Friday, February 17, 2012

Potassium, Sodium and Chloride

How often have all of us heard someone say that they are eating bananas for the potassium and wondered what that meant or why anyone cared about their potassium intake?  When I was young my mother was always eating bananas for the potassium since she had high blood pressure.  It was decades later before I understood what was going on.  Since I assume that many of you didn’t learn this in school either I thought I would explain it so we all understand why we should care about our electrolyte intake and our ratio of potassium to sodium.

Potassium (K), sodium (Na) and chloride (CI) are all electrolytes (mineral salts) which conduct electricity when dissolved in water.  These electrolytes serve important functions in the body including playing roles in the maintenance of: water balance, kidney and adrenal function, acid and base balance, muscle and nerve function, and heart function.  Doctors have known for years that diet high in sodium and low in potassium was associated with high blood pressure. Additionally many studies have showed that a high-sodium and low-potassium diet is associated with both the development of both cancer and cardiovascular disease.  I hope you are starting to see that the balance of these electrolytes in your body matter, a lot!

I will not be talking much about chloride because chloride coexists in nature with sodium and table salt is actually sodium chloride (NaCI).  Foods which contribute sodium to your diet also provide chloride.  Sodium and chloride are highly bioavailable and are typically absorbed in the small intestine.  However people who experience intestinal malabsorption (either due to disease or GI infections) can find themselves sodium deficient.  People who experience severe diarrhea and vomiting can experience sodium and chloride deficiencies.  Healthy people are unlikely to be sodium deficient.

Most Americans consume a potassium to sodium ration (K:Na) of 1:2 or lower.  What that means is that they are consuming twice the amount of sodium as they are potassium.  However the problem is that scientists think the ratio should be 5:1 (potassium to sodium) or higher.  Now the question becomes how do we increase our potassium by 10 times and that is one way to look at the problem that we are faced with.   However don’t forget that you can always decrease your sodium as well. The good news is that fresh fruit and vegetables are packed with potassium while being low in sodium.   Most fresh produce contains at least 100 grams of potassium to a few grams of sodium.   Here are a few examples of foods comparing milligram of potassium to sodium so that you can see the difference in natural versus man-made items:

Acorn Squash, 1 cup cubed and baked (896:8)
Apple, 1 medium (182:2)
Asparagus, ½ cup (165:1)
Avocado, ½ (680:5)
Banana, 1 medium (467:1)
Black strap molasses, 1 tablespoon (498:11)
Bread whole wheat, 1 slice (71:148)
Cantaloupe, 1/8th of a large (315:9)
Catsup, 1 tablespoon (72:178)
Chickpea, 1 cup cooked w/o salt (477:11)
Ham lunchmeat 1 slice (56:283)
Mozzarella, 1oz part-skim (24:132)
Mustard, 1 tablespoon yellow (24:168)
Orange, 1 medium (263:1)
Parmesan, 1 tablespoon shredded (5:85)
Potato, 1 medium (782:6)
Prunes, 1 medium (63:0)
Pudding mix, fat-free sugar-free chocolate , 1 svg prepared (122:318)
Quinoa, ¼ cup uncooked (314:8)
Tomato, 1 medium raw (444:5)
Tomato, 1 cup canned whole (530:440)
Soup Cream of Tomato, 10.75 oz can (644:1690)
Soy sauce, 1 tablespoon (64:871)
Swiss cheese, 1 oz (31:420)

I intentionally included a number of foods that I think are commonly found in the American diet.  The reason was to show you how much sodium is in a tiny amount of these processed foods.  Did you notice that the man-made food (except canned tomatoes) contains more sodium than potassium but that the opposite is true of the natural items? Why do processed foods contain so much sodium?  Salt was originally added to food to delay spoilage.  However when you read the ingredient labels of food now you will see that there are chemical preservatives added for that job. Salt is primarily added to food because our tastebuds have all grown to expect it.  When you eat a diet full of salt and give up the salt food initially tastes bland.  Since most Americans consume a lot of sodium food processors continue to use a lot of sodium to make their food appealing to the majority of consumers.

