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Naomi K. Fukagawa, professor of medicine emerita at the University of Vermont’s Larner College of Medicine, and her co-authors argue that blood pressure advice leans too hard on sodium and too lightly on potassium. Their paper in The American Journal of Clinical Nutrition, described in a University of Vermont release, calls for pairing less sodium with more potassium. The authors still describe sodium reduction as foundational, and they name 5 foods as examples of potassium sources: bananas, potatoes, beans, leafy greens and yogurt.
Why Sodium Advice Alone Leaves Out Half the Equation
The paper is titled “Rethinking the impact of dietary sodium and potassium on blood pressure to advance public health.” News-Medical reported that high blood pressure affects more than 1.28 billion adults worldwide and is a leading risk factor for cardiovascular disease. The work was supported by the Sodium in Food and Health Implications Committee of the Institute for the Advancement of Food and Nutrition Sciences, a nonprofit.
Current public health guidance focuses mainly on cutting sodium. The authors say average sodium intake remains above recommended levels, while potassium intake is “far below optimal levels in both developed and developing nations.”
Potassium matters because it helps the kidneys remove excess sodium and supports healthy blood vessel function. Fukagawa said growing evidence shows that increasing dietary potassium as well as reducing sodium intake work together.
The paper does not say salt cutting has failed. The authors write that “dietary sodium reduction is a foundational strategy for hypertension prevention and management.” Their proposal is to add potassium to that message, not to replace it.
The 5 Potassium-Rich Foods the Researchers Name
Potassium is naturally present in fruits, vegetables, legumes and dairy products, according to ScienceDaily’s write-up of the University of Vermont release. The examples it gives of foods that can help increase potassium intake are bananas, potatoes, beans, leafy greens and yogurt.
Those 5 line up with the broader groups: bananas for fruit, potatoes and leafy greens for vegetables, beans for legumes and yogurt for dairy. None of them requires a specialty store, and most are already staples in American kitchens.
Nutrition Insight noted the paper’s statement that high-potassium diets have consistently been associated with improved cardiovascular outcomes in population studies.
Why Cutting Sodium Has Been Hard to Sustain Alone
Sci.News, which also covered the paper, reported that the authors see sodium reduction as the main population strategy to date, but one that is hard to sustain because people prefer salty flavors and reformulating food is technically difficult. In wealthy nations, most dietary sodium comes from packaged and restaurant food rather than the home salt shaker.
That helps explain why the researchers want a second lever. Per the same coverage, the paper suggests using sodium-to-potassium ratios as a target for food reformulation, expanding education campaigns that promote potassium-rich foods such as fruits and vegetables, and helping lower-income households reach those foods.
The authors also raise potassium salts as a way to replace some of the sodium chloride in ordinary table salt. There is a catch. Potassium salts can only be added to foods up to a certain level before a metallic taste becomes noticeable, so food makers have to balance sodium and potassium carefully.
How Much Potassium Adults Are Advised to Get Each Day
The coverage of the paper says firm potassium targets do not yet exist, but a separate federal source gives a benchmark. The National Institutes of Health Office of Dietary Supplements lists in its potassium fact sheet an Adequate Intake of 3,400 milligrams a day for men and 2,600 milligrams a day for women, ages 19 and older.
The fact sheet adds that higher potassium intakes “may help decrease blood pressure,” and that most clinical trials suggest potassium supplementation lowers blood pressure, with the strongest effects in people who already have hypertension.
Who Needs Medical Guidance Before Raising Potassium
The release is plain about one limit. People with kidney disease or those taking certain medications may have difficulty regulating potassium levels, and potassium supplements and potassium-based salt substitutes should be used with medical guidance when these concerns apply.
The Office of Dietary Supplements goes further. It says its Adequate Intake figures do not apply to people with impaired potassium excretion from conditions such as kidney disease, and that even intakes below the Adequate Intake can cause hyperkalemia, a buildup of potassium in the blood, in those individuals.
It also notes that ACE inhibitors, angiotensin receptor blockers and potassium-sparing diuretics can lead to high potassium and call for monitoring, while loop and thiazide diuretics increase potassium loss. Anyone taking blood pressure medication or living with kidney disease should talk with a doctor or pharmacist before changing how much potassium they get.
The message from the researchers is addition, not substitution: keep cutting back on sodium, and add potassium-rich foods where it is safe to do so.
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This article was produced with AI assistance and edited for accuracy against the sources linked above.
Image: Wilfredor – CC0/Wikimedia Commons (https://commons.wikimedia.org/wiki/File:Bunch_of_bananas_on_sale.jpg)