Food News: Potassium and Your Health

Ask anyone to name a source of potassium and inevitably they’ll say “bananas.” Yet if you ask that same person why we need potassium, you might find less of a definitive answer.

In fact, few can answer that question.

Potassium is a mineral that’s not only found in bananas, but also citrus fruit, green leafy vegetables, yogurt, beans, whole grains, and sweet potatoes. Researchers suggest that it’s wise for people to increase the amount of potassium in their eating patterns, since potassium can help lower blood pressure, regardless of sodium intake.

Let’s take a closer look at some of that research…

Dr. Alicia McDonough, a professor of cell and neurobiology at the Keck School of Medicine at the University of Southern California (USC), evaluated the diets of several populations and found that higher potassium intakes were associated with lower blood pressure, no matter what the sodium intake was. Her review included a combination of interventional and molecular studies evaluating the effects of dietary potassium and sodium on high blood pressure in various populations. During this review, she found that the kidneys get rid of more salt and water when dietary potassium intake is high. McDonough likens high potassium intake to taking a diuretic or water pill.

Unfortunately, a typical American diet tends to be higher in processed foods, which in turn tend to be high in salt content and low in potassium. One of the most cost-effective strategies to reduce blood pressure is to cut back on salt. Improved consumer education regarding salt, changes in processed food, and reduced consumption of high sodium foods should be implemented to this effect.

Why?

Let’s explore some more data.

Finland and the UK were first to start salt reduction programs. According to the World Health Organization (WHO), Europeans consume an average of 7-18 grams of salt per day, which is far above the suggested limit of 6 grams per day, which contains 2400 mg sodium. The Institute of Medicine (IOM) suggested that adults consume 4.7 grams of potassium daily to reduce blood pressure, reduce the impact of high sodium intake, and slash the risk of bone loss and kidney disease. Dr. McDonough notes that consuming just ¾ cups of dried beans daily can help individuals reach half of their potassium goal.

Here are more ways to obtain more potassium:

  • Eat an orange or banana daily.
  • Include green leafy vegetables daily. Think broccoli, spinach, or kale.
  • Snack on unsalted nuts.
  • Add an avocado to your salad or sandwich.
  • Choose dark orange fruits and vegetables like melon and sweet potatoes.
  • Enjoy kiwi, mango, or papaya regularly.

By Lisa Andrews, MED, RD, LD

Reference:

Alicia A. McDonough, Luciana C. Veiras, Claire A. Guevara, Donna L. Ralph, Cardiovascular benefits associated with higher dietary K vs. lower dietary Na evidence from population and mechanistic studies.  American Journal of Physiology – Endocrinology and Metabolism. Apr 4, 2017, E348-E356

WHO Salt Facts http://www.who.int/mediacentre/factsheets/fs393/en/

It’s National High Blood Pressure Education Month!

It’s National High Blood Pressure Education Month!

Help educate your audience about hypertension with these free slides, which are excerpted from the top-selling presentation Blood Pressure 101, available now in the Nutrition Education Store.

BloodPressure101 Slide 1

This little preview will also include the speaker’s notes for each slide, so welcome to today’s show! At this presentation, we’ll discuss what blood pressure is and how to measure it. We’ll also cover the effects of hypertension and how you can lower your health risks.

Blood Pressure101 Slide 2

First let’s talk vocabulary. Blood pressure measures the way your blood presses against the walls of your arteries. To measure it, first a doctor will measure the pressure on your arteries during each heartbeat. Then that doctor will measure the pressure on your arteries between each heartbeat.

When you measure pressure on the arteries during each heartbeat, it’s called taking the systolic pressure. When you measure pressure on the arteries between each heartbeat, it’s called taking the diastolic pressure. As you age, your diastolic pressure generally decreases and you should pay more attention to systolic blood pressure. However, you should never ignore your diastolic blood pressure. In fact, when you’re young, that’s the number you really want to watch.

A doctor generally looks at both your systolic and diastolic numbers when determining whether or not you have high blood pressure. How the two factors interact is important, as is the level of each. High blood pressure is also called hypertension.

BloodPressure101 Slide 3

Now let’s take a look at how to interpret blood pressure results. Normal blood pressure is 119/79 or less. If your blood pressure is between 120/80 and 139/89, then you have prehypertension. If your blood pressure is 140/90 or more, then you have hypertension.

BloodPressure101 Slide 4

Ah! It’s time for a quiz. Now, If a person has a systolic reading of 118 and a diastolic reading of 78, what is that person’s blood pressure? The correct answer is 118/78.

Let’s move on to the next question. True or false? High blood pressure is also called hypertension. That answer is true!

The PowerPoint goes on to explore the health effects of high blood pressure, how to test blood pressure and interpret the results, and how to treat and even prevent hypertension. The presentation is peppered with quick quizzes to test knowledge and promote participant engagement too. If you like what you see, consider getting the whole show!

And of course, here are PDF copies of the slides we featured today. What will you do with yours?

BloodPressure101 Collection

And here are some more materials for High Blood Pressure Education Month!

Heart Attack Prevention: Are Statins or Eating Habits More Important?

Medication or Diet?If elevated low density lipoprotein cholesterol (LDL-C) levels were the only source of cholesterol deposited in the artery wall, then high doses of potent statins should be reversing (rather than reducing) the build-up of atherosclerotic plaques, largely eliminating deaths from coronary heart disease (CAD). Sadly, the number one cause of death in Americans taking statins to lower their elevated LDL-C to prevent heart attacks is still heart attacks?