Since so many of us consume a diet low in potassium should we be worried about potassium deficiency?  According to Dr. David Katz deficiency of potassium is not common but does occur.  Conditions which cause fluid shifts (like surgery or being in the hospital), or metabolic imbalances (such as diabetes) can produce life-threatening potassium imbalances.  Potassium deficiency at less dangerous levels results in symptom which can include:  high blood pressure, heart rhythm disturbances, muscle weakness, paralysis, mental confusion and irritability.  All this just from eating a diet low in fresh fruit and vegetables and high in sodium?  Did you realize that there are few commonly used items that rob your body of potassium?  Drinking alcohol and taking aspirin also reduce your potassium levels as do taking diuretics.  Eek!  I don’t know about you but I think it is simpler to eat my fruits and veggies than to think about this.  Also remember that herbal diuretics can reduce your potassium so you should use those sparingly as well.

The elderly are at a higher risk for potassium deficiency as are athletes.  In the elderly the problem is typically due to inadequate intake or diuretic use (common with cardiovascular disease), but in athletes the issue is usually potassium loss through sweat.  If you spend a lot of time exercising (and therefore sweating) it is recommended that you should be consuming additional potassium (produce).

I don’t recommend that anyone take potassium in supplement form since it can cause nausea, vomiting and diarrhea.  Consuming fresh vegetables and fruits in their natural form are unlikely to cause problems.  People with kidney problems need to be careful with how much sodium and potassium they include since the kidney is what balances our electrolytes. If you have kidney disease you need to talk to you doctor before you dramatically change the intake of potassium or sodium containing foods.  The adequate intake (AI) of 4,700mg/day for adults is recommended. However it is worth knowing that our ancient ancestors are thought to have eaten more than 10g of potassium per day.

What about sodium is there any easier way to lower it?  Actually it is easy to lower your sodium intake but it involves eating a diet which is once again based on whole plant-based foods.  Once you start reading labels and focusing on sodium content I think you will be shocked by the amount of sodium in foods. I was very surprised by the amount of sodium in bread and canned tomatoes.  Most bread is also a problem because it frequently contains both high fructose corn syrup and soy protein isolates not to mention preservatives and other things that I don’t eat.  Canned tomatoes contain not only a lot of sodium but also BPA.  *sigh* Sometimes it feels like nothing is safe to eat anymore doesn’t it?

There is no RDA for sodium but a daily intake of 115mg (which is very easy to both reach and to exceed) is considered essential.  According to Dr. David Katz 500mg per day is recommended, and we reach and typically exceed that every day either without adding salt to food or eating processed food if that makes you feel better about eating a diet like ours.  It is estimated that our ancient ancestors consumed less than 1,000mg of sodium per day, far less than the 4,000mg+ which the average American now consumes daily.

Asian foods tend to be very high in sodium so be careful with your use of soy sauce, liquid aminos, miso, and other Asian condiments and sauces.  As much as I love Asian food, I try to keep our consumption to a minimum so that our average sodium intake doesn’t get out of control.

If you still eat cheese that is also a hidden source of sodium that you should keep in mind. Cheese like feta is particularly high in sodium.  In addition to sodium, cheese contains an abundance of saturated fat which isn’t good for your arteries and it increases your levels of IGF-1 which fuels cancer growth.  As much as I love the taste of cheese I can’t look at it now without seeing something that I now consider a toxin.   There are days when I wish I could unlearn some of the nutrition facts that I have learned.  However I know it is in the best interest of my family to keep cheese out of our diet.  Darn it!  ;-)

If you eat lunch meat, bacon, smoked meats or processed meat like sausage you are also consuming a lot of “hidden” sodium. The next time you are in the grocery store look at the sodium content on lunchmeat and smoked salmon and I think you will be surprised by how high it is.  I calculated the potassium and sodium content of a ham and cheese sandwich assuming 2 slices of whole wheat bread, 3 slices of ham, 1 oz of Swiss cheese and 1 tablespoon of mustard and the potassium was 365mg but the sodium was 1,733mg.  Whoa!  Even I was surprised by those numbers.  However it makes it easy to see how the typical American diet would contain over 4,000mg of sodium doesn’t it?  Instead of a sandwich with lunchmeat and cheese how about a veggie wrap with hummus (no salt), roasted and raw veggies?  That would contain a lot of potassium, vitamins and micronutrients and not much sodium.  Are you starting to see why I order those when Ian makes my lunch?  ;-)

