America’s National Health and Nutrition Examination Survey (NHANES) is truly a masterpiece of nutritional science.
Once a decade, NHANES publishes a comprehensive guide to what Americans eat, broken down by age, gender, race, and geographical location. This data helps guide public policy and research agendas over the upcoming decade.
The newest NHANES data, gathered from 2003 to 2006, are just starting to seep out into the research world, and if you are an advocate for food-as-medicine, the results aren’t pretty.
More than half of the population fail to get an adequate amount of a number of nutrients from their food each day, including such important items as calcium, vitamin D, magnesium, vitamin E, and folic acid. Food fortification programs help improve this situation, but only to a small degree.
The worst nutrient, however, looks to be potassium. Nearly 98% of Americans fail to receive an adequate intake of dietary potassium each day. The average American eats just over half of the recommended 4700 mg of this important mineral.
This is important for a number of reasons. First, potassium helps to balance out salt intake, and limits the bad effect of sodium on blood pressure. This effect can be quite large, to the extent that high potassium diets can mimic the blood pressure lowering effect of first-line medications.
Given that 2/3 of people over age 65 have high blood pressure, increasing dietary potassium in the population could help dramatically lower the risk of heart attack and stroke.
The other major problem related to low potassium diets is an increased risk of kidney stones. It is probably not a surprise, then, to see that the incidence of kidney stones has been on the rise over the past 30 years.
Part of the problem might be that we are comparing intake across an unreasonably high adequate intake standard. The standard is set at a level that was necessary to show reduction in blood pressure and kidney stone risk, and assumes a high level of sodium intake. It might be that people with normal blood pressure and no history of kidney stones can do pretty well at lower potassium levels.
Still, the evidence that diets high in potassium are associated with reduced mortality should make us be a little more careful about getting more of this nutrient on a daily basis. For the most part, eating more plant-based foods will increase your potassium intake, but some plant foods are much richer than others. Supplements of potassium are hard on the gastrointestinal tract, and are generally not recommended unless your blood potassium level has fallen low.
If 98% of Americans smoked cigarettes, including children, you can bet that there would be a major effort underway to reduce that number. Yet when this percentage of Americans has a dietary pattern associated with many of the same health risks, there’s barely a peep to be heard, even in the medical textbooks. It’s about time for America to admit she has a potassium problem.
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