I'm often asked what my opinion about a diet or diseases. Who
cares, what my or anyone
else's opinion is, always you care about is what the science says. What does the best available balance of evidence published? In the peer-reviewed medical literature have to say right now, welcome to the nutrition facts podcast. I'm your host dr. Michael Greger today, we examine the need for
Or less sodium and more potassium. Rich foods, did you know that a staggering, 99.99 percent of Americans
failed to meet the minimum? Recommended potassium or the maximum recommended sodium. Here's the story. Worldwide, physical inactivity, accounted for more than 10 million years of healthy
life lost. But what we eat accounts for nearly 20 times that unhealthy diet shave hundreds of millions of disability free year.
Is off of people's lives. Every year, one of the worst aspects of our
diets four out of the five. The deadliest dietary traps involve not eating
enough of certain foods, not eating enough whole grains, not eating enough fruits, not eating enough nuts and seeds and not eating enough vegetables. But are most. Fatal flaw is too much salt
that's on the order of 15 times deadlier than dies too high and
soda. For example, just to keep things in perspective, there remains no single more effective.
Public Health action related to nutrition, then the reduction of sodium in the diet. This is why National and international health organizations have called, for warning labels on salt, packets and salt shakers with
messages like too much. Sodium in the
diet causes high blood pressure and increases risk of stomach, cancer stroke, heart disease and kidney disease limit. Your use salt also increases inflammation. For example. Sodium intake is associated with increased disease activity in multiple sclerosis.
Roses and inflammatory, autoimmune nerve condition
about three to four times. The exacerbation rate in those
with medium or high sodium, intakes compared to those getting less than a teaspoon of salt total in a day just so you can see higher sodium levels in the tissues of those who suffer from lupus and other serious inflammatory autoimmune disease. You can correlate high sodium levels in the spinal cord of Ms. Patients with the disease and decrease structural Integrity.
Where sodium found though really crappy food. So
It's hard to know if increased salt intake is
just a marker for bad diet overall.
But what we do know is that salt and high
blood pressure are caused an effect. How because we have more than 100 randomized, controlled trials demonstrating that. If you cut down on that, it's salt, your blood pressure's fall and the more you cut down the
better.
Part of the mechanism may actually be the damage so may do
to your microbiome, the, the friendly Flora in your gut
and no, wonder our bodies evolved only to handle about 750 milligrams a day. The American Heart
Association says, we should stay under least twice that about, but we're eating more than
four times what's natural and it's only getting worse increasing over the last
decade, anyone care to guess what percentage of
Americans exceed the
1500
G upper limit, recommendation, 98.8% and that was more than a decade ago.
The vast majority of us adults. Consume too much sodium
and at the same time to little potassium, a mineral that lowers blood pressure
less than two percent of u.s. adults. Consume the recommended daily minimum intake of potassium. Some
more than 98 percent of
Americans, eat potassium, deficient diets, this deficiency is even more striking When comparing our current intake with that of our
Who consumed large amounts of dietary
potassium. We evolved getting probably more than 10 thousand
milligrams a day.
The recommendation is to get around, at least half that yet. Most of us don't even come anywhere, close.
Put the two guidelines together and sodium and potassium goals are currently met by less than
0.01 five percent of the u.s. population.
So we're talking close to 99.99% non-compliance. As in only 1 in 6,000 Americans, even hits the recommended
guidelines. What about using potassium based salt substitutes? Instead of using sodium? Chloride salt? Why not Shake on some potassium? Chloride
seems a little too good to be true. I mean,
Salty taste, but you're reducing sodium, while at the same time, increasing your potassium intake. Is there a catch or potassium based salt substitute safe effective, you'll find out. Next of all the terrible things about our diets,
High dietary sodium intake. High salt intake is the leading risk estimated to be causing millions of deaths every year. Killing Millions, mainly through adverse effects, on blood, pressure, and increased risk of stroke heart attack. And
He damaged hypertension, high blood pressures still called the silent and Invisible Killer because it really causes symptoms. But is one of the most powerful independent predictors of some of our leading causes of death.
We evolved consuming a diet, very
rich in potassium and low in sodium, but today this pattern has been completely reversed this. Flip reflects a shift from traditional plant-based diets, high in potassium, and low in sodium, a shift from fruits, greens roots and tubers too. Salty processed foods, stripped of potassium, which is considered a nutrient of Public Health concern because ninety-eight percent of the u.s. population.
Doesn't even reach the recommended minimum, daily
intake of potassium. As I mentioned, in the last video
and low potassium intake itself.
