Diabetic Mediterranean Diet

Weight: 154 lb

Transgressions: TNTC (too numerous to count)

Exercise: none

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The Potassium Problem

My current food intake on the Ketogenic Mediterranean Diet appears to be low in potassium, which might have long-term health consequences if followed for many months or years.  According to the Linus Pauling Institute’s Micronutrient Information Center, adequate potassium intake apparently decreases blood pressure, reduces salt sensitivity, decreases risk of kidney stones, and protects against osteoporosis and stroke. 

These associations between higher potassium intake and lower condition rates are based mostly on observational studies of populations in which some people eat little potassium and others eat a lot.  It’s assumed that people with higher potassium intake are eating more fruits and vegetables, not taking supplements. 

The Linus Pauling Institute agrees with the U.S. Institute of Medicine’s  “Adequate Intake” value for potassium of 4,700 mg daily for average adults.  The current U.S. Food and Drug Administration Daily Value is about 3,500 mg.  I’m only getting 2,000 mg/day now. 

Multivitamin/multimineral supplements in the U.S. provide a maximum of 99 mg potassium (by law?).  I bought a potassium gluconate supplement at CVS Pharmacy last night: 90 mg potassium, a drop in the bucket.  I dropped into a Hi Health vitamin store (health food store?) today and would swear I saw a combined magnesium and potassium supplement that contained 150 mg potassium. 

Excess potassium intake can be life-threatening in certain situations such as kidney impairment and use of medications like potassium-sparing diuretics and ACE inhibitors. 

Relatively high meat intake tends to create an acidic environment in the body, which our bones help to buffer or counteract.  In the process, calcium in our bones is mobilized and can be lost through urine.  The end result after many years is osteoporosis: thin brittle bones easily broken.  And perhaps calcium-containing kidney stones.  These are traditional concerns about high-protein diets. 

Many fruits and vegetables are considered naturally alkaline, tending to counteract the acid production of other foods. 

I see sporadic reports about potassium bicarbonate supplementation acting as an acid buffer and reducing urinary calcium loss.  Potassium citrate may do the same.  Even potassium chloride may reduce urinary calcium loss separate from any acid buffering capacity (which it shouldn’t have, anyway).  Are those supplements available without a physician’s prescription?  Health food store perhaps?  [Not in Hi Health.]  Would a salt substitute containing potassium chloride be a reasonable source of potassium? 

How about reducing fruit and vegetable consumption, replacing them with a potassium bicarbonate supplement?  Probably not a fair trade.  The food has myriad other nutrients that probably promote health and longevity. 

These potassium-related health concerns are much less bothersome, perhaps nonexistent, when I admit that very few people will follow a very low-carb ketogenic diet for longer than several months.  But it’s an issue.

On the other hand, maybe I worry too much.  Remember, the foods I choose are giving me 2,000 mg potassium daily.  The total potassium could be lower or higher depending on one’s choice of food items.  I have the 1993 edition of Understanding Nutrition, a popular college textbook in basic nutrition.  The table of Recommended Dietary Allowances doesn’t even list potassium.  The text mentions an estimated minimum requirement for potassium of 2,000 mg/day.  The Canadian minimum requirement was 1,170 mg/day. 

About My Diet Transgressions

After 53 days of very low-carb eating, I decided to take a break, a cheat day.  The family was celebrating a milestone.  We drove 2 hours and 20 minutes, one way, to eat at Eat At Joe’s Barbecue in Wikiup, Arizona.  Best Texas-style barbecue outside of Texas.  I had brisket, baked beans, half a roll, cole slaw, stuffed jalapenos, Shiner Bock beer, and cherry pie.  Probably ate 3,500 calories today instead of my usual 1,850.  Expect my weight will be up 2–3 lb tomorrow.  We’ll see how far and how long this transgression sets me back.  All in the name of Science, of course.

–Steve

Update October 25, 2009

At the supermarket today I found an over-the-counter potassium supplement for anyone wanting more non-food potassium in their diet:  Morton Salt Substitute.  A quarter teaspoon has 610 mg potassium.  It contains potassium chloride, fumaric acid, tricalcium phosphate, and monocalcium phosphate.  The container carries a warning: “Consult a physician before using any salt substitute.”  I found it on the shelf near the regular salt.  I also saw a product that was half salt (NaCl) and half potassium chloride (KCl).  I haven’t tried Morton Salt Substitute yet.  It’s a cheaper source of potassium than a potassium gluconate supplement.   

-Steve