The potassium content in greens is one of two ways they can improve artery function within minutes of consumption.
Lowering Our Sodium-to-Potassium Ratio to Reduce Stroke Risk
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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
More than a thousand years ago, an ancient Persian medical text advised, for the treatment of hypertension, lifestyle interventions—such as “[a]voiding…meat, and pastries”—and recommended eating spinach. A thousand years later, researchers discovered that a single meal containing spinach could indeed reduce blood pressure, thanks to its nitrate content. All green leafy vegetables are packed with the stuff, which our body can use to create nitric oxide that improves the flexibility and function of our arteries—which may be why eating our greens may be one of the most powerful things we can do to reduce our chronic disease risk.
Just switching from low-nitrate vegetables to high-nitrate vegetables for a week can lower blood pressure by about four points. And, the higher the blood pressure they started out with, the greater benefit they got. Four points might not sound like a lot, but even a two-point drop in blood pressure could prevent more than 10,000 fatal strokes every year here in the U.S.
Potassium-rich foods may also act via a similar mechanism. If we just got the minimum recommended daily intake of potassium, we might prevent 150,000 strokes every year—because potassium appears to “increase…the release of nitric oxide.” One week of eating two bananas and a large baked potato every day significantly improved arterial function. Even a single high-potassium meal—containing the equivalent of two to three bananas’ worth of potassium—can improve the function of our arteries. Whereas a high-sodium meal—which is to say, a meal with the regular amount of salt most people eat—can impair arterial function within 30 minutes.
Whereas potassium increases nitric oxide release, sodium reduces nitric oxide release. So, the health of our arteries may be determined by our sodium-to-potassium ratio. Two slices of bacon worth of sodium, and our arteries take a significant hit within 30 minutes. But, add three bananas’ worth of potassium, and you can counteract the effects of the sodium.
When we evolved, we were eating ten times more potassium than sodium. Now, the ratio is “reversed”—more sodium than potassium. These kinds of studies “provide…additional evidence that increases in dietary potassium should be encouraged.” What does that mean? “More…beans, sweet potatoes, [and] leafy greens,” which are like a super-good double whammy—high in potassium and nitrates.
This recommendation to eat spinach from the 900s is pretty impressive—though they also recommended bloodletting, and abstaining from sex. So, we should probably take ancient wisdom with a grain of salt. But our meals should be added-salt-free.
Please consider volunteering to help out on the site.
- Frassetto L, Morris RC Jr, Sellmeyer DE, Todd K, Sebastian A. Diet, evolution and aging--the pathophysiologic effects of the post-agricultural inversion of the potassium-to-sodium and base-to-chloride ratios in the human diet. Eur J Nutr. 2001 Oct;40(5):200-13.
- Lewington S, Clarke R, Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002 Dec 14;360(9349):1903-13.
- D'Elia L, Iannotta C, Sabino P, Ippolito R. Potassium-rich diet and risk of stroke: updated meta-analysis. Nutr Metab Cardiovasc Dis. 2014 Jun;24(6):585-7.
- Blanch N, Clifton PM, Petersen KS, Willoughby SR, Keogh JB. Effect of high potassium diet on endothelial function. Nutr Metab Cardiovasc Dis. 2014 Sep;24(9):983-9.
- Heydari M, Dalfardi B, Golzari SE, Habibi H, Zarshenas MM. The medieval origins of the concept of hypertension. Heart Views. 2014 Jul;15(3):96-8.
- [no authors listed] Potassium-rich foods linked to lower stroke risk. Harv Heart Lett. 2014 Dec;25(4):8.
- Ashworth A, Mitchell K, Blackwell JR, Vanhatalo A, Jones AM. High-nitrate vegetable diet increases plasma nitrate and nitrite concentrations and reduces blood pressure in healthy women. Public Health Nutr. 2015 Oct;18(14):2669-78.
- Liu AH, Bondonno CP, Croft KD, Puddey IB, Woodman RJ, Rich L, Ward NC, Vita JA, Hodgson JM. Effects of a nitrate-rich meal on arterial stiffness and blood pressure in healthy volunteers. Nitric Oxide. 2013 Nov 30;35:123-30.
- Hung HC, Joshipura KJ, Jiang R, Hu FB, Hunter D, Smith-Warner SA, Colditz GA, Rosner B, Spiegelman D, Willett WC. Fruit and vegetable intake and risk of major chronic disease. J Natl Cancer Inst. 2004 Nov 3;96(21):1577-84.
