Sodium / Potassium in the Modern and Primal diets

(Michael - When reality fails to meet expectations, the problem is not reality.) #31

Let’s start at the beginning:

Body composition in Pan paniscus compared with Homo sapiens has implications for changes during human evolution

(Edith) #32

Robb Wolf on the Healthy Rebellion has mentioned several times that low salt can contribute to sleep issues. That is one of the things that’s improved since upping my salt. Much better sleep. That and my heart palpitations are gone.

I do take almost a 1/2!teaspoon of KCl mixed in with my salt, so I do get some extra K as well.

(Michael - When reality fails to meet expectations, the problem is not reality.) #33

Unfortunately, behind a payway

Abstract

Prehistoric animals and humans consumed a diet low in sodium but high in potassium, and thus, evolutionary forces fostered the development of physiologic systems that conserved sodium and excreted potassium. With the advent of civilized societies, food cooking and processing have greatly increased the sodium but decreased the potassium content of the diet. However, there has been little time for physiologic systems to adapt. The resulting excess of sodium has been implicated as an important factor in the development of hypertension and congestive heart failure. This traditional focus on sodium has ignored the potential role that an inadequate dietary intake of potassium might play in the degenerative diseases of the heart, brain and kidney. Yet dietary potassium may be as powerful a determinant of cardiovascular morbidity and mortality as dietary sodium. In experimental and clinical hypertension, an increased intake of potassium (without a change in dietary sodium) can reduce blood pressure, may suppress the activity of the sympathetic nervous and renin-angiotensin systems, and can prevent the development of vascular injury; conversely, potassium depletion has been associated with an increase in stroke and sudden death. In patients with chronic heart failure, potassium can modify both the mechanical and electrical properties of the heart, it can exert diuretic effects, and it can reduce the frequency and complexity of potentially lethal ventricular tachyarrhythmias. Given this central role, the effects of many pharmacologic interventions on the morbidity and mortality of patients with hypertension or chronic heart failure can be enhanced or diminished by the effect that these treatments might have on potassium homeostasis.(ABSTRACT TRUNCATED AT 250 WORDS)

Another paywall:

Abstract

The high sodium-low potassium environment of civilized people, operating on a genetic substrate of susceptibility, is the cardinal factor in the genesis and perpetuation of “essential” hypertension. The noxious effects begin in childhood, when habits of excess salt consumption are acquired at the family table, and are perpetuated by continuing habit and by increasing use of convenience and snack foods with artificially high concentrations of sodium and low levels of potassium. Present methods of food preparation leach out the protective potassium. Extradietary sodium chloride is a condiment not a requirement. Some primitive populations clearly preferred potassium chloride to sodium chloride. Chronic expansion of extracellular fluid volume induced by excess salt consumption causes the central and peripheral circulatory regulatory mechanisms to work at cross purposes, resulting in increased arterial pressure. The protective effect of potassium is dramatic and easily demonstrable in animals and man but its mechanism is not known. It cannot be entirely a direct effect on blood pressure because rats protected with extra potassium against a moderately high salt intake live much longer than control rats but have the same elevated blood pressures. In hypertension with a demonstrable “cause,” the high sodium-low potassium environment makes a bad matter worse. In nature, feral man and his forebears were not confronted with excessive sodium and deficient potassium; indeed, the reverse was the case. Evolution has provided powerful mechanisms for conserving sodium and eliminating potassium, but no efficient physiologic mechanisms for conserving potassium and eliminating excess sodium. Most laboratory animal “control” diets contain an amount of sodium that fully suppresses aldosterone secretion, and the same is true of the “average” diet of the American people. Inadequate attention to dietary sodium and potassium makes many studies in both animals and man of uncertain validity. Internally, essential hypertension is an exceedingly complex mosaic of physiologic interactions. Viewed from outside, it is a disorder for which genetic material sets the stage; excessive sodium precipitates it and perpetuates it. Extra salt makes all forms more rapidly progressive and accelerates the onset of terminal events; extra potassium is everywhere protective. When an entire population eats excessively of salt, hypertension will develop among those genetically susceptible, but epidemiologic studies of salt versus blood pressure will not show a relation of salt to hypertension. This is the saturation effect. Low sodium diets are therapeutically effective but generally regarded as an impossible or an unnecessary nuisance. Effective prevention programs must be instituted at as early an age as possible. The efficacy of a prophylactic/therapeutic low sodium-high potassium diet should be weighed against the uncertain hazards of a lifetime of pill taking.