The bottom line is that most of us are consuming too much sodium and not enough potassium. We would all be healthier if we reduced our consumption of packaged or processed food and ate more fresh food.  If you just do those two things you will be making a huge difference in your health.


Breakfast for both of us was a green smoothie which was made with:  kale, frozen mango, frozen banana, walnuts cinnamon, water, coconut extract and a little stevia.  I ran out of frozen cherries but did have a frozen mango which is why you aren’t seeing the chocolate cherry green smoothies currently.

I spent some time reading a new textbook that I purchased on health psychology before it was time see my girlfriend Deirdre for lunch.  Deirdre is my friend who quit her federal government job to go back to school to get her PhD in psychology.   Have I said recently that Deirdre is my hero?  I am still in awe of her ability to quit her job and go back to school being a single girl.  Wouldn’t we all love to have chutzpah like that?

Lunch with Deirdre took place at the usual place. Since Deirdre lives in the neighborhood now we can get together at my favorite place.  Deirdre likes it enough that she now goes there without me as well. I think that speaks volumes.

I started lunch with a bowl of the white bean, kale and sweet potato soup.  Deirdre had tomato bisque, which I did not photograph.

For my entrĂ©e I asked if the kitchen would make the veggie and hummus wrap and put a small salad with that.  I never get tired of this combination.  Deirdre had a turkey burger and sweet potato fries which again I did not photograph.

Being girls Deirdre and I talked for hours and hours and that meant there was time for Deirdre to have a little dessert. She ordered a carrot cake cupcake which was so cute that I had to take its picture. Carrot cake was always my favorite cake but I was good and didn’t have a bite.  It smelled delicious even from across the table.  LOL

Dinner was a simple bowl of leftover curried lentil soup.  Thank goodness for intentional leftovers. Having intentional leftovers on hand is the primary reason that I am able to keep such an uber healthy diet. If you are trying to eat a healthier diet, start with making intentional leftovers.   I think you will be surprised by what a difference that makes.

Happy Thoughts:

·         Wednesday we had the most glorious weather. I went to the dentist got a little beat up but it was all good.  I took a few pictures leaving the dental office to give you a sense of life in the city.  While I was at the dentist I learned something new.  The outer covering of popcorn can get under your gums and when it does that it also does not degrade and can turn into an abscess. Thankfully mine just required some digging to remove (fun stuff!) but I won’t be having popcorn for a while now that is for sure. After that little revelation popcorn might just be off my “preferred” food list now.  It wasn’t all that thrilling without oil and salt anyway.  ;-)  Poor Binky, he is going to miss having popcorn when we watch movies.  Yes, Binky actually eats popcorn which we found out by accident one day and I had to snap the picture of him getting his own.  Only at our house would that be considered cute.  LOL

·         I stopped at the library on Wednesday and picked up more books. I know what you are thinking believe me.  How does she have time to read all these books?  Dan asks the very same question.  No matter where I am I have a book with me. Tuesday while I waited for Deirdre to arrive at lunch I was reading.  Wednesday I was reading while in the waiting room at the dentist.  I literally always have a book with me. You didn’t think I got all this nutrition knowledge from osmosis did you?  LOL

·         While I was in Hunt Valley I stopped at Wegman’s for provisions which in my case meant raw organic nuts and seeds (raw cashews, raw pumpkin seeds and Brazil nuts), many bags of dried organic beans, black strap molasses (an excellent source of potassium, calcium and iron), turmeric (always good to have one hand), and some hulled hemp seeds to name a few items.  I must be quite the sight checking out at the grocery store. I often wonder what the clerks think when they ring this stuff up and put in the bags.  ;-)