- Blanch N, Clifton PM, Keogh JB. Postprandial effects of potassium supplementation on vascular function and blood pressure: a randomised cross-over study. Nutr Metab Cardiovasc Dis. 2014 Feb;24(2):148-54.
- Dickinson KM, Clifton PM, Keogh JB. Endothelial function is impaired after a high-salt meal in healthy subjects. Am J Clin Nutr. 2011 Mar;93(3):500-5.
- Blanch N, Clifton PM, Petersen KS, Keogh JB. Effect of sodium and potassium supplementation on vascular and endothelial function: a randomized controlled trial. Am J Clin Nutr. 2015 May;101(5):939-46.
- Oberleithner H, Riethmüller C, Schillers H, MacGregor GA, de Wardener HE, Hausberg M. Plasma sodium stiffens vascular endothelium and reduces nitric oxide release. Proc Natl Acad Sci U S A. 2007 Oct 9;104(41):16281-6.
- Oberleithner H, Callies C, Kusche-Vihrog K, Schillers H, Shahin V, Riethmüller C, Macgregor GA, de Wardener HE. Potassium softens vascular endothelium and increases nitric oxide release. Proc Natl Acad Sci U S A. 2009 Feb 24;106(8):2829-34.
Image credit: Kristina DeMuth. Image has been modified.
Video credit: Daniel Black.
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
More than a thousand years ago, an ancient Persian medical text advised, for the treatment of hypertension, lifestyle interventions—such as “[a]voiding…meat, and pastries”—and recommended eating spinach. A thousand years later, researchers discovered that a single meal containing spinach could indeed reduce blood pressure, thanks to its nitrate content. All green leafy vegetables are packed with the stuff, which our body can use to create nitric oxide that improves the flexibility and function of our arteries—which may be why eating our greens may be one of the most powerful things we can do to reduce our chronic disease risk.
Just switching from low-nitrate vegetables to high-nitrate vegetables for a week can lower blood pressure by about four points. And, the higher the blood pressure they started out with, the greater benefit they got. Four points might not sound like a lot, but even a two-point drop in blood pressure could prevent more than 10,000 fatal strokes every year here in the U.S.
Potassium-rich foods may also act via a similar mechanism. If we just got the minimum recommended daily intake of potassium, we might prevent 150,000 strokes every year—because potassium appears to “increase…the release of nitric oxide.” One week of eating two bananas and a large baked potato every day significantly improved arterial function. Even a single high-potassium meal—containing the equivalent of two to three bananas’ worth of potassium—can improve the function of our arteries. Whereas a high-sodium meal—which is to say, a meal with the regular amount of salt most people eat—can impair arterial function within 30 minutes.
Whereas potassium increases nitric oxide release, sodium reduces nitric oxide release. So, the health of our arteries may be determined by our sodium-to-potassium ratio. Two slices of bacon worth of sodium, and our arteries take a significant hit within 30 minutes. But, add three bananas’ worth of potassium, and you can counteract the effects of the sodium.
When we evolved, we were eating ten times more potassium than sodium. Now, the ratio is “reversed”—more sodium than potassium. These kinds of studies “provide…additional evidence that increases in dietary potassium should be encouraged.” What does that mean? “More…beans, sweet potatoes, [and] leafy greens,” which are like a super-good double whammy—high in potassium and nitrates.
This recommendation to eat spinach from the 900s is pretty impressive—though they also recommended bloodletting, and abstaining from sex. So, we should probably take ancient wisdom with a grain of salt. But our meals should be added-salt-free.
Please consider volunteering to help out on the site.
- Frassetto L, Morris RC Jr, Sellmeyer DE, Todd K, Sebastian A. Diet, evolution and aging--the pathophysiologic effects of the post-agricultural inversion of the potassium-to-sodium and base-to-chloride ratios in the human diet. Eur J Nutr. 2001 Oct;40(5):200-13.
- Lewington S, Clarke R, Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002 Dec 14;360(9349):1903-13.
- D'Elia L, Iannotta C, Sabino P, Ippolito R. Potassium-rich diet and risk of stroke: updated meta-analysis. Nutr Metab Cardiovasc Dis. 2014 Jun;24(6):585-7.
