The dietary sodium/potassium ratio and human health | The Paleo Diet®
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Sodium/Potassium Ratio

One of the main tenets of a Paleolithic diet is to provide our physiology with foods that match our genetically determined nutritional requirements. Dietary mismatches can result in health concerns, and many people are consuming a sodium (Na+)/potassium (K+) ratio 10 times greater than it should be.

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The Western diet is low in plant foods containing potassium alkali salts (K-base), which our ancestors ate in abundance. Simultaneously, modern diets comprise foods that replace those K-base salts with sodium chloride (NaCl). As a result, in a typical Western diet the ratio of sodium to potassium is often 1-to-1, or worse.

The ratio of sodium to potassium is crucial for our health. Hunter-gatherer societies consume about a 1-to-5 to 1-to-10 ratio—far more potassium than sodium. The increased sodium consumption on a Western diet, compounded by insufficient potassium, drives us away from this natural ratio.

Every cell in our body relies on an intricate balance of sodium and potassium. The Na+-K+ pump, found in the outer plasma membrane of almost every cell, is responsible for maintaining a higher concentration of sodium outside the cell and a higher concentration of potassium inside the cell, which is crucial for the physiological processes of all cells in our body. We would die if this high concentration gradient was not maintained. In fact, close to 25 percent of our energy at rest is used by these pumps to maintain this critical gradient.

An understanding of the importance that sodium and potassium play in cellular function makes clear that a shift away from our genetically determined nutritional requirements can have dire consequences for our health.

A diet that is low in potassium and high in sodium increases the net systemic acid load on the body. This then leads to a chronic metabolic acidosis, which has a host of negative effects on the body including bone mineral loss, cardiovascular disease and insulin resistance.

Following a Paleo Diet high in plant foods balances with the acidity of animal proteins; many plants contain large quantities of potassium. So crucial is the intake of potassium that while dietary acid load is associated with chronic kidney disease (CKD), potassium intake is negatively associated with CKD1.

A review of the scientific literature is overwhelmingly supportive of decreasing sodium while simultaneously increasing potassium for improved health benefits. Yet, too many people fall short of this guideline. Thankfully, you can accomplish this with little effort by following the guidelines and recipes here at The Paleo Diet®.

  1. Ko BJ, Chang Y, Ryu S, Kim EM, Lee MY, Hyun YY, Lee KB. Dietary acid load and chronic kidney disease in elderly adults: Protein and potassium intake. PLoS One. 2017 Sep 27; 12(9).
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