·         Thursday I spent most of the day at Hopkins again.  There are definitely positives and negatives to sitting in hospital waiting rooms all day. Every time we are here I am always reminded how fortunate we are with how things have gone for us.  However I am also struck by the pain and suffering that other people have to endure.  *long exhale*  When you are someone like me who feels for others it is extremely difficult to see other people suffering.  There were people in wheelchairs who obviously didn’t have the energy to walk.  Other people were on oxygen and many people without hair.  Cancer is a horrible disease that I probably see more often than the rest of you.  The fact that always surprises me is the number of people that I see who are very obviously younger than I am.  When I was in my 30’s I thought cancer was something that happened to old people but that is not the case now. There were plenty of people in their 30’s and 40’s in the waiting room again yesterday.  That is part the reason I am so dedicated to show you that it is more than possible to live a healthy life, and that it does make a difference.  You have no idea how much I want you understand that.  I don’t want any of you to be one of those people I see in the Hopkins waiting room who cause me to fight back tears when I see them.

·         Friday I expected to spend the afternoon with my friend Will who just came back from NYU where he did a nutrition certification program.  However he needed to run to the dentist for an emergency procedure so I ended up having a little time on my hands to get caught up on some tasks at home.

·         We had incredible weather again on Friday with temperatures in the med-50s and even a little sun.  I love this time of year!  Anytime it is still in the 50s at 8 o’clock at night is fine with me. We went for a nice walk this evening before dinner.

Signing out:

This has been a crazy busy week for me.  Every day this week I have been out of the house for much of the day.  Next week I have much more free time in my schedule which I am definitely looking forward to.  Do you ever feel like your to-do list is completely out of control?  That describes my life at the moment, too much to do and not enough time to do it.  On that cheery note I have to get back to my to-do list so that I can relax a little and enjoy my weekend with Dan. Talk with you again soon.  I hope that you enjoy your weekend.


  1. I started reading this post while I was eating a delicious organic banana. Very informative Ali. The potassium to sodium ratios are pretty astounding.

    I learned recently that bananas are considered truly ripe when they have little brown spots on them. I never knew that and realized I had been eating many not fully ripe bananas. I ripened mine well and have really been enjoying them the last few days.
    I had the pleasure of using my very own Vitamix for the first time last night to make a "dinner smoothie" - it was so amazing! I put hemp, kale, banana, berries, mango, a bunch of supplements, walnuts and ice in it and it blended smooth in 30 seconds - I was so excited! The kale actually blended smooth :)

    My hygienist gave me this neat tool that is like a soft bristle mini brush to clean the gums. I use it every time I eat popcorn and it really works.

    I find hospitals to be very draining emotionally - you are such a trooper. *HUGS*

    1. Possum (N),

      Yay for your new Vitamix. I know you were doing the happy dance last night. I just love mine and use it every day multiple times per day and bet you will too. Your smoothie sounds delicious! Now that you have your Vitamix you can store ripe bananas in the freezer. I let them get a lot of black spots, then I peel them and put them on a half sheet pan lined with a silpat and freeze them until they are solid and then pop them into ziptop bag. Frozen bananas are great in smoothies.

      Great tip on the mini brush I will send my hygentist an email today to ask about those. Dan's office is literally one building away from our dentist so he can pick up the mini brushes for me on Monday. Binky thanks you for the tip because he loves popcorn during movie night and now gets his own bowl. Only at my house. LOL

      Hospitals are definitely draining and I never realized that when I worked there. But then again I also didn't have as much exposure to patients as I do now and I am sure that is the difference. Thanks for the hugs, I appreciate them a lot! :-)

      Enjoy your weekend,

  2. Hi Ali,
    Many of my hiking pals seem to think they need extra NaCl to prevent leg cramps--do you know if that's true?

    What do you do with blackstrap molasses? I think I've only used it in cookies (healthy ones, of course)!

    1. Laura,

      There are many possible of causes of leg cramps so I wouldn't automatically assume it is low sodium since most Americans are high not low. I wouldn't be taking sodium to "prevent" leg cramps that haven't happened particularly since too much sodium has been linked to both cardiovascular disease and cancer.

