Did you know…
Before agriculture, human diets delivered 6,000 to 11,000 mg of potassium per day and about 500 mg of sodium. The potassium-to-sodium ratio was somewhere between 10:1 and 20:1. Human kidneys and vascular biology evolved under that ratio. Every homeostatic mechanism we possess for sodium and potassium is calibrated to it. Modern Western diets have inverted the ratio, and three decades of dietary guidance have not moved the median.
The claim, in the reference of population physiology
The largest and most-cited multi-population study on the sodium-potassium-blood-pressure relationship is INTERSALT (Intersalt Cooperative Research Group, 1988), covering 10,079 participants in 52 populations across 32 countries. The four populations still eating close to the ancestral ratio (Yanomami, Xingu, rural Kenya, Papua New Guinea highlands) showed essentially no hypertension and no age-related rise in blood pressure. That finding is not a lifestyle observation. It is a physiological demonstration that the vascular disease of ageing is not universal to the species. It is a specific response to a specific diet.
The recent authoritative call
Filippini and colleagues, in the Journal of the American Heart Association in 2020, restated the case that four decades of ignored evidence had not translated into practice:
“The need to carefully address and manage potassium intake within comprehensive efforts to prevent CVD in both the general population and high-risk subgroups.”
— Filippini et al., Journal of the American Heart Association, 2020
The public-health failure
The top dietary sources of potassium (potatoes, beans, spinach, avocados, bananas, dairy) are exactly what public-health advice recommends. Yet NHANES data show median US potassium consumption stuck around 2,500 mg per day since the mid-1990s. This is not because the advice is wrong. It is because the food environment is structured against it, and the tissue level of potassium, whose measurement would show who is actually depleted, is not part of any standard laboratory panel.
This entry is a companion to Right to Optimal Potassium Status and to False Negative: Serum Potassium.