- Blanch N, Clifton PM, Petersen KS, Willoughby SR, Keogh JB. Effect of high potassium diet on endothelial function. Nutr Metab Cardiovasc Dis. 2014 Sep;24(9):983-9.
- Heydari M, Dalfardi B, Golzari SE, Habibi H, Zarshenas MM. The medieval origins of the concept of hypertension. Heart Views. 2014 Jul;15(3):96-8.
- [no authors listed] Potassium-rich foods linked to lower stroke risk. Harv Heart Lett. 2014 Dec;25(4):8.
- Ashworth A, Mitchell K, Blackwell JR, Vanhatalo A, Jones AM. High-nitrate vegetable diet increases plasma nitrate and nitrite concentrations and reduces blood pressure in healthy women. Public Health Nutr. 2015 Oct;18(14):2669-78.
- Liu AH, Bondonno CP, Croft KD, Puddey IB, Woodman RJ, Rich L, Ward NC, Vita JA, Hodgson JM. Effects of a nitrate-rich meal on arterial stiffness and blood pressure in healthy volunteers. Nitric Oxide. 2013 Nov 30;35:123-30.
- Hung HC, Joshipura KJ, Jiang R, Hu FB, Hunter D, Smith-Warner SA, Colditz GA, Rosner B, Spiegelman D, Willett WC. Fruit and vegetable intake and risk of major chronic disease. J Natl Cancer Inst. 2004 Nov 3;96(21):1577-84.
- Blanch N, Clifton PM, Keogh JB. Postprandial effects of potassium supplementation on vascular function and blood pressure: a randomised cross-over study. Nutr Metab Cardiovasc Dis. 2014 Feb;24(2):148-54.
- Dickinson KM, Clifton PM, Keogh JB. Endothelial function is impaired after a high-salt meal in healthy subjects. Am J Clin Nutr. 2011 Mar;93(3):500-5.
- Blanch N, Clifton PM, Petersen KS, Keogh JB. Effect of sodium and potassium supplementation on vascular and endothelial function: a randomized controlled trial. Am J Clin Nutr. 2015 May;101(5):939-46.
- Oberleithner H, Riethmüller C, Schillers H, MacGregor GA, de Wardener HE, Hausberg M. Plasma sodium stiffens vascular endothelium and reduces nitric oxide release. Proc Natl Acad Sci U S A. 2007 Oct 9;104(41):16281-6.
- Oberleithner H, Callies C, Kusche-Vihrog K, Schillers H, Shahin V, Riethmüller C, Macgregor GA, de Wardener HE. Potassium softens vascular endothelium and increases nitric oxide release. Proc Natl Acad Sci U S A. 2009 Feb 24;106(8):2829-34.
Image credit: Kristina DeMuth. Image has been modified.
Video credit: Daniel Black.
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Title
Lowering Our Sodium-to-Potassium Ratio to Reduce Stroke Risk
LicenseCreative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Content URLDoctor's Note
Why might abstaining from sex not be the best idea for cardiovascular health? Because the opposite may actually be true. See my video Do Men Who Have More Sex Live Longer?.
What else can we do about stroke risk? Check out:
For more on potassium, see Potassium and Autoimmune Disease and 98% of American Diets Potassium-Deficient.
Interested in learning more about the dangers of sodium? See:
- High Blood Pressure May Be a Choice
- Sprinkling Doubt: Taking Sodium Skeptics with a Pinch of Salt
- The Evidence That Salt Raises Blood Pressure
- Sodium Skeptics Try to Shake Up the Salt Debate
- Shaking the Salt Habit
- Sodium and Arterial Function: A-Salting Our Endothelium
- Big Salt: Getting to the Meat of the Matter
Sodium isn’t just bad for our arteries. Check out How to Treat Asthma with a Low-Salt Diet and Sodium and Autoimmune Disease: Rubbing Salt in the Wound?.
I further explore the wonders of nitrate-rich vegetables in:
- Whole Beets vs. Juice for Improving Athletic Performance
- Oxygenating Blood with Nitrate-Rich Vegetables
- “Veg-Table” Dietary Nitrate Scoring Method
- Slowing Our Metabolism with Nitrate-Rich Vegetables
- Best Brain Foods: Greens and Beets Put to the Test
Sweet potatoes are an excellent high-potassium, low-sodium choice, but what’s the best way to prepare them? Check out The Best Way to Cook Sweet Potatoes.
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