(Michael - When reality fails to meet expectations, the problem is not reality.) #34

Full study online:

Intelligent discussion:

My rationale for thinking why our paleolithic ancestors did not need ‘fruit, veggies, nuts’ to get a diet with a healthy K-factor as discussed by Passwater/Moore above.

(Michael - When reality fails to meet expectations, the problem is not reality.) #35

I discovered this site searching for research papers. It’s an advocacy site but includes citations following articles. It does not look like it’s been updated recently, however. So… Various articles discuss some of the health issues claimed by Passwater/Moore as resulting from a sodium/potassium imbalance. Might be a start to answering your question. I’ve linked to the Beef Table:

PS: I’ll also mention that I’ve come across numerous studies and analyses that put the causation of many of the issues mentioned by Passwater/Moore to a high sodium to potassium ratio. I’ve linked a couple above for starters. I’ll link more as I encounter them and think them relevant and/or interesting.

(Edith) #36

I’ve only read through one study so far. It was certainly not done with people who eat low carb or keto. Can those results be trusted for our portion of the population?

This discussion got me curious about my potassium intake, so I did a little math. I am mostly carnivore. I eat about a 1.5 pounds of meat a day, plus a few eggs. I supplement with my salt mix (3:1 Salt to No Salt), and drink a Zip Fizz every other day for some vitamins. Normal vitamin supplements don’t agree with my stomach, but for some reason Zip Fizz does.

My meat is a mix of beef, pork, and chicken, so I took an average of their potassium content. I did use raw values. I don’t boil my meat, but I do understand some potassium is lost via cooking.

My potassium intake through food is about 1800-2000 mg a day. With my salt mix, I get another 1200 mg, so I’m somewhere around 3100 mg K/day. The days I have a Zip Fizz I am actually up around 4000 mg/day.

Using the same method for sodium intake, I am getting a little over 4g (4000 mg) a day. Without even realizing it, I’m pretty balanced between the two.

So… a few months or so ago, I upped my “salt” intake to the 2 teaspoons using my salt mix. I was getting muscle cramps, heart palpitations, and my sleep has been cruddy for years. Since I upped my intake, cramps, palpitations, and cruddy sleep are gone. I’m not thirsty all the time. I sleep through the night without having to get up to urinate. I’m realizing as I type this message, that when I upped my salt, I upped my potassium intake along with it. I guess that means I really can’t say what caused the improvements the increased salt, increased potassium, or both.

If what the articles say is true that the ratios should be skewed toward the potassium is true, and quantity shouldn’t matter, then upping the amount of salt mix I was taking shouldn’t have mattered. My ratios would have been the same.

Back to the one article I read, it seemed like most of the people in the study testing the Na:K were unhealthy already and eating crap high-carb diets. Food questionaires were used. (Need I say more on that? ) Again, does that really pertain to people keeping their insulin low on keto? :woman_shrugging:

I shall end my ramblings here. :blush:

(Michael - When reality fails to meet expectations, the problem is not reality.) #37

Thanks. We keto/carnivores are a small fringe, so I don’t expect much in ‘mainstream’ physiology to be based on studying us. I totally agree with you about FFQ based studies. That said, I just looked up the RDAs and ave consumption for both sodium and potassium.

In the US the sodium RDA is ~2300mg and in Canada ~1500mg. Average daily intakes for are 3400mg (US) and 2800mg (Can). For potassium the RDA (AI) in both US and Canada is 4700mg. Ave daily intake is 2800mg. The recommendations are max for sodium and min for potassium. So even the ‘mainstream’ recommends a 2:1 K-factor (US) and 3:1 K-factor (Can). Whereas actually consumed the K-factors are <1.

So getting back to the OP. Why are we keto/carnivore folks being told that we need to eat 4-6 grams of sodium per day? Well, if we actually ate the RDA for potassium or more that would be a ratio of 1. Is it plausible to think that our paleolithic ancestors consumed so much sodium? Or that they ‘supplemented’ one or the other to get to those quantities - eg the ‘salt lick’ idea? I think not. Looking at the sodium/potassium contents of various meats I suspect they consumed lots more potassium than sodium and had ratios of 3,4 or higher (@ctviggen and without weighing anything!). Of course, the meats we’re eating now (with the possible exception of ‘game’ meat) don’t contain the same amounts or ratios of potassium and sodium as the megafauna of the Pleistocene. So we can’t say for sure exactly what those amounts and ratiois were. But I think it’s reasonable to suspect they’re similar overall.

