The Sodium to Potassium Ratio Is One Reason Cheese is Not Paleo

As more and more people get into The Paleo Diet, a frequent question comes up – how do I know which foods are permitted and those which are not part of contemporary Paleo Diets? The Paleo Diet movement has become so large and fractionated in recent years that many versions of “Paleo” have now arisen. An interesting, but flawed adaptation of present day Paleo Diets frequently permit regular/daily consumption of dairy products (including cheese).

So how can you easily determine if any common modern day food mimics the nutritional characteristics of those foods our Stone Age ancestors would have consumed, and whether or not you should include or delete these contemporary foods from your menu? A near universal nutritional characteristic of junk and processed foods is that they contain added, mined salt (NaCl), a compound that was rarely or never present in Stone Age or preagricultural diets. [1-9]

Added Salt

Check out the labels on your foods – virtually every and all packaged and processed foods contain added salt. In fact, the typical U.S. diets contain 9.1 grams of salt per day. [10] Our ancestral dietary intakes of salt were about 1/6th (1.5 grams) to 1/10th (0.91 grams) this level (1-8, 11) and sometimes lower still. [12] Governmental agencies require manufacturers of canned, processed or packaged foods to reveal the sodium content of their food products, but this information doesn’t necessarily tell us the entire story.

Sodium in food almost always comes from added salt, a compound containing not just sodium (Na+), but also chloride (Cl). If you want to find out how much salt has been added to a canned, packaged or processed food, multiply the sodium content by 2.54 (the molecular weight of Cl is 35.45 and that of Na+ is 22.98 and the ratio of Cl to Na+ is 2.54), this calculation will give you the total salt (NaCl) content in the food. It’s not just the sodium content of a food which is harmful to our bodies, but also the chloride content [13-16], and since nearly all excess sodium in our diet comes from salt added to food [1, 8] anytime you have a high sodium intake, you also will have a high chloride intake.

The importance of the sodium to potassium ratio

One nearly universal characteristic of fresh, natural, unsalted foods is that they contain high concentrations of potassium (K+) and low concentrations of sodium (Na+). [1, 7, 8, 11, 17] Our research group has recently completed an extensive compilation of the K+ and Na+ concentrations found in more than 1200 wild and domesticated unsalted foods from all food groups. [18] From our results, you can easily see that consuming only natural, unsalted foods, it is implausible or impossible to eat > 2,400 mg Na+/day for adult men and women. Further, consumption of natural, unsalted foods show that it is virtually impossible to eat a K+/Na+ ratio of less than 5.0. Unfortunately, in the typical U.S. diet, we eat more Na+ (3,584 mg/day) than K+ (2795 mg/day) (10) yielding a daily K+/Na+ ratio of 0.77 which is 6.5 lower than the K+/Na+ ratio (5.00) that is normally obtained by only eating natural, unsalted foods (18).

The scientific literature (based upon randomized controlled human trials [RCT] and epidemiological evidence) is nearly in universal agreement of their condemnation of high salt/low potassium diets. [8, 10, 17, 19-26] How is it that the Paleo community has missed this fundamental nutritional concept and still promotes cooking and recipes using sea salt or refined salt?

Cheese

One of the original “processed foods” which first appeared during the Neolithic (5,400 to 4,800 years ago) was cheese. [27] Cheese is not a “natural” food, but rather represents a complex, manufactured, processed food requiring multiple steps for its synthesis and production. [27, 28] These steps and procedures simply would have been beyond the technological capabilities of hunter-gatherer societies.

Some contemporary Paleo Dieters regularly include cheese in their nutritional repertoires because they believe that cheese is a wholesome and natural food with nutritional characteristics similar to foods our pre-agricultural ancestors consumed. Nothing could be further from the truth. I only examine a single nutritional characteristic of modern day cheeses – their high salt content – and show you why you should avoid them.

Below is a list of the 14 bestselling cheeses in the U.S. and their respective share of the total U.S. cheese market along with their added salt content.

Of all the cheese eating countries in the world, Greece ranks first with a per capita consumption of 68.5 pounds per year, followed by France with an annual per capita consumption of 57.5 pounds. The U.S. ranks 15th world wide with a yearly per capita consumption of 32.6 pounds or 1.43 ounces (41 grams) per day. From the graph below, you can see that over the past 43 years U.S. cheese consumption has increased more than any other dairy product.

The table below alphabetically lists the salt content of 26 other cheeses commonly consumed worldwide.

Finally, the table below ranks the Na+ content for 40 cheeses from highest to lowest, their potassium (K+) concentrations and their K+ to Na+ ratios, and then contrasts these values to fresh, unsalted milk.

[Alternate Version]

It is obvious that all cheeses contain much more Na+ than K+ (on average 16 times more Na+ than K+) compared to their unadulterated, non-salted milk pre-cursors). Clearly, these K+/Na+ ratios in cheeses lie far beyond the evolutionary normative values which conditioned our species’ genome. [1-8, 10-12, 17, 18] Accordingly, it is not surprising that randomized controlled trials of salt consumption in humans as well as epidemiological studies [19-26] support the notion that added salt (be it sea salt or refined salt) from cheese or any other processed food, promotes cardiovascular disease, cancer, autoimmunity, chronic inflammation, immune system dysfunction and ill health. [19-26, 31-57]

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