A new report of the critical role inadequate potassium intake plays in contributing to hypertension finds that sodium reduction in combination with boosting potassium intake may be the best path forward.

Public health guidelines underscore sodium reduction as a way to reduce hypertension and cardiovascular disease risk.

But in a new report, a team of physicians and other health experts propose that dietary impact will be greater if North Americans embraced a paradigm shift away from a singular focus on sodium reduction to include increasing potassium intake, which can serve as a salt substitute.

The article reviews 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.

The peer-reviewed article appears in the American Journal of Clinical Nutrition and was supported by IAFNS Sodium in Foods and Health Implications Committee.

Excessive sodium intake and insufficient potassium consumption are major modifiable contributors to elevated blood pressure as hypertension affects over 1.28 billion adults across the globe. 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.

Food manufacturers have been using potassium chloride (KCl) and other potassium-containing ingredients as a way to reduce sodium over the years, but 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.

“With experience and new evidence at hand, we are proposing a shift from the singular focus on significant sodium reduction to include the complementary strategy of increasing potassium intake,” the authors say.

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.”

According to author Dr. Naomi Fukagawa, “it is time to view dietary interventions holistically because food components interact and physiology is integrative across systems. Growing evidence shows that increasing dietary potassium as well as reducing sodium intake work together to better manage hypertension.”

The paper is freely available here.

The Institute for the Advancement of Food and Nutrition Sciences (IAFNS) is committed to leading positive change across the food and beverage ecosystem. This paper was supported by IAFNS Sodium in Foods and Health Implications Committee. IAFNS is a 501(c)(3) science-focused nonprofit uniquely positioned to mobilize government, industry and academia to drive, fund and lead actionable research. iafns.org