So the question then becomes, why did our more recent ancestors start consuming lots more sodium?

(Bacon is a many-splendoured thing) #38

Because of study data that suggest that to be the healthiest range of sodium intake. (Granted, very few of the forty or fifty thousand people studied were likely to have been on a low-carb diet.)

U.S. dietary recommendations for sodium intake are pegged to what is thought to be a safe level for salt-sensitive hypotensives, who form a very small minority of the population. But those in charge of the dietary guidelines feel that the needs of that minority supersede those of the general population.

(Bacon is a many-splendoured thing) #39

Do any of those references you read attempt to define “recent,” in this context? And I’d be curious to know, how do they know when the change actually occurred? I’m wondering what metric they could have used.

(Edith) #40

This sentence makes me automatically assume there is bias in the paper.

I would love to read the source for this information. How do they know this? Is it based on present day wildlife? Ancient bone composition?

#41

Thanks team for a great discussion, very informative. Dont stop here, keep it going and let it evolve !

We looked at some potassium / sodium food data of foods we commonly consume. An easy to use list of was found on this site: https://www.weightloss.com.au/diet/food-nutrition-tables/sodium-potassium-table-a.html As we get Kangaroo and other foods that are not on the US databases, this site gives us the data we needed.

From here we will keep an eye on the K / Na ratio in our nutrition and use a compounded salt as a taste enhanser on our food and in cooking. That we will make from KCl and NaCl, yet to work out the ratio, but lets say 3:1 for now. If anyone has alternative suggestions to KCl, such as KC₄H₅O₆ or other types, then please put them forward.

Our water source is tank/rain water and would have negligable mineral content, so we are not getting any from that source.

As our weight is currently dropping, there is probably a little bit more need for salts as the total amount of food is less, when we reach our healthy lean mass, we can reduce the salts and see how we feel.

Taking into accout the great info posted above, in day to day nutrition I can not see the need to add copious amounts of either Na or K, but as we also run ultra marathons, that will toss up an additional need at times (especially in summer). Here again we may aim for a K/Na ratio favoring the K factor, but open to suggestions on this ?

(Michael - When reality fails to meet expectations, the problem is not reality.) #42

Here’s one, full text.

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Article Highlights

:black_small_square: Over several million years, physiology and metabolism of humans evolved to retain Na+ and excrete K+ in response to a diet that was low in Na+ and high in K+. With the onset of agriculture and industrialization, there has been a precipitous drop in dietary K+ consumption and an equal rise in dietary salt consumption, contributing to disease onset. This is further supported by the fact that the newest Dietary Guidelines for Americans have listed K+ as a “nutrient of public health concern” because of its inadequate consumption. Low K+ intake is then implicated in various chronic diseases including hypertension, cardiovascular disease, osteoporosis, and nephrolithiasis.

The authors contend:

… The changes in K+ and Na+ intake over time reflect a shift from traditional plant-based diets high in K+ and low in Na+ (characterized by fruits, leafy greens, roots, and tubers) to processed foods high in Na+ and low in K+. The transition to processed foods began approximately 10,000 years ago with the onset of agriculture.

I think they are incorrect about the sources of potassium… But, however we got the high potassium and low sodium, they discuss the physiology of why they think humans evolved in a potassium-high and sodium-low environment. And “…our current diet represents a mismatch between what our body has the capability to metabolize and what we are actually consuming”. The authors provide a very detailed physiological discussion to support their contention. Worth the long read.

@PaulL

Conclusion

There are abundant data suggesting that ingestion of K+-rich foods is beneficial and may reduce the incidence of stroke, hypertension, nephrolithiasis, and osteoporosis. The data on dietary consumption indicate that Western diets are high in processed foods, high in Na+ content, and low in K+. The kidney is designed to handle significantly higher K+ loads than are currently consumed in our diet. Furthermore, patients who could most benefit from increasing their intake of K+-rich foods are the very same patients who are unable to do so because of reductions in renal function.

