Dietary Reference Intakes for Sodium and Potassium (2019) / Chapter Skim
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7 Potassium Dietary Reference Intakes: Risk Characterization and Special Considerations for Public Health
7 Potassium Dietary Reference Intakes: Risk Characterization and Special Considerations for Public Health
Pages 183-204
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From page 183... ...
are usually established when the evidence is not sufficient to derive Estimated Average Requirements and Recommended Dietary Allowances. The potassium AIs were derived using the highest median usual potassium intakes across two nationally representative surveys among children and normotensive male and female adults.
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From page 184... ...
Median usual potassium intakes among infants 7–12 months of age ranged from approximately 900–1,300 mg/d (23–33 mmol/d) and varied by whether infants included in the analyses consumed breast milk (see Table 7-2)
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From page 185... ...
No analyses were identified that estimated usual potassium intake distribution for breastfed infants 0–6 months of age. FITS 2016 = Feeding Infants and Toddlers Study 2016; mg/d = milligrams per day; NHANES = National Health and Nutrition Examination Survey; Not BF = analysis of infants who did not consume breast milk.
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From page 186... ...
BF = analysis of infants who consumed breast milk; FITS 2016 = Feeding Infants and Toddlers Study 2016; mg/d = milligrams per day; NHANES = National Health and Nutrition Examination Survey; Not BF = analysis of infants who did not consume breast milk. aPresented as intake (standard error)
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From page 187... ...
Although no statistical comparisons were carried out to explore differences, the percent of the population with intakes above the AI was relatively similar in males and females in each of the DRI age groups. Characterization by Country Although no statistical comparisons were carried out to explore differences, median and 75th percentile of potassium intakes are relatively comparable between the United States and Canada for many DRI age,
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From page 188... ...
e 3,211 (158) e 51e NOTES: Bold indicates the value is higher than the AI for the DRI age, sex, and life-stage group.
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From page 189... ...
Risk Characterization by Hypertension Status Although the apparently healthy population used to derive the adult potassium AIs were normotensive, there is no indication that the AIs cannot be applied to hypertensive individuals, with the exception of those taking medications that may interfere with blood potassium levels (see Special Considerations section below)
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From page 190... ...
To convert the milligram value to mmol, divide the intake level by 39.1. AI = Adequate Intake; mg/d = milligrams per day.
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From page 191... ...
In both analyses, individuals who self-reported having a history of cardiovascular disease were excluded.1 For comparability between the United States and Canada, the elevated blood pressure group from the NHANES 2009–2014 data is omitted from this section. In some DRI life-stage groups, median usual potassium intakes were higher in normotensive individuals compared to individuals with hypertension, particularly for males 51–70 years of age and females 51 years of age and older (see Figure 7-3)
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From page 192... ...
Synthesizing this information with the evidence presented in Tables 7-5 through 7-8 shows that the foods that are among the highest in potassium content are not necessarily the top contributors to potassium intake in the diet. Foods with lower potassium content per standard portion can contribute to a substantial proportion of total potassium intake when such foods are consumed commonly and in large quantities.
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From page 193... ...
Fruits and vegetables 81 20 Milk and milk drinksb 55 11 Meats and poultry 66 10 Grain-based mixed dishesc 50 10 Coffee and tea 55 7 100 percent juices 25 5 Meat/poultry mixed dishesd 18 4 Plant-based protein foodse 27 4 Savory snacksf 45 3 NOTE: Data are from What We Eat In America, National Health and Nutrition Examination Survey 2009–2010, day 1 dietary intake data, weighted, excluding breastfed infants. aPercent of individuals reporting the foods in the category at least once on the reporting day.
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From page 194... ...
Persons 19 Years of Age and Older, Ranked by Percent Contribution -- National Health and Nutrition Examination Survey, 2003–2006 (N = 9,490) 19–50 Years of Age (n = 5,429)
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From page 195... ...
Percent Percent Food Group Contributionb Food Group Contributionc Milk 15.6 Milk 15.0 Fruits 7.3 White potatoes 6.1 Flavored milk 5.7 Fruits 5.6 100 percent juice 5.3 100 percent fruit juice 4.6 White potatoes 4.5 Poultry 4.5 Savory snacks 4.0 Vegetablesd 4.1 Poultry 3.9 Savory snacks 4.0 Pizza 3.7 Mexican mixed dishes 3.9 Grain-based mixed dishes 3.7 Grain-based mixed dishes 3.7 Mexican mixed dishes 3.6 Meats 3.7 cMean potassium intake for this group was 2,308 mg/d (59 mmol/d)
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From page 196... ...
An analysis of NHANES 2007–2010 data of individuals 4 years of age and older found that multivitamin/mineral supplements provide approximately 11 mg/d (0.3 mmol/d) potassium to the overall estimated usual potassium intake of 2,606 mg/d (67 mmol/d)
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From page 197... ...
Nevertheless, there are certain situations and subpopulations in which potassium intakes may need to differ from the AI. Such special considerations are described below, and followed by a discussion of the implications of the updated potassium DRI values.
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From page 198... ...
. ACE-Is and ARBs are also used frequently in heart failure populations; these individuals typically have high serum potassium concentrations, and are likely to have a higher risk of potassium toxicity.
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From page 199... ...
. A post-hoc analysis including 812 participants from the Modification of Diet in Renal Disease Study, however, reported higher baseline urinary potassium level being associated with a lower risk of all-cause mortality but not kidney failure (Leonberg-Yoo et al., 2017)
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From page 200... ...
The potassium AIs established in this report are almost all lower than the values established in the Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2005 DRI Report)
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From page 201... ...
The committee was further limited in its ability to consider blood pressure a qualified surrogate marker, in context of potassium intake, as evidence on the independent effect of potassium intake on cardiovascular disease risk is lacking. Pursuant to the guidance and recommendations offered in the Guiding Principles for Developing Dietary Reference Intakes Based on Chronic Disease (NASEM, 2017)
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From page 202... ...
2016. Dietary reference values for potassium.
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From page 203... ...
2003. Dietary Reference Intakes: Applications in dietary planning.
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From page 204... ...
2017. Guiding prin ciples for developing Dietary Reference Intakes based on chronic disease.
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