Tag Archives: potassium

Does Diet Influence Risk of Stroke?

Harvard researchers suggest that our food consumption does indeed influence our risk of suffering a stroke.  This matters since stroke is the third leading cause of death in the U.S.

Scientists looked carefully at 121 different studies—published between 1979 and 2004—on the relationship between dietary factors and stroke.  High blood pressure is a major modifiable risk factor for stroke, so it also was considered.  Dietary factors included fats, minerals, animal protein, cholesterol, fish, whole grains, fiber, carbohydrate quality, fruits and vegetables, antioxidants, B vitamins, and dietary patterns.

I quote their conclusions:

Diets low in sodium and high in potassium lower blood pressure which will likely reduce stroke risk.

Consumption of fruits and vegetables, whole grains, folate, and fatty fish are each likely to reduce stroke risk.

A prudent or traditional Mediterranean dietary pattern, which incorporates these individual dietary components as well as intake of legumes and olive oil, may also prevent stroke.

Evidence is limited or inconsistent regarding optimal levels of dietary magnesium, calcium, antioxidants, total fat, other fat subtypes, cholesterol, carbohydrate quality, or animal protein for stroke prevention.

A diet low in sodium, high in potassium, and rich in fruits, vegetables, whole grains, cereal fiber, and fatty fish will likely reduce the incidence of stroke.

Take Home Points

The article abstract does not address the optimal intake amount of these various foods, vitamins, and minerals.  That’s probably not known with any certainty.

The traditional Mediterranean diet incorporates many of these stroke-preventing foods.  The Advanced Mediterranean Diet helps people lose weight while teaching how to eat Mediterranean-style.

The very low-carb Ketogenic Mediterranean Diet includes these stroke-preventing foods and minerals, except for whole grains and a tendency to be low in potassium.  The KMD is high in total fat and animal protien, and potentially high in cholesterol; this study indicates those issues are nothing to worry about in terms of future strokes.

I’ll use articles such as this to recommend long-term food consumption for followers of any future Diabetic Mediterranean Diet.

Steve Parker, M.D.

Reference:  Ding, E.L, and Mozaffarian, D.  Optimal dietary habits for the prevention of stroke. Seminars in Neurology, 26 (2006): 11-23.

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My Ketogenic Mediterranean Diet: Day 59 + Updated Supplement Recommendations

888894Weight: 154 lb

Transgressions: none

Exercise: 90 minutes horse grooming and trail riding

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I’ve finalized the latest supplements for dieters on the Ketogenic Mediterranean Diet, and tinkered with the original plan: Version 2.0 is published.

Daily supplements:

  • 1 or 2 plain Centrum multivitamin/multimineral supplements (two if over 250 lb or 114 kg)
  • Magnesium oxide 250 mg
  • Calcium carbonate 500 mg elemental calcium  (500 mg twice daily if over 250 lb or 114 kg)
  • Extra vitamin D to reach total of 1,000–1,2000 IU (each Centrum has 400 IU)
  • Potassium gluconate 2,750 mg (450 mg elemental potassium) or Morton Salt Substitute (potassium chloride) ¼ tsp (1.2 g)
  • If prone to constipation: sugar-free Metamucil powder 1–2 rounded tsp (5.8–11.6 g) in water
  • At least three quarts or liters of water 

Steve

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My Ketogenic Mediterranean Diet: Day 54 + Potassium Deficiency

The Monument Valley Navajo Tribal ParkWeight: 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

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Recap of My Ketogenic Mediterranean Diet: Weeks 5-7

 

Drilling down into the data

Drilling down into the data

Body Stats

My weight is 155 lb now compared with160.5 at the end of Week 4.  I seem to have plateaued around 155 over the last few weeks.  Waist circumference is 34.25 inches, down an inch over the last three weeks.  This is a pretty good weight for me.

What am I eating? 

Ninety percent of my food consists of:

eggs (3/day), mozarella string cheese sticks, nuts (almonds, mixed, peanuts), steak, sausage, hamburger, chicken, canned tuna, canned sardines, tomatoes, onions, avocadoes, cucumbers, baby spinach, celery, romaine lettuce, red wine (7 fl oz/day), extra virgin olive oil, sugar snap peas, butter, Italian vinaigrette dressing, mayonnaise (on tuna), salt, pepper.  [You and I should eat greater variety of vegetables and nuts.]