One of their sources is the following. Unfortunately full text available to subscribers only:

Another source, again unfortunately behind an subscriber wall:

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…The genetically conditioned nutritional requirements of human beings established themselves over millions of years in which ancestral hominins, living as hunter-gatherers, ate a diet markedly different from that of agriculturally dependent contemporary human beings. In that context, we sought to quantify the ancestral-contemporary dietary difference with respect to the supply of one of the body’s major mineral nutrients: potassium. In 159 retrojected Stone Age diets, human potassium intake averaged 400 ± 125 mEq/d, which exceeds current and recommended intakes by more than a factor of 4. We accounted for the transition to the relatively potassium-poor modern diet by the fact that the modern diet has substantially replaced Stone Age amounts of potassium-rich plant foods (especially fruits, leafy greens, vegetable fruits, roots, and tubers), with energy-dense nutrient-poor foods (separated fats, oils, refined sugars, and refined grains), and with potassium-poor energy-rich plant foods (especially cereal grains) introduced by agriculture (circa 10,000 years ago).

Again, I disagree with the source of potassium, but otherwise I find the argument persuasive. It seems logical to me that so many ailments/diseases being related to potassium deficiency (and/or elevated sodium) that evolution in a period of potassium abundance and sodium dearth makes sense.

(Michael - When reality fails to meet expectations, the problem is not reality.) #43


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#44

Free access to download: https://www.researchgate.net/publication/14112331_Eaton_SB_Eaton_III_SB_Konner_MJ_Paleolithic_nutrition_revisited_a_twelve-year_retrospective_on_its_nature_and_implications_Eur_J_Clin_Nutr_51_207-216/link/542030700cf203f155c2b121/download

#45

Having just gone through this myself as an n=1 sample size this was not true for me. I consumed tons of salt and tons of water through the entire journey. While I never felt negative cognitive effects I felt extraordinarily weak. Only starting now to feel any strength return day 22.

#46

Sometimes the site is down/buggy but when it’s working it’s absolutely amazing, second to none.

(Michael - When reality fails to meet expectations, the problem is not reality.) #47

Thanks!

Appendix

Method

We have collected from the literature nutrient analyses of wild plant and animal foods which have been utilized by recent gatherer-hunters and which were presumably consumed by preagricultural humans as well…

I think it has long been an erroneous assumption of anthropological researchers that the study of modern (by which I mean neolithic/Holocene hunter gatherers) can be used to determine the characteristics of paleolithic hunter gatherers. For example, Dr Michael Eades has several YouTube videos that show via bone analysis (carbon isotope composition) that meat and fat were a much higher percentage of dietary intake in our paleolithic hunter gatherer ancestors than in modern hunter gatherers. Even though they may subsist by scavenging, hunting and gathering, modern hunter gatherers are in contact with non-hunter gatherers and exchange goods and foods with them. This did not nor could not happen during the Paleolithic. Also, because of climate change (yes, even in central tropical Africa), cultivation and hybridization of plants (far more extensive than most realize) since the beginning of the Holocene, modern plants contain more digestible carbohydrate than Pleistocene plants. So I think it is a mistake to think because modern hunter gathers can derive a large percentage of nutrients from eating plants to conclude that Paleolithic hunter gatherers could do so as well. The flora of the Pleistocene was very different with much higher percentages of indigestible cellulose. So there was little opportunity to get much nutrition. Whereas, as I quoted above:

… Humans can earn tens of thousands of calories per hour hunting medium-sized animals, in contrast with the meager 1,431 calories from foraging plants [27]. Human specialization for hunting large animals during the Pleistocene provided even bigger returns [28]. Our fat stores and our hunting seem to go hand in hand.

Our ancestors weren’t stupid.

(Edith) #48

Yes, but as mentioned in another thread, the feelings of weakness are not sodium related, that is from needing to adapt to a new fuel source.

Now that you are three weeks in, your cells are improving in using fat as fuel. You’re energy is going to keep improving.

(Bacon is a many-splendoured thing) #49

The symptoms of lack of sodium are lightheadedness, dizziness, headache, and the like. The weakness you are experiencing is from the fact that you are depriving your muscles of glucose, and they have not yet become reaccustomed to metabolising fatty acids. This is called fat-adaptation, and everyone goes through it.

Give yourself another month or so for your mitochondria to heal, and so forth. In the meantime, lighten up your exercise routine until your performance returns. Endurance takes somewhere in the range of six to eight weeks to return, explosive power somewhat longer. Once you are fat-adapted, your muscles will gladly metabolise fatty acids, sparing ketones and glucose for those cells that need them.

(Michael - When reality fails to meet expectations, the problem is not reality.) #50

Excellent source papers linked in the following: