Potassium Supports Cardiac and Neurological Function

Potassium is a major mineral and an essential nutrient for humans. Higher intakes are associated with better endothelial function and lower blood pressure. However, potassium intake often falls short when needs are increased or decreased due to reduced availability in the soil, consumption of highly processed foods, and inadequate intake of fruits, vegetables, and other potassium sources.

Conversely, the Mediterranean diet contains a significant number of high-potassium foods and is associated with improved endothelial function and reduced cardiovascular risk.

Source: Serra-Majem, Lluís et al. “Updating the Mediterranean Diet Pyramid towards Sustainability: Focus on Environmental Concerns.” International journal of environmental research and public health vol. 17,23 8758. 25 Nov. 2020, doi:10.3390/ijerph17238758 This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license

High-potassium intake (D'Elia 2023):

• Suppresses reactive oxygen species
• Inhibits vascular smooth muscle cell proliferation
• Increases endothelial nitric oxide
• Significantly improves flow-mediated vasodilation (FMD), a measure of endothelial dysfunction.
• A low FMD is associated with increased atherosclerosis and cardiovascular disease risk.
• A 39 mg (1 mmol) increase in potassium intake is associated with a 0.03% increase in FMD, i.e., greater vasodilation.
• The optimal potassium intake for reducing blood pressure and stroke risk is 3,500 – 4,680 mg (90-120 mmol) daily, and the World Health Organization recommends a target of at least 3,500 mg/day for adults.
• Potassium intake may need to be restricted in those with reduced renal function and inadequate potassium excretion.

Neurological benefits

• A meta-analysis of 16 studies found that a potassium intake of 3,500 mg/day was associated with a 13% reduced risk of stroke compared to 975 mg/day. Relative risk started to decline at an intake of 1,560 mg/day (Vinceti 2016).
• A cross-sectional analysis of data from 10,254 adults found a potassium intake of 1771–2,476 mg/day significantly reduced severe or migraine headache incidence compared to 1771  mg/day or less (Xu 2023).
• Increasing potassium intake resulted in improved neuronal plasticity, cognitive performance, and clearing of amyloid beta deposits and plaques in an animal model of Alzheimer's disease (Cisternas 2015).
• However, high serum potassium levels, i.e., 8.4 mEq/L have been associated with increased stroke incidence per analysis of the prospective Malmo Prevention Project data (Johnson 2017).

High-potassium foods (NIH ODS Potassium):

• 755 mg in ½ cup of dried apricots
• 731 mg in 1 cup of cooked lentils
• 644 mg in 1 cup of acorn squash
• 635 mg in ½ cup of dried prunes
• 618 mg in ½ cup of raisins
• 610 mg in 1 medium baked potato
• 607 mg in 1 cup of cooked kidney beans
• 496 mg in 1 cup of orange juice
• 443 mg in ½ cup of boiled soybeans
• 422 mg in 1 medium banana
• 366 mg in 1 cup of milk
• 334 mg in 2 cups of raw spinach
• 322 mg in 3 ounces of grilled chicken breast

Optimal Takeaways

• A high potassium intake is associated with better endothelial function, lower blood pressure, and reduced risk of CVD and stroke.
• The WHO recommends a potassium intake of at least 3,500 mg/day  
• High-potassium foods include dried fruits, baked potatoes, lentils, and kidney beans
• The Mediterranean contains an optimal amount of potassium and is associated with reduced CVD risk.
• Potassium depletion may be caused by aldosterone, insulin, magnesium depletion, beta-adrenergic agents, alkalosis, diuretics, beta-2 sympathomimetic bronchodilators, and genetic factors. Potassium retention can be associated with acidosis, alpha-adrenergic agents, catecholamines, ACE inhibitors, NSAIDS, and RAAS inhibitors (Udensi 2017).

NOTE: The National Academy of Sciences decreased the adult Adequate Intake (AI) for potassium from 4,700 mg/day in 2005 to 2,600 mg/day for women and 3,400 mg/day for men in 2019 citing “Given the lack of evidence of potassium deficiency in the population, median intakes observed in an apparently healthy group of people are appropriate for establishing the potassium Adequate Intake (AI) values.”

The AI is “a recommended average daily nutrient intake level based on observed or experimentally determined approximations or estimates of nutrient intake by a group (or groups) of apparently healthy people who are assumed to be maintaining an adequate nutritional state” (DRIs)

References

D'Elia, Lanfranco et al. “Effect of Potassium Supplementation on Endothelial Function: A Systematic Review and Meta-Analysis of Intervention Studies.” Nutrients vol. 15,4 853. 8 Feb. 2023, doi:10.3390/nu15040853 This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

NIH ODS Potassium. Health Professional. https://ods.od.nih.gov/factsheets/Potassium-HealthProfessional/