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11.9: Potassium

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    Potassium is the most abundant positively charged ion inside of cells. Ninety percent of potassium exists in intracellular fluid, with about 10 percent in extracellular fluid, and only 1 percent in blood plasma. As with sodium, potassium levels in the blood are strictly regulated. The hormone aldosterone is what primarily controls potassium levels, but other hormones (such as insulin) also play a role. When potassium levels in the blood increase, the adrenal glands release aldosterone. The aldosterone acts on the collecting ducts of kidneys, where it stimulates an increase in the number of sodium-potassium pumps. Sodium is then reabsorbed and more potassium is excreted. Because potassium is required for maintaining sodium levels, and hence fluid balance, about 200 milligrams of potassium are lost from the body every day.

    Other Functions of Potassium in the Body

    Nerve impulse involves not only sodium, but also potassium. A nerve impulse moves along a nerve via the movement of sodium ions into the cell. To end the impulse, potassium ions rush out of the nerve cell, thereby decreasing the positive charge inside the nerve cell. This diminishes the stimulus. To restore the original concentrations of ions between the intracellular and extracellular fluid, the sodium-potassium pump transfers sodium ions out in exchange for potassium ions in. On completion of the restored ion concentrations, a nerve cell is now ready to receive the next impulse. Similarly, in muscle cells potassium is involved in restoring the normal membrane potential and ending the muscle contraction. Potassium also is involved in protein synthesis, energy metabolism, and platelet function, and acts as a buffer in blood, playing a role in acid-base balance.

    Imbalances of Potassium

    Insufficient potassium levels in the body (hypokalemia) can be caused by a low dietary intake of potassium or by high sodium intakes, but more commonly it results from medications that increase water excretion, mainly diuretics. The signs and symptoms of hypokalemia are related to the functions of potassium in nerve cells and consequently skeletal and smooth-muscle contraction. The signs and symptoms include muscle weakness and cramps, respiratory distress, and constipation. Severe potassium depletion can cause the heart to have abnormal contractions and can even be fatal. High levels of potassium in the blood, or hyperkalemia, also affects the heart. It is a silent condition as it often displays no signs or symptoms. Extremely high levels of potassium in the blood disrupt the electrical impulses that stimulate the heart and can cause the heart to stop. Hyperkalemia is usually the result of kidney dysfunction.

    Needs and Dietary Sources of Potassium

    The IOM based their AIs for potassium on the levels associated with a decrease in blood pressure, a reduction in salt sensitivity, and a minimal risk of kidney stones. For adult male and females above the age of nineteen, the adequate intake for potassium is 4,700 grams per day. The AIs for other age groups are listed in Table \(\PageIndex{1}\).

    Table \(\PageIndex{1}\): Adequate Intakes for Potassium
    Age Group mg/day
    Infants (0–6 months) 400
    Infants (6–12 months) 700
    Children (1–3 years) 3,000
    Children (4–8 years) 3,800
    Children (9–13 years) 4,500
    Adolescents (14–18 years) 4,700
    Adults (> 19 years) 4,700

    Dietary Reference Intakes: Water, Potassium, Sodium, Chloride, and Sulfate. Institute of Medicine. www.iom.edu/Reports/2004/Dietary-Reference-Intakes-Water-Potassium-Sodium-Chloride-and-Sulfate.aspx. Updated February 11, 2004. Accessed September 22, 2017.

    Food Sources of Potassium

    Potassium is found in a wide variety of fresh plant and animal foods. Fresh fruits and vegetables are excellent sources of potassium, as well as dairy products (e.g., milk and yogurt), beans (e.g., lentils and soybeans), and meat (e.g., salmon and beef).5 Greater than 90 percent of dietary potassium is absorbed in the small intestine. Although highly bioavailable, potassium is a very soluble mineral and easily lost during cooking and processing of foods. Fresh and frozen foods are better sources of potassium than canned.

    Bar graph showing dietary sources of potassium compared with the AI for adults of 2,600 mg for women and 3,400 mg per day for men. Top sources include vegetables (potatoes, spinach, chard), fruit (orange juice, dried apricots), beans, salmon, and dairy (yogurt and milk). Photos are shown of potatoes, milk, orange juice, salmon, and chard.
    Figure \(\PageIndex{1}\): Dietary sources of potassium. Source: Dietary Guidelines for Americans, 2015-2020

    Figure 8.11. Dietary sources of potassium. Source: Dietary Guidelines for Americans, 2015-2020

    The 2020-2025 Dietary Guidelines for Americans identifies potassium as a “dietary component of public health concern,” because dietary surveys consistently show that people in the United States consume less potassium than is recommended.6 This is a nutritional gap that must be corrected through food since most dietary supplements do not contain significant amounts of potassium.

    Potassium Deficiency and Toxicity

    Low potassium intake may have negative health implications on blood pressure, kidney stone formation, bone mineral density, and type 2 diabetes risk. Although there is a large body of evidence that has found a low potassium intake increases the risk of hypertension, especially when combined with high sodium intake, and higher potassium intake may help decrease blood pressure, especially in salt-sensitive individuals, the body of evidence to support a cause-and-effect relationship is limited and inconclusive.7 However, it is important to remember that a lack of evidence does not mean there is a lack of effect of potassium intake on chronic disease outcomes. This is an area that needs more research to determine the effect dietary potassium has on chronic disease risk.

    There is no UL set for potassium since healthy people with normal kidney function can excrete excess potassium in the urine, and therefore high dietary intakes of potassium do not pose a health risk.7 However, the absence of a UL does not mean that there is no risk from excessive supplemental potassium intake, and caution is warranted against taking high levels of supplemental potassium.8

    References

    1. Aggett, P. J. 2012. Iron. In: Erdman, J. W., I. A. Macdonald, S. H. Zeisel, eds. Present Knowledge in Nutrition, 10th ed., pp. 506–520. Washington, DC: ILSI Press.

    2. Boeing, H., A. Bechthold, A. Bub, et al. 2012. Critical review: Vegetables and fruit in the prevention of chronic diseases. European Journal of Nutrition 51(6):637–663.


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