It is often pointed out, at least anecdotally, that potassium deficiency is common among low carbohydrate dieters. Potassium deficiency can lead to a number of unpleasant symptoms and health problems. This micronutrient is present in small quantities in meat and seafood; main sources are plant foods.
A while ago this has gotten me thinking and asking myself: what about isolated hunter-gatherers that seem to have thrived consuming mostly carnivorous diets with little potassium, such as various Native American tribes?
Another thought came to mind, which is that animal protein seems to be associated with increased bone mineralization, even when calcium intake is low. That seems to be due to animal protein being associated with increased absorption of calcium and other minerals that make up bone tissue.
Maybe animal protein intake is also associated with increased potassium absorption. If this is true, what could be the possible mechanism?
As it turns out, there is one possible and somewhat surprising connection, insulin seems to promote cell uptake of potassium. This is an argument made many years ago by Clausen and Kohn, and further discussed more recently by Benziane and Chibalin. See also this recent commentary by Clausen.
Protein is the only macronutrient that normally causes transient insulin elevation without any glucose response. And the insulin response to protein is nowhere near that associated with refined carbohydrate-rich foods. It is much lower, analogous to the response to natural carbohydrate-rich foods.
A very low carbohydrate diet with more animal protein, and less fat, would induce insulin responses after meals, possibly helping with the absorption of potassium, even if potassium intake were rather limited. Primarily carnivorous diets, like those of some traditional Native American groups, would fit the bill.
Also, a low carbohydrate diet with emphasis on fat, but that was not so low in carbohydrates from certain sources, would probably achieve the same effect. This latter sounds like Kwaśniewski’s Optimal Diet, where people are encouraged to eat a lot more fat than protein, but also a small amount of carbohydrates (e.g., 50-100 g/d) from things like potatoes.
Kwaśniewski’s suggestions may sound counterintuitive sometimes. But, as it turns out, potatoes are good sources of potassium. One potato may not be a lot, but that potato will also increase insulin levels, bringing potassium intake up at the cell level.
This comment has been removed by the author.
ReplyDeleteSpinach and other LC veggies are loaded with potassium. Eating more of such greens would make more sense to me than eating potatoes to get insulin levels up.
ReplyDeleteEating a high-fat diet provides plenty of potassium. I average 4,100 mg of potassium and 2,200 mg sodium daily. Whole foods are naturally high in potassium and low in sodium. In fact, I add sea salt to my food because I ran into a problem with hyponatremia.
ReplyDeleteI eat a largely meat diet (less than 10 g carbs daily...no fruits or vegetables). My potassium levels were in the normal range in a recent blood test. (I've been eating this way for quite some time.) Interestingly, my sodium levels were low. Go figure.
ReplyDeleteLets not forget avocado's, super high in potassium and has a carb level acceptable for a LC diet.
ReplyDeleteNed, that's an ingenious train of thought.
ReplyDeleteI think the problems people have with potassium on low-carb diets usually come during the period where they are losing weight rapidly. (Dumping water weight takes electrolytes along with it, and many low-carb diets advise drastically upping water intake.)
I don't think many people maintaining their weight on a low-car diet have potassium problems, and your hypothesis explains one of the reasons.
Like Ed Terry, I, too, had problems with hyponatremia after fairly rapid weight loss. On a doctor's advice, I was also following a low-sodium diet. If you are exercising, losing weight, sucking down lots of water, and not supplementing with more salt than usual you may be in dangerous territory. (In my case, I was awakened from sleep by convulsions. Not a pleasant experience.)
One of the first symptoms is often cramping--which people usually assume is from low potassium rather than low sodium.
Hi Gretchen. There is no doubt that spinach is a great source of potassium, comparable to white potato on a gram-adjusted basis.
ReplyDeleteStill, many people experience symptoms that seem to be related to potassium deficiency during the Atkins induction phase, where vegetables are not only allowed but strongly encouraged.
The so-called Atkins induction “flu”.
Why? Maybe it is a drop in circulating insulin, combined with existing insulin resistance that many people already have entering the Atkins diet.
Hi Ed, wjones3044, and David. Given that animal protein may increase potassium absorption, mediated by insulin, LC with emphasis on animal protein would also require more sodium to be consumed to allow the sodium-potassium pump to work properly.
ReplyDeleteIndeed, many people seem to experience hyponatremia on LC as well. Theoretically, those are the ones who should not experience hypokalemia.
This reminds me of the so often trumpeted “evils of salt”. Well, you may want to take a look at this article linking high salt intake with REDUCED heart disease risk:
ReplyDeletehttp://ow.ly/5RL3O
Avocados have an amount of potassium comparable to that of white potatoes, gram-for-gram. But not enough carbs to lead to any significant insulin response – Atkins induction “flu”.
ReplyDeleteNed, whenever we change a diet suddenly, it takes the body a bit to become accustomed to the new regimen. You can kill sheep by suddenly giving them a lot of grain, for example. They need time to build up a new grain-loving bacterial population in the rumen.
