Health Advice



Less Sodium, More Potassium

Charlyn Fargo on

Here's more proof that skipping the saltshaker and processed foods with high sodium, along with adding potassium-rich foods, can lessen your risk for a heart attack.

In a large-scale study of more than 10,000 adults with accurate sodium measurements from individuals, researchers from Harvard T.H. Chan School of Public Health reaffirmed that lower sodium consumption and higher potassium intake is linked with lower risk of cardiovascular disease in most people. The study was published in the New England Journal of Medicine, November 2021.

Researchers decided to conduct the study because past research had used less-than-ideal methods to assess sodium and got mixed results -- with some studies showing both low and high sodium diets linked to cardiovascular disease.

This study measured excretion of sodium and potassium in participants urine -- the most accurate way possible to measure intake.

Researchers calculated that each daily increment of 1,000 milligrams in sodium excretion was associated with an 18% higher cardiovascular risk and each daily increment of 1,000 milligrams in potassium excretion was associated with an 18% lower risk.

Most of us consume far more sodium than the recommended 2,300 milligrams of sodium per day, not from the saltshaker, but from packaged foods and restaurant meals.


On the other hand, we don't get enough potassium, found in fruits, vegetables and legumes.

Too much sodium in the bloodstream pulls water into the vessels, increasing the volume of blood flowing through them. That can lead to high blood pressure and an increased risk of heart attack and stroke. Potassium helps lower blood pressure by lessening the effects of sodium.

The researchers examined data from 10,709 generally healthy adults who were an average of 52 years old. They were participants in six different studies across the U.S. and Europe. Their sodium and potassium levels were measured with at least two 24-hour urine samples, meaning all urine produced in a full day, which is considered the optimal method.

During an average follow-up of 8.8 years, there were 571 cardiovascular disease events such as a heart attack or stroke. The researchers found that higher sodium levels, lower potassium levels and higher sodium-to-potassium ratio were all associated with higher risk.


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