Sixty percent of the Standard American Diet (SAD) is estimated to be composed of processed foods. (That is SAD!) This may sound shocking, but when you realize that 73 percent of the food on grocery store shelves fits into the processed food category, it is less surprising. Processed food is the largest contributor of salt in the Standard American Diet. Whether it comes from restaurants or grocery stores, over 70 percent of the sodium Americans take in comes from eating prepared foods. Not surprisingly, sodium intake plummets when processed foods are eliminated from the diet.
In seeking to achieve optimal sodium status, overall sodium intake is typically the focus, but understanding its relation to other minerals is equally significant. When individuals consume too much table salt while neglecting potassium-rich fruits and vegetables, an imbalance between sodium and potassium occurs in the body. This imbalance is an important contributor to the negative consequences of our excessive sodium intake, such as high blood pressure. In fact, there is a stronger correlation between the sodium/potassium ratio to hypertension than sodium or potassium intake alone.1 The imbalance is a reflection of our overconsumption of salty processed foods—and under-consumption of beans and greens.
Changes in blood pressure in response to changes in salt intake is referred to as salt sensitivity. Not everyone with hypertension is salt-sensitive. Some are more predisposed than others. According to the American Heart Association, 73 percent of black Americans with hypertension are salt sensitive.2 That’s a much higher percentage than other population groups. Worthy of noting though, is that black Americans consume less potassium than the rest of the population. Researchers have found that when potassium intake increases above the recommended dietary allowances (RDA), “the racial disparity in salt sensitivity disappears.”3 In other words, if sufficient potassium is consumed in the diet, this salt sensitivity is no longer experienced.
The following research further illustrates the relationship between sodium, potassium, and cardiovascular disease. “After adjusting for other cardiovascular risk factors such as age, smoking status, cholesterol and diabetes, participants with the highest levels of sodium in the urine (an average of about 4,700 mg) were 60% more likely to have a cardiovascular event than those with the lowest sodium levels (about 2,200 mg). Those with the highest levels of potassium (about 3,500 mg) had a 31% lower risk of cardiovascular events than those with lowest levels (about 1,750 mg).”4
This is beyond hypertension. We are talking about the number one killer of Americans being dramatically affected by our salt and potassium intake!
In summary:
- The majority of sodium in our diet comes from processed food. Reduce processed food intake. Eliminate processed food that is very high in salt, and low in potassium and other essential nutrients.
- Consuming more potassium is just as important for limiting chronic disease risk factors as limiting sodium.
- Research shows an association between higher potassium intake and lower blood pressure, regardless of sodium intake.3 Potassium works in the body to relax artery walls, keep muscles from cramping, and lower blood pressure.
Eat a diet of whole, unprocessed foods. Examples of potassium-rich foods include beans, greens, watermelon, avocados, oranges, bananas, coconut water, winter squash, potatoes, cantaloupe, tomatoes, sweet potatoes, and beets.
- Yang, Y., Wu, Q., Lv, Q., Li, J., Li, L., & Wang, S. (2023b). Dietary sodium, potassium intake, sodium-to-potassium ratio and risk of hypertension: a protocol for systematic review and dose–response meta-analysis of cohort studies. BMJ Open, 13(2), e065470.
- Svetkey, L. P., McKeown, S. P., & Wilson, A. F. (1996). Heritability of salt sensitivity in Black Americans. Hypertension, 28(5), 854–858. https://doi.org/10.1161/01.hyp.28.5.854
- Little, R., & Ellison, D. H. (2023). Modifying dietary sodium and potassium intake: An end to the “Salt Wars”? Hypertension, 81(3), 415– 425.
4. Thor Christensen. (2021). New study reaffirms risk of too much sodium, too little potassium. American Heart Association News. https://www.heart.org/en/news/2021/11/15/new-study-reaffirms-risk-of-too-much-sodium-too-little-potassium