Nutrient Analysis  (thanks to NutritionData.com)

Average daily calories: 1,800

Macronutrient percentages: 8% carbohydrate, 30% protein, 53% fat, 9% alcohol

Daily digestible carbohydrates: 25 g

Daily fats: 110 g total fat, 31 g saturated fat, 52 g monounsaturated fats

Daily cholesterol: 800 mg (mostly from eggs)

Daily fiber: 7-10 g

Daily sodium: 1,500 mg (not counting salt from shaker)

Any potential micronutrient deficiencies? 

Yes.  Considering the amounts of the various foods I’m eating, the un-supplemented Ketogenic Mediterranean Diet on many, if not most, days would be deficient in vitamins D, E, K, thiamin, folate, and pantothenic acid, and the minerals calcium, iron, magnesium, potassium, sodium, copper, manganese.  Less often, there are deficiencies of zinc and vitamins A, C, B12, riboflavin, and B6.  [I’m using table salt from the shaker but not tracking it; sodium deficiency is very unlikely.]

These potential deficiencies are based on the % Daily Values recommended by U.S. government authorities for an adult eating 2,000 calories daily.  Someone following the Ketogenic Mediterranean Diet but eating a different mixture of foods could have a better or worse micronutrient profile.

Version 1.01 of the Ketogenic Mediterranean Diet from the outset recommended one daily Centrum multivitamin/multimineral supplement, plus extra vitamin D 400 IU/day, and elemental calcium 500-1,000 mg/day.  These would prevent a large majority of these potential deficiencies. 

I started a daily magnesium supplement a week ago to suppress nocturnal leg cramps.  It’s working well.

Implications

I’m in the midst of revising my recommended supplements and will post them here within the next few days.  I’m likely to add magnesium, potassium, table salt, and fiber. 

Remember, this is not a life-long eating plan; it’s a temporary weight-loss program.  Natural sources of vitamins and minerals along with phytonutrients will be added later.

Steve Parker, M.D.

Disclaimer:  All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status.  Always consult your personal physician before making any dietary, nutritional supplement, or exercise changes.

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My Ketogenic Mediterranean Diet: Day 39 + Potassium Review

Nuts are a rich source of potassium

Nuts are a rich source of potassium

Weight: 157 lb

Transgressions: extra 0.5 oz sunflower seeds (above the 1 oz nut allowance)

Exercise: none

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My nutrient analysis at NutritionData suggests that the un-supplemented Ketogenic Mediterranean Diet may be deficient in potassium.  Here’s a summary of potassium physiology from UpToDate:

Potassium’s Role

Fluid and blood mineral balance.  Cell integrity.  Muscle contraction.  Nerve transmission.

Dietary Sources

Very high in molasses, seaweed, dried figs.  Nuts, dried fruits, avocado, wheat germ, spinach, bran cereals, tomatoes, potatoes, broccoli, cauliflower, beets, winter squash, oranges, bananas, kiwis, cantaloupe, and meats (ground beef, steak, pork, veal, lamb).  Also salt substitutes (potassium chloride). 

Centrum multivitamin/multimineral supplement has very little potassium.

Signs of Deficiency

Weakness, easy fatigue, paralysis, belly distension, loss of appetite, nausea, vomiting, muscle cramps, numbness or tingling, sore muscles, heart rhythm disturbances.

Implications

You have a several options if you have minor signs or symptoms suggesting potassium deficiency: 1) consult your physician for an accurate diagnosis, 2) have your physician draw a blood level of potassium , 3) increase your intake of potassium-rich foods (e.g., meats, avocados, spinach, cauliflower, broccoli) for a few days and note your response, 4) try a salt substitute (potentially dangerous if you have kidney disease or your blood potassium is already high and you don’t know it).

If you have physcal signs or symptoms to a moderate or severe degree, consult your personal physician.

Steve

Disclaimer:  All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status.  Always consult your personal physician before making any dietary or exercise changes.

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