Detail-Document #240904 −This Detail-Document accompanies the related article published in− PHARMACIST'S LETTER / PRESCRIBER'S LETTER
September 2008 ~ Volume 24 ~ Number 240904
Potassium Content of Foods and Salt Substitutes
Patients who take potassium-wasting diuretics (loops, thiazides) are often counseled to increase potassium intake to help prevent hypokalemia.
For patients with uncomplicated hypertension, an extra 20 mEq to 40 mEq potassium/day is usually sufficient to prevent potassium loss. This increase in potassium can easily be achieved through dietary sources. Typically, leafy green vegetables, fruit from vines, and root vegetables are good dietary sources of potassium. It's been shown that a low-sodium diet that's high in potassium (like the "DASH diet") can help lower blood pressure by as much as 8 to 10 mm Hg.1 A daily dietary potassium intake of 4.7 g/day (120 mEq/day or 120 mmol/day) or more is safe for healthy people, since excess potassium is excreted in the urine. On the other hand, patients with renal dysfunction (CrCl < 60 mL/min), adrenal insufficiency, the elderly, and those taking medications like ACE inhibitors, ARBs, NSAIDs, or potassium-sparing diuretics (spironolactone, triamterene) may be prone to hyperkalemia and should be mindful of high potassium intake. These folks should receive < 4.7 g/day (120 mEq/day or 120 mmol/day) of potassium.2 It's important to note that dietary potassium should NOT be used to correct hypokalemia. Most potassium in foods comes as the phosphate salt, and not the chloride salt. Because of this, dietary potassium is not effective in correcting chloride depletion which can be caused by diuretics, vomiting, and nasogastric drainage.2 This document includes a helpful table that lists commonly consumed potassium-rich foods and salt substitutes.
To calculate mEq and mmol of potassium from mg of potassium, use 39 mg K+ = 1 mEq K+ = 1 mmol K+7,8 Elemental Potassium Content1,3-6 Milligrams (mg) Milliequivalents (mEq) = Millimoles (mmol) Dairy (serving size is 8 oz = 1 cup = 240 mL, unless otherwise indicated) Milk, skim, whole, or buttermilk Fruits Apricots, 5 dried
Copyright 2008 by Therapeutic Research Center
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(Detail-Document #240904: Page 2 of 3) Elemental Potassium Content1,3-6 Milligrams (mg) Milliequivalents (mEq) = Millimoles (mmol) Juices (serving size is 4 oz = ½ cup = 120 mL) Apple juice Nuts Almonds, dry roasted (1 oz or 30 gm) Salt substitutes (serving size is 1/4 tsp) (contain potassium chloride) AlsoSalt Morton Salt Substitute, NoSalt, Nu-Salt Vegetables (serving size is 8 oz = 1 cup = 240 mL, unless otherwise indicated) Acorn squash, cooked
Copyright 2008 by Therapeutic Research Center
Pharmacist's Letter / Prescriber's Letter ~ P.O. Box 8190, Stockton, CA 95208 ~ Phone: 209-472-2240 ~ Fax: 209-472-2249
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(Detail-Document #240904: Page 3 of 3)
3. Anon. Potassium supplement (oral route, parenteral
Users of this document are cautioned to use their own professional judgment and consult any other necessary or appropriate sources prior to making clinical
information/DR602373. (Accessed May 8, 2008).
judgments based on the content of this document. Our
4. Anon. Appendix B. Food sources of selected
editors have researched the information with input from
nutrients. USDA. http://www.health.gov/dietaryguidelines/dga2005/doc
experts, government agencies, and national
ument/html/appendixB.htm#appB1. (Accessed May
organizations. Information and Internet links in this article were current as of the date of publication.
5. National Academy of Sciences. Dietary reference
intakes for water, potassium, sodium, chloride, and
Project Leader in preparation of this Detail-
sulfate. http://www.nap.edu/catalog.php?record_id=10925.
Document: Stacy A. Hester, R.Ph., BCPS,
6. Anon. Palo Alto Medical Foundation. Potassium
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http://www.merck.com/mkgr/mmg/appndxs/app2.jsp.
2. Appel LJ, Brands MW, Daniels SR, et al. Dietary
approaches to prevent and treat hypertension: a
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scientific statement from the American Heart
assn.org/content/vol292/issue1/images/pdf/data/112/DC
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6/JAMA_auinst_si.dtl. (Accessed May 10, 2008).
Cite this Detail-Document as follows: Potassium content of foods and salt substitutes. Pharmacist's Letter/Prescriber's Letter 2008;24(9):240904.
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