INSTITUTE OF MEDICINE Americans' diet lacks potassium, has too much salt

People should eat more foods containing potassium, the report says.
By JANE E. ALLEN
LOS ANGELES TIMES
Americans eat far too much salt and not enough potassium -- and they don't need a water bottle with them at all times.
The Institute of Medicine, in a report released last week, said that most people are getting enough water from beverages at meals and snack times, from water-rich foods such as fruits and vegetables and from responding to their own thirst.
But they're risking hypertension by overdoing the salt -- found largely in fast food, canned and frozen foods and prepared meals, not to mention the shaker on the table -- and skimping on potassium. Excessive salt contributes to high blood pressure, which in turn can cause strokes, heart attacks and kidney disease.
Potassium's benefits
Potassium, on the other hand, lowers blood pressure and blunts the effect of excess sodium, while helping to reduce bone loss and prevent kidney stones. The mineral can be found in many fresh fruits and vegetables, such as bananas, oranges and potatoes, as well as in yogurt and raisins.
The report included new salt and potassium intake recommendations that will be incorporated into dietary guidelines being drafted by a joint committee of the Department of Health and Human Services and the U.S. Department of Agriculture.
The advice for healthy 19- to 50-year-olds is part of an ongoing effort by U.S. and Canadian scientists to establish the components of a healthy diet, which should rely more on plant-based foods, said Dr. Lawrence Appel, head of the panel that studied consumption of water, salt and potassium.
"I don't think we're going to get there tomorrow and maybe not in 10 years, but these should be goals we try to achieve," Appel said.
Lower salt in foods
The study authors suggested that food manufacturers should be encouraged to reduce the salt they use to make foods tasty, without altering flavor, shelf life and affordability.
The recommendations, announced last week in Washington, were criticized by some members of the food industry. "There is no evidence that asking everyone to reduce dietary salt improves health outcomes," said Richard L. Hanneman, president of the Salt Institute.
Dr. Robert Earl, senior director of nutrition policy for the National Food Processors Association, issued a statement saying the new guidelines "may be very challenging for most consumers to achieve" and suggested that setting sodium levels "unrealistically low" and potassium levels "unrealistically high" could discourage consumers from even trying.
But Appel, a professor of medicine at Johns Hopkins Medical Institutions in Baltimore, said that in a country where 90 percent of adults develop hypertension, there's good reason to rethink our diet.
"Maybe we won't achieve these values, but that's what the evidence says are best for people," he said.
How much is OK?
As for sodium, the salt component listed on food labels, healthy Americans need 1,500 milligrams and shouldn't consume more than 2,300 milligrams, the report said. But 95 percent of men and 75 percent of women regularly exceed 2,300 milligrams. It's easy to see why. Two slices of a 12-inch cheese pizza, Appel noted as an example, can contain 1,200 milligrams of sodium.
Senior citizens, black Americans and those with hypertension, diabetes and kidney disease are particularly sensitive to salt and should keep their intake below the upper limit.
The report found that adults need 4.7 grams of potassium a day, but men average 2.8 to 3.3 grams daily and women average 2.2 to 2.4 grams. Some low-carb dieters miss out on potassium by avoiding fruits and potatoes, despite the general advice that Americans eat five daily servings of fruits and vegetables.
To reach the new potassium recommendations, people have to increase their fruits and vegetables to 10 servings a day from five, Appel said.
Water amounts
The report doesn't specify how many glasses of water people should drink each day because all fluids count. Caffeinated coffee and tea, juice, milk, plain water and the liquid in fruits and vegetables all contribute to the 2.7 liters (91 ounces) that women need daily and the 3.7 liters (125 ounces) men need daily.
If consumed only as beverages, those amounts translate into more than 11 eight-ounce glasses for women and 15 glasses for men. Of course, anyone who lives in a hot climate or engages in strenuous activity needs more.