Most of us know we should reduce the salt (sodium chloride) in our diet to help control blood pressure and reduce the risk of having a heart attack or stroke. While the amount of sodium we eat is important, it’s not the whole story. A recent study has confirmed what other studies have suggested for years: sodium intake alone isn’t as important as the ratio of sodium to potassium.
The study was reported in the January issue of the Archives of Internal Medicine. 1 It evaluated the records of 2275 patients who are being followed as part of the Trials of Hypertension Prevention (TOHP) studies begun in the early 1990s.
What the study showed was that over a 10-15 year period, 193 participants had a serious cardiovascular episode (heart attack, stroke, need for coronary artery bypass or death due to stroke or heart attack).
They then compared the risk of these problems to the level of both sodium and potassium in the diet. They measured these levels by looking at how much of each was excreted in the urine each day. This is an easier and more accurate way to get a handle on how much potassium or sodium someone is taking in than recording everything they eat. It works because our bodies maintain their internal balance of sodium and potassium by excreting any excess in the urine.
The researchers found that there was little relationship between the levels of either sodium or potassium and the risk of a stroke or heart attack.
What did make a difference was the ratio of sodium to potassium.
People with high sodium levels compared to their potassium levels fared the worst. They were the most likely to have a heart attack or stroke.
Those with low sodium and higher potassium levels did the best. They stayed the healthiest.
What does this mean to you? Cut out the salt and increase your potassium.
To reduce the sodium in your diet, you’re going to need to read the labels on any prepared foods you buy. Most packaged and canned foods are extremely high in sodium (although I did finally find a brand of crushed tomatoes that doesn’t have any salt added).
When it comes to increasing potassium, many people think about bananas. Bananas are relatively high in potassium, but they also are calorie dense and high on the glycemic index so they aren’t my first choice to add potassium to my diet.
Here’s what I do.
I drink tomato juice or a tomato-based vegetable juice. One cup has about 500 mg of potassium, about the same as in a banana.
Tomato juice also contains lycopenes as well as a host of other nutrients. The positive effect of lycopenes on prostate health is well established so I want to be sure to get them in my diet.
Unfortunately, manufacturers usually add a lot of salt, but low salt and no-salt versions are available if you look for them. If you buy organic, so much the better.
I add a little potassium chloride (NoSalt is one brand) to my tomato juice because I think it improves the taste and it adds some more potassium. If you do that, be a little careful — too much potassium can be toxic.
Anyone who has kidney disease needs to be especially cautious and shouldn’t add potassium to their diet without talking to their doctor.
Also, I enjoy the taste of horseradish and there are some studies that show the glucosinolates in horseradish support liver function and suppress the growth of some cancer cells, so I add that to my tomato juice drink as well.
Cut your salt intake and have a glass of tomato juice every morning and you’ll reduce your risk of stroke and heart attacks. You’ll also be eating one of the nine servings of fruits and vegetables you should have every day.
Arch Intern Med. 2009;169(1):32-40.
[ Ed. Note: Joseph F. McCaffrey, MD, FACS is a board-certified surgeon with extensive experience in alternative medicine, including certification as a HeartMath Trainer. His areas of expertise include mind-body interaction and cognitive restructuring. Dr. McCaffrey strives to help people attain their optimum level of vitality through attention to all aspects of wellness. For more information, click here.]