Is implicated in high blood pressure and cardiovascular disease yet. Few Physicians actually think about proposing. Their patients. Eat more foods that are potassium-rich like fruits and vegetables to better control blood pressure. Even though several meta-analyses have now confirmed that high potassium intake appears to reduce the risk of stroke.
There's even a reduction in stroke risk independent of blood pressure effects. Consistent, with other protective effects of potassium, such as reducing clot formation reducing hardening of the arteries, reducing the generation of free radicals higher sodium intake, is associated with a
20% increase risk of dying prematurely wear higher potassium, intake was associated with twenty percent reduced risk of dying prematurely. Yeah, but sodium is found in crappy processed foods, while potassium is constricted and healthy foods, like
Beans and greens. So having low sodium
intake in high potassium intake. May
just be a marker for more healthful that more plant foods and less crap. How do we know sodium is cause and effect? Bad?
Because randomized control trial show, sodium reduction, leads to blood pressure reduction,
just like they're randomized, controlled trials showing that. If you give people extra potassium, you can bring down their blood pressures as well. So what about using
potassium chloride to salt? Your food rather than sodium chloride?
That's what's found in these zero. Sodium, salt substitutes,
potassium, chloride is a naturally
occurring mineral salt, which is
obtained. The same way we get
regular sodium salt
since we get too much sodium and not enough potassium. This would seem to make potassium chloride a win-win solution. Now,
whole healthy, plant Foods would be the best way to increase, potassium, intake, fruits and vegetables, have all sorts of other good things in them, besides
potassium, but we have 10 studies now, randomized, control trial showing that
Swapping in some potassium, chloride for regular salt can lead to significant reductions in blood pressure and people with hypertension. Suggesting,
that salt substitutes may even help prevent hypertension as well. We know, salt
substitutes can lower blood pressure, but does it actually decrease the
incidence of hypertension and more importantly disease endpoints like stroke mortality? You don't know until you put it to the
test and a randomized. Controlled trial
households had their salt replaced with just a quarter, potassium chloride.
I'd and that level. Most people either can't tell the difference or even prefer the salt with the potassium
mixed in.
Okay. But did it actually do any good? The use of even the
quarter salt substitute was associated with cutting, the risk of developing hypertension in half.
Okay, but what about actually following people out to see if there's any change in the risk of dying from cardiovascular disease. 5 kitchens in a veteran's. Retirement home were randomized into two groups
for about two and a half years. Salting meals with regular salt or unbeknownst to the cooks and the diners.
A 50/50 blend of potassium, chloride.
Those in the have potassium group, cut their risk of dying from cardiovascular disease by about 40 percent and lived up to nearly a year. Longer the life expectancy difference at age. 70 was equivalent to that, which would have naturally occurred in 14 years, meaning that just switching to have potassium, salt appeared, effectively make people more than a decade younger when it came to risk of death
as we speak. There's a massive randomized controlled trial wrapping up in China involving six hundred villages more than
People that'll give us an idea of just how low we can drop stroke risk with this strategy. China is perfect because sub to
75% of their sodium
intake. Comes from Salt. They add in the home kitchen or dining room whereas most sodium in the American diet comes prepackaged in the meat and processed foods. We buy
those, certainly the food companies could switch over themselves. Why haven't they and why haven't more people Embrace these salt? Substitutes if they work well and can taste just as good.
We could be achieving the benefits of a high potassium Paleolithic diet without the toxicity. So is salt substitution ready for prime time or what? What about safety, yes,
there are convincing arguments about the benefits,
but what about the risks? Like you know, the quote, unquote inclusion of potentially fatal salt substitutes in the food supply. Wait what? We'll talk about the potential
downsides next based on how we evolve the
Dietary potassium intake, likely greatly exceeds, current it even
recommended intakes. The problem is, we replace many of the potassium rich plant
Foods. We used to stuff our faces with like fruits, leafy greens and other vegetables including roots and tubers with calorie-dense junk
strip, not only a fiber, but also
potassium such as, you know, added fats and sugars. So in a traditional largely plant-based diet, potassium content is high. Sodium content is low
but now high blood
pressure is the second leading cause of death.
In the world. Can we more than 10 million people a year? Second only to unhealthy diets. The number one, killer of humanity,
we can improve both by eating more whole
healthy plant foods like beans and greens, which are packed with potassium, which lowers blood pressure.
