For individuals advised by their healthcare team to lower potassium in their diet, this article provides detailed guidance on how to achieve this through dietary modifications, lifestyle adjustments, and a better understanding of potassium's role in the body. It's crucial to only follow this guidance if your healthcare team has specifically advised you to do so.
Why Lower Potassium Levels?
Potassium is an essential mineral that helps maintain healthy heart function and muscle activity. When potassium is absorbed into the blood, it plays a crucial role in ensuring these vital functions operate correctly. The kidneys are responsible for regulating the amount of potassium in the blood. However, both low and high potassium levels can lead to heart problems, necessitating careful management. Having too much potassium in your body is called hyperkalemia.
Understanding Hyperkalemia
Hyperkalemia, or high potassium levels, can arise from various factors, including kidney disease, a diet high in potassium, certain medications, Addison’s disease, poorly controlled diabetes, serious injuries, or severe burns. People with kidney disease, in particular, may struggle to remove excess potassium, leading to a buildup in the blood.
Who Is at Risk?
Several factors can increase your risk of developing hyperkalemia:
- Kidney Disease: Impaired kidney function hinders the effective removal of excess potassium from the body.
- High-Potassium Diet: Consuming excessive amounts of potassium-rich foods can exacerbate hyperkalemia, especially in individuals with advanced kidney disease.
- Certain Drugs: Some medications can interfere with the kidneys' ability to remove potassium, leading to elevated levels.
- Addison’s Disease: This condition results in the body not producing enough of certain hormones, affecting potassium balance.
- Poorly Controlled Diabetes: High blood sugar levels are linked with high potassium levels.
- Serious Injury or Severe Burn: These conditions can cause a rapid release of potassium into the bloodstream.
How to Identify High Potassium Levels
A simple blood test can determine the level of potassium in your blood. If you are at risk, be sure you ask your healthcare provider about a blood test for potassium. Many people with high potassium have few, if any, symptoms. If symptoms do appear, they are usually mild and non-specific.
Read also: Comprehensive Alkalinity Guide
Symptoms of High Potassium
Symptoms of high potassium may include:
- Muscle weakness
- Numbness
- Tingling
- Nausea
- Other unusual feelings
High potassium usually develops slowly over many weeks or months and is often mild but can recur. If high potassium happens suddenly and you have very high levels, you may feel heart palpitations, shortness of breath, chest pain, nausea, or vomiting. This is a life-threatening condition that requires immediate medical care. If you have these symptoms, call 911 or go to the emergency room.
Strategies to Lower Potassium Levels
Several strategies can help manage and lower potassium levels, including medications, dietary changes, and lifestyle adjustments.
Medications
Always adhere to prescribed medications to regulate potassium levels. Discuss all medicines that you take with your doctor including over-the-counter drugs, herbals and supplements. Do not stop taking any medicine on your own. Water pills (diuretics) help rid your body of extra potassium. They work by making your kidney create more urine. Potassium is normally removed through urine. Potassium binders can also help remove extra potassium from the body.
Dietary Changes
Dietary changes are a cornerstone of managing potassium levels. Potassium is found in many foods and drinks, including processed foods such as fruit juice, crisps, chocolate and food containing potassium additives. You may not need to limit all high-potassium foods, but you may need to reduce your portion sizes, or how often you eat them. A well-balanced diet contains a variety of foods from different food groups to make sure you get all the nutrients you need to stay as healthy as possible. It can be harder to get a good balance when you have been advised to limit the amount of some foods you eat.
Read also: Review: Low-Carb Impact on BP
Foods to Limit or Avoid
- High-Potassium Fruits: Apricots, bananas, cantaloupe, dried fruits, honeydew melon, kiwis, mangoes, nectarines, oranges, papayas, pomegranates, prunes, pumpkin, raisins.
- High-Potassium Vegetables: Avocado, artichoke, beets, baked beans, black beans, refried beans, broccoli (cooked), Brussels sprouts, kohlrabi, lentils, okra, parsnips, potatoes (white and sweet), rutabagas, spinach (cooked), squash (especially acorn, butternut, and Hubbard), tomatoes, tomato sauce, and tomato paste, vegetable juice.
- Other High-Potassium Foods: Bran products, chocolate, coconut, creamed soups, French fries, granola, ice cream, miso, molasses, nuts, peanut butter, potato chips, salt substitutes, seeds, tofu, yogurt.
- High-Potassium Drinks: Coffee (over 8 oz), orange juice, pomegranate juice, prune juice, milk (buttermilk, chocolate, eggnog, evaporated, malted, soy, and milkshakes).
- Salt Substitutes: Avoid any salt substitutes which list potassium chloride on the ingredients list, including SoLo®, Lo-Salt® or sodium-free salt. Check processed foods such as crisps for potassium chloride on the ingredients list. You may be able to find a similar product which does not contain added potassium.
Low-Potassium Food Choices
The recommended serving size for these low-potassium foods is 1/2 cup. Be mindful not to overdo it, as too much of a low-potassium food makes it a high-potassium food.
- Low-Potassium Fruits: Apples and applesauce, blackberries, blueberries, cranberries, fruit cocktail, grapes, mandarin oranges, peaches, pears, pineapple, plums, raspberries, strawberries, tangerine, watermelon.