      Blackstrap molasses is something that I add to green smoothies (sometimes) and I use a little when I make granola. It is also good in baked beans.


  3. Hey Ali!

    hope you and Dan are doing well. I have a question which came up for me again today. If you've touched on it before and could point me to the info that would be great.

    My cholesterol is good, but my HDL is low. I received the standard recommendation: fish oil pills, eat more salmon & tuna. I don't want to do that! Is the ratio really that much of a concern? Wouldn't chia and/or flax seeds accomplish the same thing?

    Take care,

    1. Hey Neca,

      Sorry for the delay in responding to this. There are a few ways to increase your HDL, a few glasses of red wine per week is the recommendation of a cardiologist friend of ourse. However I would probably opt for more exercise. How is your total cholesterol? I found that adding a tablespoon of chia, flax or hemp daily seemed to increase my HDL. Hope you find something that works.


  4. It's been a month.... I miss you! Miss your facebook posts on all the latest research, too.

    1. Laura,

      Life got completely out of control at our house. It is a long story but hopefully things will be more like normal going forward. *fingers crossed* Sorry to make you worry.


  5. No popcorn?! I'm pretty sure I would just die without popcorn. :-( But the food from the restaurant looks delicious!

    1. Bianca,

      I was pretty sure I would die without popcorn too but it is okay. However I will admit that I still miss it. LOL


  6. thanks for all the nutritional info., ali! xoxo

  7. Alicia,
    You said the key word, "Hummus". I love hummus.
    Is the white kitty eating popcorn?
    Peace :)

    1. Chandra,

      Yep Binky (the white kitty) was eating popcorn. I am not sure which one of us misses popcorn more me or the cat. LOL


  8. Ali, I just thought I'd stop by and see if you're doing okay. I am thinking of you today! :-)

    1. Cindy,

      Thank you for thinking of us. Life has been crazy for a few months but I think I have things under control now. Only time with tell though. ;-) I hope things are going well for you.


  9. Very good information about electrolytes. They are indeed very important. And I agree that eating them is the best way to obtain them. I am seeing more and more value in whole foods. I have stopped cooking with dairy and eggs, and am redoing my website to reflect that.

    The food all looks delish, both the restaurant food and your (I am sure very yummy!:) creations. The soup looks especially good to me. Thanks for instilling the value of intentional leftovers. I am now doing that more, and attempting to find uses for unintentional leftovers, which can be fun. :P

    I am glad you are doing well, and I hope to see a new post from you soon! God bless! :)

    1. Angel,

      Woo hoo for eliminating the dairy and eggs and your house! Good for you. I hope that the transition was easy for you and for your family. :-)

      Thank you for telling me that the idea of intentional leftovers was helpful for you. I really wouldn't know what to do without out.

      thanks for checking on us,

  10. Hi,

    This is the wrong place for this comment, but I've been searching all over and can't seem to figure out if you have posted this anywhere...

    Basically, I'm just curious as to what you use in your kitchen as far as appliances. I know you have a vitamix, which is great because I do too, now :)

    What kind of pressure cooker do you use? Electric vs Stovetop? I have an electric Cuisinart.
    Do you use a food processor and a vitamix or just use the words interchangably?
    Also, do you make your own breadcrumbs?


    1. Yup,

      I have a stove top pressure cooker which is a 6-quart Fagor. I also have a 14 cup Cuisinart food processor that I use when I want the food to have some texture.

      Yes I also make my own breadcrumbs. I use my 100% whole wheat focaccia and turn that into crumbs in my food processor and then freeze them in ziptop bags.

      hope that helps,

  11. If this shows up twice, I apologize, my interwebs are acting up...

    What kind of pressure cooker do you use? Stove top or electric? I have an electric.
    Do you have a vitamix and food processor or do you just use those interchangably?
    Finally, do you make your own breadcrumbs or use store bought?

    Sorry for the barrage of questions ;)

    1. Yup,

      Your comment did show up twice but no worries. My connection seems to act up a lot too.



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