largest impact on: bread, processed fruit and vegetables, snacks and processed meat. Replacement of sodium chloride by potassium chloride, particularly in key contributing product groups, would result in better compliance to potassium intake guidelines (3510 mg/day). Moreover, it could be considered safe for the general adult population, as intake remains compliant with EFSA guidelines. Based on current modeling potassium chloride presents as a valuable, safe replacer for sodium chloride in food products. Full article

(This article belongs to the Special Issue Potassium and Human Health)

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11 pages, 2735 KiB

Open AccessArticle

Potassium and Obesity/Metabolic Syndrome: A Systematic Review and Meta-Analysis of the Epidemiological Evidence

by Xianlei Cai, Xueying Li, Wenjie Fan, Wanqi Yu, Shan Wang, Zhenhong Li, Ethel Marian Scott and Xiuyang Li

Nutrients 2016, 8(4), 183; https://doi.org/10.3390/nu8040183 - 25 Mar 2016

Cited by 65 | Viewed by 10652

Abstract

The objective of this study was to investigate the associations between potassium and obesity/metabolic syndrome. We identified eight relevant studies and applied meta-analysis, and nonlinear dose-response analysis to obtain the available evidence. The results of the pooled analysis and systematic review indicated that high potassium intake could not reduce the risk of obesity (pooled OR = 0.78; 95% CI: 0.61–1.01), while serum potassium and urinary sodium-to-potassium ratio was associated with obesity. Potassium intake was associated with metabolic syndrome (pooled OR = 0.75; 95% CI: 0.50–0.97). Nonlinear analysis also demonstrated a protective effect of adequate potassium intake on obesity and metabolic syndrome. Adequate intake of fruits and vegetables, which were the major sources of potassium, was highly recommended. However, additional pertinent studies are needed to examine the underlying mechanism. Full article

(This article belongs to the Special Issue Potassium and Human Health)

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9 pages, 444 KiB

Open AccessArticle

Balancing Sodium and Potassium: Estimates of Intake in a New Zealand Adult Population Sample

by Rachael McLean, Julia Edmonds, Sheila Williams, Jim Mann and Sheila Skeaff

Nutrients 2015, 7(11), 8930-8938; https://doi.org/10.3390/nu7115439 - 28 Oct 2015

Cited by 27 | Viewed by 7173 | Correction

Abstract

Dietary intakes of sodium and potassium are important determinants of blood pressure. We assessed sodium and potassium intake in a cross-sectional survey which included a random sample of New Zealand Adults aged 18 to 64 years from two New Zealand cities: Dunedin and Wellington. Participants completed a short questionnaire, had height, weight and blood pressure measured, and collected a 24 h urine sample. Mean 24 h sodium excretion was 3386 mg/day (95% CI 3221, 3551): 3865 mg/day for men and for 2934 mg/day women. Mean 24 h potassium excretion was 2738 mg/day (95% CI 2623, 2855): 3031 mg/day for men and 2436 mg/day for women. Mean sodium:potassium ratio was 1.32 (95% CI 1.26, 1.39); 1.39 for men and 1.26 for women. Sodium intake was higher among younger people, men, those with a higher BMI and higher potassium excretion. Potassium excretion was higher among older people, men and those with a higher sodium excretion. New Zealand adults have high sodium intakes and low potassium intakes compared to recommended levels. This is likely to adversely affect population blood pressure levels as well as incidence of cardiovascular disease. A comprehensive public health programme to reduce dietary sodium intake and increase intake of fruit and vegetables is warranted. Full article

(This article belongs to the Special Issue Potassium and Human Health)

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13 pages, 235 KiB

Open AccessReview

Potassium Intake, Bioavailability, Hypertension, and Glucose Control

by Michael S. Stone, Lisa Martyn and Connie M. Weaver

Nutrients 2016, 8(7), 444; https://doi.org/10.3390/nu8070444 - 22 Jul 2016

Cited by 190 | Viewed by 35946

Abstract

Potassium is an essential nutrient. It is the most abundant cation in intracellular fluid where it plays a key role in maintaining cell function. The gradient of potassium across the cell membrane determines cellular membrane potential, which is maintained in large part by the ubiquitous ion channel the sodium-potassium (Na+-K+) ATPase pump. Approximately 90% of potassium consumed (60–100 mEq) is lost in the urine, with the other 10% excreted in the stool, and a very small amount lost in sweat. Little is known about the bioavailability of potassium, especially from dietary sources. Less is understood on how bioavailability may affect health outcomes. Hypertension (HTN) is the leading cause of cardiovascular disease (CVD) and a major financial burden ($50.6 billion) to the US public health system, and has a significant impact on all-cause morbidity and mortality worldwide. The relationship between increased potassium supplementation and a decrease in HTN is relatively well understood, but the effect of increased potassium intake from dietary sources on blood pressure overall is less clear. In addition, treatment options for hypertensive individuals (e.g., thiazide diuretics) may further compound chronic disease risk via impairments in potassium utilization and glucose control. Understanding potassium bioavailability from various sources may help to reveal how specific compounds and tissues influence potassium movement, and further the understanding of its role in health. Full article

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