Effect of increased potassium intake on blood pressure, renal function, blood lipids and other potential adverse effects
Overview
The 32nd Session of the Codex Committee on Nutrition and Food for Special Dietary Uses (CCNFSDU) – held in Santiago, Chile on 1–5 November 2010 – made a special request to the World Health Organization (WHO) to consider establishing daily potassium intake values for the general population on the basis of dietary adequacy or reduction of chronic NCD risk (or both). The CCNFSDU requested that this work be included as part of the update of recommendations on sodium intake by the WHO Nutrition Guidance Expert Advisory Group (NUGAG).
A 2002 joint WHO/Food and Agriculture Organization of the United Nations (FAO) Expert Consultation (WHO, 2003) concluded that the general population should consume a sufficient amount of potassium to maintain the molar ratio of sodium to potassium of 1:1. This ratio can generally be achieved with an intake of 70–80 mmol potassium/day if sodium is consumed at the recommended level. This recommendation is based on an improvement in blood pressure, and a blunting of the detrimental effects of higher sodium consumption on blood pressure.
The expert consultation recommended that this intake of potassium be achieved through fruit and vegetable consumption. A report from the Institute of Medicine recommends a much higher level of potassium as an adequate intake – 120.5 mmol/day – based on literature citing benefits in blood pressure, risk of developing kidney stones and possibly decreased bone loss (Institute of Medicine, 2005). The latter two outcomes were not considered by the 2002 joint WHO/FAO Expert Consultation when recommending the level of potassium intake (WHO, 2003). The review presented here was undertaken in light of more recent evidence regarding potassium and blood pressure, and the association with 2 renal function and potential bone loss, plus the contradictory findings of recent systematic reviews. NUGAG will make use of this document when generating, reviewing and updating WHO guidelines on potassium intake.