Benefits of a High-Potassium, Paleolithic Diet

Dr. Biff F. Palmer, a Professor of Internal Medicine at the University of Texas Southwestern Medical Center, in Dallas, TX, and Dr Deborah J. Clegg, a Professor of Internal Medicine at Cedars Sinai and UCLA Medical Centers in Los Angeles, CA, discuss their article appearing in the April 2016 issue of Mayo Clinic Proceedings, where they explore the capacity of the kidney to process potassium and describe benefits for patients to enhance consumption of potassium-rich diets. Available at:

Hello my name is dr. beth palmer and i’m a professor of internal medicine here at the university of texas southwestern medical center and i’m dr. debra clegg i’m a professor of internal medicine at ucla and cedars-sinai medical center in los angeles and we are co-authors of a paper entitled ingesting a high potassium intake a paleolithic diet without the toxicity

And one of the reasons we became interested in this are some recent guidelines that have been published with regards to nutritional recommendations yes there are new usda guidelines that provide nutritional recommendations specifically for nutrients not only that are in excess but also are considered to be nutrients of concern and surprisingly potassium is actually

Denoted as a nutrient of concern and it’s quite interesting one of the things we talked about in our paper is that there’s evidence that stone-age man actually ingested about 15,000 milligrams of potassium a day nearly four times what we ingest at the current time and about 10,000 years ago with the onset of agriculture and the subsequent development of processing of

Food there’s been a progressive decline in potassium intake and a progressive increase in dietary sodium and this mismatch between what arguably is the evolutionary design of the kidney that is to handle a lot of potassium and the current diet which is low in potassium has been associated with diseases at least in epidemiologic studies one of the things we talked

About in our paper is that the normal kidney really has a tremendous capacity to excrete potassium potassium whenever a dietary potassium intake is high and we comment on some recent data that actually has identified within the distal nephron a sensing capacity where by dietary potassium can lead to increases in urinary excretion even without a change in serum

Concentration or a change in mineralocorticoid activity in addition we also cite evidence of a sensing mechanism that exists within the stomach they can actually signal the kidney to augment renal potassium secretion even without a change in blood potassium or once again without a change in mineralocorticoid activity so again the evolutionary design characteristic

Of the normal kidney appears to be one in which there’s a prodigious capacity to excrete dietary k and one of the things we then talk about is what is the consequences then of ingesting a low potassium diet and there are many negative consequences and actually you could flip it on the other side and say that there are some positive consequences associated with

Eating a diet that’s actually elevated in potassium specifically there’s improvements in overall blood pressure there’s also improvements in reduction in overall stone formation improvements and acid-base balance these are things that actually are normally associated with consuming diets that are high in potassium so in addition to talking about some of the health

Benefits we then in our paper ask the question what about the patients who do not have normal kidneys the standard of care obviously in the setting of chronic kidney disease is to restrict dietary potassium and one might ask are we withholding a potential therapeutic benefit in terms of diet by restricting dietary potassium in that setting obviously the reason we

Do so is to prevent life-threatening hyperkalemia the risk for that is increased because patients with chronic kidney disease are frequently taking drugs that impaired renal potassium secretion but we now have drugs that are available that might in fact allow us to test whether a high potassium intake could be a benefit exactly so there are two new drugs one is

The has already been approved by the fda and their other is waiting pending approval and these drugs actually going to potassium and they actually help people who have hyperkalemia and we think that this might not be an interesting time to relook at potassium as an important cation we have to understand that there are these medical benefits associated with eating

Diets that are high in potassium we typically restrict this important nutrient from individuals and yet at the same time maybe with these new drugs we can actually start to liberalize the diet a bit and actually afford them the benefits of eating a potassium enriched diet and there are indeed some small studies that would suggest a potassium enriched diet has

Benefits in the ckd population for example a plant-based diet administered to patients with impaired kidney function is associated with less elevations in their serum phosphorus and there’s also a beneficial effect in terms of controlling the degree of metabolic acidosis almost equivalent to what’s been shown with the use of a sodium bicarbonate tablet so these

Are issues that warrant again examining whether a high k intake could be given to patients with chronic kidney disease and avoid hyperkalemia with the use of these new potassium binding drugs so i would conclude by saying that this is really a timely article particularly given recent nutritional guidelines and with the advent of new potassium binding drugs to be

Able to test the hypothesis of whether or not chronic kidney disease patients might enjoy the cardiovascular benefits of a high potassium intake we hope you found this presentation from the content of mayo clinic proceedings valuable our journals mission is to promote the best interests of patients by van singh the knowledge and professionalism of the physician

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Benefits of a High-Potassium, Paleolithic Diet By Mayo Proceedings