Yes, statin drugs are very effective for reducing high LDL-C levels, and they do slow the progression of cholesterol-filled plaques. However, they rarely reverse the build-up of cholesterol in the artery wall. More importantly, statin drugs alone do not come close to eliminating the risk of heart attacks and most strokes despite impressive reductions in LDL-C levels. Research now shows that other lipoproteins besides LDL particles can and do carry cholesterol from the blood into the artery wall, promoting the growth of cholesterol-filled plaques and CAD. These lipoproteins are neither LDL-C or high density lipoprotein cholesterol (HDL-C), but rather consist of the cholesterol-rich remnants of triglyceride-rich lipoproteins produced by the liver (VLDL) and the small intestine (chylomicrons)(1). Both genetic factors and dietary factors influence the amount of these triglyceride-rich lipoproteins produced and also the amount of cholesterol-rich remnant particles derived from each of them in the blood. Fat and cholesterol-rich meals can dramatically increase the production of chylomicrons and lead to greater amounts of cholesterol-rich chlyomicron remnants in the blood for several hours after each fat-rich meal (2).

Dr. Borge Nordestgaard’s recent study followed nearly 12,000 people with established CAD in Denmark and found that each 1 mmol (38.7 mg/dl) increase in non-fasting remnant cholesterol caused 2.8 times greater risk of a CAD event that was independent of HDL-C levels. The increased causal risk of CAD from elevated cholesterol remnant particles appeared much stronger than for changes in either LDL-C or HDL-C levels (3). Most doctors (MDs) now check only fasting blood lipids and focus largely on LDL-C and HDL-C to assess their patient’s future CAD risk. This was based on the simplistic notion that it was only the LDL-C particles delivering cholesterol to the artery wall, making it the “bad” cholesterol, while the HDL-C particles were removing the cholesterol from the artery wall and bringing it back to the liver, making their cholesterol content “good”. Of course, we now know HDL-C particles can actually become proinflammatory and proatherogenic “bad” HDL particles, perhaps partly in response to biochemical changes in the HDL particles triggered in part by chylomicrons and other remnant cholesterol particles in the blood.

Chylomicrons and their cholesterol-rich remnants remain in the blood for several hours after each fat-rich meal and likely play a major role in promoting inflammation (by increasing IL-6 & CRP), thrombosis (by activating clotting factor VII), and atherosclerosis (by delivering more cholesterol-rich remnant particles to the artery wall). The fact that damage to the endothelium (inside “skin” of the artery wall) as evidenced by reduced flow mediated dilation (FMD) occurs to a much greater extent after a single fat-rich meal than after a meal high in carbohydrate points to the fact that pathological changes must be occurring in the artery wall in response to fat and cholesterol-rich particles coming from the intestines (4). Indeed, this reduced FMD is likely the main reason why many people with angina tend to experience far more chest pain after a large, fat-rich meal than they do after a meal high in carbohydrate-rich plant foods. The only legitimate debate is not whether LDL-C or other cholesterol-rich remnant particles promote atherosclerosis and increase the risk of CAD, but rather which is more atherogenic. Clearly both LDL-C and other remnant lipoprotein particles deliver cholesterol to the artery wall and promote foam cell formation and atherosclerosis. Unlike LDL-C particles (which must first be oxidized), remnant cholesterol particles are readily taken up by scavenger receptors of macrophages in the cell wall to form foam cells (5,6). Increasing evidence suggests that damage to the artery wall from cholesterol-rich remnant particles appears to be at least as important as either fasting LDL-C or HDL-C levels for predicting future CAD events.

It should be noted that diets high in refined carbohydrates (particularly large amounts of refined sugars) combined with inactivity can contribute to a marked increase in the liver’s production of VLDL particles because the liver converts some of the excess carbohydrate (especially fructose) into triglyceride. This leads to more triglyceride-rich VLDL particles being released into the blood, which then degrade into cholesterol-rich remnant particles and eventually also LDL particles. This is particularly true in people who are genetically prone to develop insulin resistance and type 2 diabetes and who experience significant increases in fasting triglyceride levels as visceral fat stores accumulate.

Bottom Line: Reducing LDL-C levels with statin drugs alone is insufficient for stopping and reversing CAD and preventing most heart attacks and strokes. A diet low in fat, salt, cholesterol, and refined carbohydrates coupled with increased activity and loss of excess weight may also be necessary to stop and reverse CAD in part by reducing remnant cholesterol levels in the blood.

By James J. Kenney, PhD, FACN

Sources:

  1. Mark Nordestgradd BG, Freiberg JJ. Clinical relevance of nonfasting and postprandial hypertriglyceride and remnant cholesterol. Curr Vasc Pharm. 2011;9:281-6
  2. Mark Cesar TB, et al. High cholesterol intake modifies chylomicron metabolism in normolipidemic young men. J Nutr 2006;136:971-6
  3. Mark Varbo A, et al. Remnant cholesterol as a causal risk factor for ischemic heart disease. J Am Col Cardiol. 2013;61:427-36
  4. Mark Tomaino RM, Decker EA. High-fat meals and endothelial function. Nutr Rev. 1998;56:182-5
  5. Mark Zilversmit DB. A proposal linking atherogenesis to the interaction of endothelial lipoprotein and triglyceride-rich lipoproteins. Circ Res.1973;33:633-8
  6. Mark Nakajima K, Nakano T, Tnaka A. The oxidative modification hypotheis of atherosclerosis: the comparison of atherogenic effects of oxidized LDL and remnant lipoproteins in plasma. Clin Chim Acta. 2006;367:534-42

Looking for fun ways to improve your clients’ understanding of cholesterol and its health risks? Check out this free handout: Cholesterol Puzzle.

Cholesterol Puzzle Handout

And, as you well know, there are tons of other heart health education materials available in the Nutrition Education Store. Pay special attention to the posters, which have been flying off the shelves lately!

LDL Cholesterol Poster

Premium Heart Health Education Kit

Heart Health Brochure: Lower Your Heart Attack Risk

Blood Pressure Poster