But since most of us are getting too much sodium, along with two little potassium, what about
using salt substitutes? After
all the most commonly used, salt substitute is
potassium, chloride should be
swapping out sodium for potassium and it works based on
Meta-analysis more than a dozen randomized control, trials, replacing sodium chloride with potassium, chloride, lowers blood pressure, and most of the trials involve just swapping out regular salt for less
than 30 percent, potassium chloride and they still got
results and it less than
30%, most people can't even tell the difference
between regular salt in the potassium salt.
So, can taste exactly the same and drop your blood pressure's? What's the catch
potassium? Chloride is generally considered to Safe by the FDA with the only major concern for health.
Healthy people
being that if you go completely 100 percent sodium free and you straight potassium, chloride, can
taste, kind of funny, adding a bitter or metallic taste. I've
found that it depends on what I'm seasoning with it. It works perfectly well, in some things, but makes other
things completely inedible. When I learned about the sodium science and throughout my salt shaker for good within a few weeks. My palate totally changed
everything. Tasted fine without salt except pesto for some reason pesto without salt,
just, never tasted like it used to
me. So,
So I tried the potassium chloride, salt substitute, and it worked perfectly. I couldn't tell the difference at all. So I had the best of both worlds. Then I remembered how, as a kid, I used to put a tiny sprinkle of salt on watermelon, like they do in the South to make it even sweeter. So, I tried it with potassium, salt, and almost gagged, so definitely not for everything. The reason healthy people don't have to worry about getting too much potassium. Is that our kidneys just pee out the excess, okay, but that's with potassium.
In food, what about supplements? No, adverse effects have been shown for long-term, intakes of potassium, supplements is the highest 3000 milligrams a day. In fact, blood levels of potassium
or maintained in the normal range by healthy kidneys, even when potassium intake is increased, approximately fifteen thousand milligrams a day, which is no
surprise since we evolved eating
so many healthy plant Foods, so many fruits and
vegetables. That the normal natural potassium intake, for the human
species, may be on the
order of 15 thousand milligrams.
Basically, the
normal range were passing levels in the
blood is between three point five and five. And you start to worry when it starts creeping up towards 6:00. But give people potassium
supplements, like all this salt substitution trials have been giving study subjects. An average of about 2,000 milligrams of potassium a day and blood levels only
go up 0.14. So they might go up from four to four point. One four,
not something that would push you into
trouble. Now, there's a
Limit. If you have a quote unquote, massive banana, eating habit. You could
bump your potassium from normal to
above 6, but that was evidently from years of not doing much of anything except up to 20, Bananas a Day. Eating 10 pounds of carrots. Every day, is also probably not a good idea, that's like 75 carats in one day. What about overdoing salt, substitutes?
This report from the 1940s with son, lithium poisoning from the use of salt substitutes, why? Because
Theme chloride was used as a salt substitute Cheese's. But what about potassium chloride? Which is what's used today, there is
one fatal case of someone who committed suicide by Downing a little more than a tablespoon of potassium chloride salt
substitute
that doesn't seem
like a lot, just a
tablespoon. I mean, how can we keep that on the shell as if only a tablespoon will kill you? Well, even less than that of regular salt taking it once.
Kill you do. In fact, salt water ingestion was evidently a traditional method of suicide in
ancient China, though. These days, one may be more likely to die that way from abusive religious practices. Having said, all that there are a small number of the population who may run into problems, primarily those with, severely impaired kidney function. That's why there's been such a reluctance to push potassium based salt substitutes on a population level.
If your kidneys can't regulate your potassium, then you can definitely
run into
A serious issue and
we're talking about folks with known kidney disease diabetes,
since diabetes can lead to kidney damage, severe heart failure, those are medications that impair, potassium excretion, older adults, and individuals with adrenal insufficiency, if you aren't sure, if you're a risk, ask your doctor about getting your kidney function tested.
Ironically, potassium is so good at reducing deaths from high blood pressure, even among those with kidney disease, using potassium. Chloride salt substitutes, would probably still save
More lives despite the risk,
traditional dietary recommendations to kidney patients, limited the intake of fruits and vegetables because of their high potassium content.
However, this Paradigm is
rapidly changing due to the multiple benefits, derived from a fundamentally plant-based diet, a whole food plant-based diet, may even
ameliorate chronic kidney disease.
There's increasing evidence that a whole food plant-based diet may offer benefits like a slowing. The progression of chronic kidney disease and delaying kidney
failure. So the practice of restricting, dietary potassium in kidney
Should really be reserved for patients, with documented
hyperkalemia, potassium level of 6 or higher, because the key to halting the progression of chronic kidney disease. May, in fact lie in the produce aisle
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