- Low-Potassium Vegetables: Alfalfa sprouts, asparagus (6 raw spears), broccoli (raw or cooked from frozen), cabbage, carrots (cooked), cauliflower, celery (1 stalk), corn (half an ear if it's on the cob), cucumber, eggplant, green beans or wax beans, kale, lettuce, white mushrooms (raw), onion, parsley, peas (green), peppers, radish, water chestnuts, watercress, yellow squash and zucchini.
- Other Low-Potassium Foods: Bread (not whole grain), cake (angel or yellow), cookies (no nuts or chocolate), noodles, pasta, pies (unless it's made with chocolate or high-potassium fruits), rice.
- Low-Potassium Drinks: Certain fruit juices, such as apple, grape, and pineapple, coffee (less than 8 oz), tea (less than 16 oz).
Sample Low-Potassium Diet Plan
On a low-potassium diet, you’ll try to eat no more than 2,000 to 3,000 milligrams of potassium each day. (People without health issues usually aim to eat about 4,700 milligrams.) The exact amount of potassium you’ll aim for depends on your height and weight.
Depending on your needs, a low-potassium diet plan might look like this:
- Fruit: 1-3 servings of low-potassium fruits, such as apples or grapes
- Vegetables: 2-3 servings of low-potassium vegetables, such as carrots or corn
- Dairy/calcium-rich foods: 1-2 servings of low-potassium choices, such as cottage cheese
- Meat/plant-based meat: 3-7 servings of low-potassium choices, such as turkey or shrimp
- Grains: 4-7 servings of low-potassium grains, such as rice or noodles
Cooking Methods to Lower Potassium
Cooking methods can significantly impact the potassium content of foods.
- Boiling: Boiling potatoes and other vegetables reduces their potassium content as some of the potassium leaks into the cooking water. Potatoes that have been par-boiled (partly cooked by boiling) can then be fried, roasted or added to casseroles.
- Soaking: Soak dried pulses (beans, lentils, chickpeas) in plenty of water overnight, discard the water and boil. Soaking reduces potassium levels in white and sweet potatoes, carrots, beets, and leafy and cruciferous vegetables.
- Avoid Using Cooking Water: Avoid using cooking water to make gravy, stocks or soups to keep out the extra potassium.
- Leaching: Leaching is a process by which some potassium can be pulled out of the vegetable. Learn how to leach vegetables. An study from 2023 found that simply bringing a pot of water to the boil, removing it from the heat, then soaking the potassium-rich foods in the hot water for 5-10 minutes can reduce the potassium. For canned or potted fruits and vegetables, drain and rinse them to remove any excess minerals in the canning liquid.
Other Important Considerations
- Portion Control: Watch your serving sizes. A low-potassium food can quickly become high-potassium if you eat a lot of it. Keep an eye on your portions. Some serving sizes may be smaller than you think. For instance, a serving of chicken is about the size of your palm.
- Read Food Labels: Check the Nutrition Facts on the package to see how much potassium a food contains. Try to choose items that contain no more than 100 milligrams of potassium per serving.
- Plan Ahead: If you know you’ll be eating dinner out and want to enjoy some foods that may be high-potassium, try to stick to low-potassium foods throughout the day leading up to your meal out.
- Avoid Certain Liquids: The juices in canned fruits and vegetables, as well as cooked meats, contain high amounts of potassium. Avoid drinking them or using them in recipes as much as you can.
- Skip the “Fake” Salt: On a low-potassium diet, you’ll need to skip low-sodium salt or other “fake” salts. Flavor your food with herbs and spices instead. For seasoning, try pepper, fresh or dried herbs, spices, lemon juice, chilli or garlic.
- Healthy Bowels: Regular bowel movements can help prevent potassium from building up in the blood. If you are struggling with constipation, you may benefit from eating more fibre. Fibre is found in fruit, vegetables, wholegrains, beans, pulses, lentils, nuts and seeds. Your dietitian may also recommend a fibre supplement. If you are still constipated, your healthcare team may prescribe some laxatives.
- Blood Sugar Control: High blood sugar levels are linked with high potassium levels. Talk to your dietitian or diabetes team for help with managing your blood sugar levels.
Lifestyle Adjustments
Certain lifestyle adjustments can complement dietary changes in managing potassium levels.
Read also: The Carnivore Diet: Impact on Blood Pressure
Stay Hydrated
While it's true that drinking a lot of water can lower your blood potassium levels, it isn't a safe way to do so. This is because drinking a lot of water doesn't only lower your potassium levels. It affects all your nutrient levels.
Limit Processed Foods
Processed foods are also often high in salt. Wherever possible, limit your intake of processed food and cook from scratch.
Seeking Professional Guidance
It is essential to consult with healthcare professionals for personalized advice and monitoring.
Kidney Dietitian
Please speak to your kidney dietitian for individual dietary advice, and for information about your specific dietary requirements. If you need help with meal plans or figuring out food swaps, talk to a dietitian or nutritionist. Your doctor can refer you to one.
Doctor
Ask your doctor what your potassium levels should be, and use a dietitian to help you plan your diet properly. Tell your doctor about all the medicines you are taking including over-the-counter drugs, herbals and supplements.