Salt versus potassium blood pressure debate

The salt versus potassium blood pressure debate has been rewarding; it highlights just how much we can influence our own well-being simply by being more responsible in what we eat. Some very easy isometric exercises done daily will also make a significant difference.

The problem

The problem in a nutshell is that we are eating foods with too much sodium and not enough potassium. That is universally agreed upon by scientists.

A sub-problem is that once millers have extracted many of the nutrients from grains they have no flavour. So we have to add a lot of salt to make them palatable; and sugar too.

On the potassium side we eat far too little dark-green leafy vegetables, one of the prime sources of the mineral.

So the ratio that profoundly affects our kidneys goes way out of sync; too much sodium and not enough potassium.

Broccoli branching small headBranching broccoli

The Salt Wars

The Salt Wars[1] are raging; should we be cutting sodium from our diet or eating more potassium-rich foods.

The case for sodium is stronger.

"A meta-analysis of 85 trials showed a consistent and linear relationship between sodium reduction and blood pressure."

The massive problem though is consumer resistance. Food from the so-called "industrial diet" is so bland without extra salt; and various flavour enhancers.

Added to that is the fact that "others" add 75% of the salt to our food; so if we eat out a lot and purchase many processed meals from the grocery store we actually have little control ourselves over the amount of sodium.

Sodium reduction is not easy.

Added to that is the corruption amongst some scientists. The "Jackson Six" for example never disclosed funding from the salt industry. Consumers have begun to distrust research, particularly if it goes against their innate desires.

Nevertheless there are strong studies such as the CARDIA-SSBP crossover trial that proved that reducing dietary sodium was as effective as medication when it came to lowering blood pressure.

The case for potassium is strong too

Physiologists have clearly shown that low levels of K turn on the "potassium switch" in the kidneys which leads to sodium reabsorption; even in the setting of high Na intake from our food.

More complex is that diets low in sodium used by researchers almost invariably have higher levels of potassium; so it cannot be claimed that the results were conclusively because of one mineral or the other.

Potassium salt

There are some recommending potassium salt or a mixture lower in the mineral. The problem is that it's very bitter and has a metallic aftertaste; so there is consumer resistance.

And prescribing potassium tablets has to be very carefully managed; it can induce serious "hyperkalemia."

Nevertheless the pharmaceutical industry argues that doctors happily prescribe iron, vitamins B12 and D so why not potassium too?

More fruit and veg

Fruit and vegetables are rich in potassium and lower in sodium; both sides from the Salt Wars are in agreement.

But there again there is consumer resistance on the street. There are complaints that fresh fruit is too expensive and the fast-food industry has very successfully convinced us that our nosh comes from grocery stores and restaurants.

So why not just eat whatever we like and simply take anti-hypertensive medication? Or, for those reluctant to take drugs doctors can prescribe potassium supplements?

Cape gooseberriesFresh fruit is easy to grow

Sodium in processed foods

Others are calling for legislation to reduce the sodium in processed foods. Universally commercial bread, pizzas and canned soups for example have very high levels of salt.

Many find that draconian and unenforceable in any case; and our food without its natural flavouring would be very bland.

Great-grandmother's cooking

Long ferment sourdough breadWholemeal sourdough bread

"Let thy food be thy medicine, and medicine be thy food."

Hippocrates (460 - 370 BC)

Being a disciple of Hippocrates compels me to recommend, unpalatable though that may also be that we return to the good food that our great-grandmothers once put on the table. Is that practical and doable? Or have we moved so far from our roots that suggesting we start growing and preparing our own meals once again simply cannot and will not be done?

That's what they Blue Zone people do; grow and prepare their own food. There are many plusses.

  • Out of doors we are exposed to more sunlight; vitamin D will no longer be a problem
  • Digging in the garden, preparing compost heaps and using the wheelbarrow is good exercise. We can cancel our gym contracts.
  • A quiet walk in the garden whether simply to admire your handiwork and nature at work is very relaxing; it's akin to what is being called forest bathing.
  • Fresh vegetables from the garden are so much tastier.
  • Fresh fruit all year round from the garden is feasible in many climes; and far cheaper.
  • The salt versus potassium blood pressure debate can be relegated to where it belongs; on the scrap heap.

Investing in long-term health may seem like a "bridge too far." And spending more time in the kitchen once again preparing food that is naturally low in sodium and high in potassium impossible. Then we are faced with anti-hypertensive medication with all its side effects; and bucketloads of supplements.

The salt versus potassium blood pressure debate is all set to continue for those unwilling to change their ways.

"There is increasing evidence that exposure to plants and green space, and particularly to gardening, is beneficial to mental and physical health."

- Clinical Medicine (PMC6334070)[2]


Lifting new potatoesNew potatoes are rich in potassium; and much less fattening.

There are conflicting opinions on potatoes but one of their virtues is that just one medium-sized spud contains 20% of the daily recommended allowance of potassium; if you use the water it was cooked in for making a soup or gravy.

Alas potatoes from cold storage are not be recommended especially if baked or eaten as french fries; the GI is very high and they certainly contribute to the growing insulin-resistance pandemic.

For the home gardener though new potatoes are a gem; they have far more "resistant starch" which goes to feed the bugs in the colon instead of being turned into glucose.

Isometric exercises for lowering blood pressure

Astonishing research that two simple isometric exercises for the quadriceps muscle will low both diastolic and systolic blood pressure by 6 to 10 points; enough for some people to go off medication.

Use about 80% of your leg power and hold for 45 seconds.

These knee exercises are not an alternative to the salt versus potassium blood pressure debate; coupled with a return to fresh fruit and vegetables most folk could get off anti-hypertensive medication.

Isometric knee bends for hypertensionExtend the knee against the weight of the chair
Isometric knee bends for hypertensionNot too deep

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