How Important is the Sodium to Potassium Ratio in Our Diets?

More than a thousand years ago, for the treatment of hypertension, an ancient Persian medical text advised lifestyle interventions, such as avoiding meat and pastries, and recommended eating spinach. A thousand years later, researchers discovered that a single meal containing spinach could indeed reduce blood pressure, thanks to its nitrate content. All green leafy vegetables are packed with nitrate, which our body can use to create nitric oxide that improves the flexibility and function of our arteries. This may be why eating our greens may be one of the most powerful things we can do to reduce our chronic disease risk.

As you can see at 0:54 in my video below just switching from low-nitrate vegetables to high-nitrate vegetables for a week can lower blood pressure by about 4 points, and the higher the blood pressure people started out with, the greater benefit they got. Four points might not sound like a lot, but even a 2-point drop in blood pressure could prevent more than 10,000 fatal strokes every year in the United States.

Potassium-rich foods may also act via a similar mechanism. If we get even just the minimum recommended daily intake of potassium, we might prevent 150,000 strokes every year. Why? Potassium appears to increase the release of nitric oxide. One week of eating two bananas and a large baked potato every day significantly improved arterial function. Even a single high-potassium meal, containing the equivalent of two to three bananas’ worth of potassium, can improve the function of our arteries, whereas a high-sodium meal—that is, a meal with the amount of salt most people eat—can impair arterial function within 30 minutes. While potassium increases nitric oxide release, sodium reduces nitric oxide release. So, the health of our arteries may be determined by our sodium-to-potassium ratio.

As you can see at 2:30 in my video, after two bacon slices’ worth of sodium, our arteries take a significant hit within 30 minutes. However, if you add three bananas’ worth of potassium, you can counteract the effects of the sodium. As I show at 2:48 in my video, when we evolved, we were eating ten times more potassium than sodium. Now, the ratio is reversed, as we consume more sodium than potassium. These kinds of studies “provide additional evidence that increases in dietary potassium should be encouraged,” but what does that mean? We should eat more beans, sweet potatoes, and leafy greens, the latter of which is like giving you a double whammy, as they are high in potassium and nitrates. The recommendation from a thousand years ago to eat spinach is pretty impressive, though bloodletting and abstaining from sex were also encouraged, so we should probably take ancient wisdom with a grain of salt—but our meals should be added-salt free.

More on salt here.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations—2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not to Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

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53 comments

Olivia H
Olivia H18 days ago

Thank you

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Barbara S
Barbara S19 days ago

thanks very much

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Doris F
Doris F20 days ago

@C2...what happens with C2 ?????
All actions are break down ! hmmmpfff :-(

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Janet B
Janet B22 days ago

Thanks

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Renata B
Renata B23 days ago

As a child I hated spinach that my mother made them in a soup: slimy and awful. But now I eat them raw in salads and cooked in quiches and other dishes. They are very good. Buy organic whenever you can.

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Renata B
Renata B23 days ago

Unfortunately I don't digest bananas, but I can do with the other things. Thank you.

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Linda Wallace
Linda Wallace23 days ago

Thank you

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hELEN hEARFIELD
hELEN hEARFIELD23 days ago

tyfs

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Susan Brandwein
Susan Brandwein23 days ago

Moderation helps.

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Ingrid A
Isabel A23 days ago

Thanks for sharing

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