ReplyDeleteSo if you're speaking of the Atkins induction period, with a sudden change in diet plus very very strict carb control, that's one thing. Chronic LC dieting is different.
You didn't clarify that but referred to "among low carbohydrate dieters," so I misunderstood what you were suggesting.
Most LC gurus suggest adding salt on LC diets, and especially in the initial stages.
What about Lite Salt, which contains potassium chloride, as a source of potassium?
ReplyDeleteI see Gretchen, good points.
ReplyDeleteHi Anon. I have occasionally seen these types of comments about potassium-based salt substitutes:
ReplyDeletehttp://www.straightdope.com/columns/read/1364/can-salt-substitute-kill-you
Enough to be somewhat alarmed, I’d say.
Hi Ned,
ReplyDeleteIf one can assume the serum ref range is a proper estimate of what potassium levels should be, and they are in range, what is the likelihood that one needs to concern themselves with monitoring intake?
Hi Nick. You can get out of range in as little as a few days. The triggers may be a new strict diet, physical activities that are unusually demanding, a very stressful period at work or home, to name a few.
ReplyDeleteI have always steered clear of potassium chloride. If I want to supplement, I use Electro-Mix, a balanced electrolyte mix (except for the lack of sodium!), stir-it-into-a-drink, fizzy concoction based on potassium carbonate & bicarbonate:
ReplyDeletehttp://www.emergenc.com/index.php/products/specialty/electro-mix
There are interesting correlations between low potassium status, adiponectin, and metabolic syndrome:
http://www.nature.com/ajh/journal/v20/n8/full/ajh2007246a.html
(Alas, just the abstract...)
The second seemed to be the full article David, or maybe my connection gave me access to it. Interesting graphs there of adiponectin levels and IR; suggesting a strong negative relationship.
ReplyDeleteCoffee is VERY high in potassium. A cup or two in the am should very neatly take care of the problem. And this applies to decaf as well.
ReplyDeleteAlso, the original Atkins induction, which ran for two weeks, did NOT allow a variety of vegetables, but only for the first two weeks. It allowed like two cups of plain lettuce only per day.Period.
ReplyDeleteHi mem. Two cups of regular coffee will give you about 1/3 of the potassium in a medium-sized white potato, which is itself less than 20 percent of the officially recommended amount. This is according to data from Nutritiondata.com.
ReplyDeleteHi Ned,
ReplyDeleteOops...my source broke down potassium per 200cal servings! So, that is a lot of coffee at 2.4 cal for about a 6 oz serving, lol! And it was: 10801mg for decaf brewed at home and 9799 for caf. Although it seemed very high, it sped right past me as over in the years in ERs I've seen many people with shooting high K+ in part due to HUGE daily coffee intakes - the 10+ cups a day set. Thanks for the correction! (Source: Self Nutrition Data)
In studies on rats a protein-fat diet at 75% energy fat, 20% protein and 5% carbohydrates - decreased demand for protein by 35%, energy by 34%, the minerals by 68%
ReplyDeletewww.dr-kwasniewski.pl/media/2/bib-1/krystyna.txt_3/news_444.doc
This comment has been removed by the author.
ReplyDeleteBlah that article is in polish.
ReplyDeleteThe increase in carbohydrate intake, increased levels of insulin increases the demand for vitamins (B1)and minerals (Mg), and proteins (Glycolysis)
ReplyDeleteDoes Diabetes Mellitus Increase the Requirement for Vitamin C?
http://onlinelibrary.wiley.com/doi/10.1111/j.1753-4887.1996.tb03932.x/abstract
Vitamins are small biomolecules that are needed in small amounts in the diet of higher animals.
Stryer Biochemistry
http://www.health-science-spirit.com/HF5-2.gif
ReplyDeleteWell magnesium is needed to hold potassium into solution.
ReplyDeleteI have read that some races of people can't absorb properly some proteins and that's why they need following by doctors.
ReplyDeleteHi,
ReplyDeleteHealthline just published a visualization of your daily value of sodium. In the chart, you can see what half of your DV of salt looks like for 30 foods: http://www.healthline.com/health/high-blood-pressure-hypertension/daily-value-sodium
This is very valuable content as it puts nutrition information into perspective and helps a person understand how much sodium is actually in their food. I thought this would be of interest to your audience and wanted to see if you would include this as a resource on your page: http://healthcorrelator.blogspot.com/2011/08/potassium-deficiency-in-low.html
If you do not believe this would be a good fit for a resource on your site, even sharing this on your social communities would be a great alternativeto help get the word out.
Thanks for your time reviewing. Please let me know your thoughts and if there are any questions I can answer.
All the best,
Maggie Danhakl • Assistant Marketing Manager
p: 415-281-3124 f: 415-281-3199
Healthline • The Power of Intelligent Health
660 Third Street, San Francisco, CA 94107
www.healthline.com | @Healthline | @HealthlineCorp
About Us: corp.healthline.com