Changing Your Diet: Choosing Nutrient-rich Foods

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The 11 Most Nutrient-Dense Foods on the Planet
We're your online guide to making conscious choices that help people, animals and the planet. For more information about building a healthy diet, refer to the Dietary Guidelines for Americans and the U. Calorie-dense foods, also called energy-dense foods, contain high levels of calories per serving. Hi Chris, Nice article and also thanks for share vitamins chart. My bowels and the results of their labours are as they were in my twenties now.

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Two earlier meta-analyses of 19 trials [ 44 ] and 33 trials [ 45 ] had similar findings. However, a Cochrane review of six of the highest-quality trials found nonsignificant reductions in systolic and diastolic blood pressure with potassium supplementation [ 46 ].

In , the Agency for Healthcare Research and Quality AHRQ published a draft systematic review of the effects of sodium and potassium intakes on chronic disease outcomes and their risk factors [ 47 ]. The authors concluded that, based on observational studies, higher potassium intakes were not associated with lower blood pressure in adults or with the risk of hypertension.

Based on 13 randomized controlled trials that primarily enrolled patients with hypertension, the review found that the use of potassium-containing salt substitutes in place of sodium chloride significantly reduced systolic blood pressure in adults by a mean of 5. However, reducing sodium intake decreased both systolic and diastolic blood pressure in adults, and increasing potassium intake via food or supplements did not reduce blood pressure any further.

This finding suggests that at least some of the beneficial effects of potassium salt substitutes on blood pressure may be due to the accompanying reduction in sodium intake, rather than the increase in potassium intake. Higher potassium intakes have been associated with a decreased risk of stroke and possibly other cardiovascular diseases CVDs [ 14 , 48 ].

However, a draft AHRQ report found inconsistent relationships between dietary potassium intakes and risk of stroke based on 1 case-cohort and 10 prospective cohort studies [ 47 ]. Any beneficial effect of potassium on CVD is likely due to its antihypertensive effects.

However, some research shows a benefit even when blood pressure is accounted for. These findings suggest that other mechanisms e. The FDA has approved the following health claim: Overall, the evidence suggests that consuming more potassium might have a favorable effect on blood pressure and stroke, and it might also help prevent other forms of CVD.

However, more research on both dietary and supplemental potassium is needed before firm conclusions can be drawn. Kidney stones Kidney stones are most common in people aged 40 to 60 [ 51 ]. Stones containing calcium—in the form of calcium oxalate or calcium phosphate—are the most common type of kidney stone. Low potassium intakes impair calcium reabsorption within the kidney, increasing urinary calcium excretion and potentially causing hypercalciuria and kidney stones [ 14 , 36 ].

Low urinary levels of citrate also contribute to kidney stone development. Observational studies show inverse associations between dietary potassium intakes and risk of kidney stones. Some research suggests that supplementation with potassium citrate reduces hypercalciuria as well as the risk of kidney stone formation and growth [ 51 , 54 ]. In a clinical trial of 57 patients with at least two kidney stones either calcium oxalate or calcium oxalate plus calcium phosphate over the previous 2 years and hypocitraturia low urinary citrate levels , supplementation with 30—60 mEq potassium citrate providing 1, to 2, mg potassium for 3 years significantly reduced kidney stone formation compared with placebo [ 54 ].

This study was included in a Cochrane review of seven studies that examined the effects of potassium citrate, potassium-sodium citrate, and potassium-magnesium citrate supplementation on the prevention and treatment of calcium-containing kidney stones in a total of participants, most of whom had calcium oxalate stones [ 51 ].

The potassium citrate salts significantly reduced the risk of new stones and reduced stone size. However, the proposed mechanism involves citrate, not potassium per se; citrate forms complexes with urinary calcium and increases urine pH, inhibiting the formation of calcium oxalate crystals [ 51 , 55 ]. The authors of a draft AHRQ report [ 47 ] concluded that observational studies suggest an association between higher potassium intakes and lower risk of kidney stones.

However, they also found the evidence insufficient to determine whether potassium supplements are effective because only one trial that addressed this question [ 54 ] met their inclusion criteria. Additional research is needed to fully understand the potential link between dietary and supplemental potassium and the risk of kidney stones.

Bone health Observational studies suggest that increased consumption of potassium from fruits and vegetables is associated with increased bone mineral density [ 56 ].

This evidence, combined with evidence from metabolic studies and a few clinical trials, suggests that dietary potassium may improve bone health.

The underlying mechanisms are unclear, but one hypothesis is that potassium helps protect bone through its effect on acid-base balance [ 36 ]. Diets that are high in acid-forming foods, such as meats and cereal grains, contribute to metabolic acidosis and might have an adverse effect on bone. Alkaline components in the form of potassium salts potassium bicarbonate or citrate, but not potassium chloride from food or potassium supplements might counter this effect and help preserve bone tissue.

In the Framingham Heart Study for example, higher potassium intake was associated with significantly greater bone mineral density in elderly men and women [ 57 ]. In another study, the DASH eating pattern significantly reduced biochemical markers of bone turnover [ 58 ].

This eating pattern has a lower acid load than typical Western diets and is also high in calcium and magnesium, in addition to potassium, so any independent contribution of potassium cannot be determined. Only a few clinical trials have examined the effects of potassium supplements on markers of bone health. Potassium supplementation significantly increased bone mineral density at the lumbar spine and bone microarchitecture compared with placebo.

Conversely, a clinical trial in postmenopausal women aged 55—65 years found that supplementation with potassium citrate at either Overall, higher intakes of potassium from diets that emphasize fruits and vegetables might improve bone health.

Although obesity is the primary risk factor for type 2 diabetes, other metabolic factors also play a role. Because potassium is needed for insulin secretion from pancreatic cells, hypokalemia impairs insulin secretion and could lead to glucose intolerance [ 2 ]. This effect has been observed mainly with long-term use of diuretics particularly those containing thiazides or hyperaldosteronism excessive aldosterone production , which both increase urinary potassium losses, but it can occur in healthy individuals as well [ 2 , 10 , 14 , 64 ].

Numerous observational studies of adults have found associations between lower potassium intakes or lower serum or urinary potassium levels and increased rates of fasting glucose, insulin resistance, and type 2 diabetes [ ]. These associations might be stronger in African Americans, who tend to have lower potassium intakes, than in whites [ 67 , 70 ]. For example, one study of 1, adults aged 18—30 years without diabetes found that those with urinary potassium levels in the lowest quintile were more than twice as likely to develop type 2 diabetes over 15 years of follow-up than those in the highest quintile [ 67 ].

Among 4, participants from the same study with potassium intake data, African Americans with lower potassium intakes had a significantly greater risk of type 2 diabetes over 20 years of follow-up than those with higher intakes, but this association was not found in whites. Serum potassium levels were inversely associated with fasting glucose levels in 5, participants aged 45—84 years from the Multi-Ethnic Study of Atherosclerosis, but these levels had no significant association with diabetes risk over 8 years of follow-up [ 69 ].

Although observational studies suggest that potassium status is linked to blood glucose control and type 2 diabetes, this association has not been adequately evaluated in clinical trials.

In a small clinical trial in 29 African American adults with prediabetes and low to normal serum potassium levels 3. The findings from studies conducted to date are promising.

Dietary potassium In healthy people with normal kidney function, high dietary potassium intakes do not pose a health risk because the kidneys eliminate excess amounts in the urine [ 1 ]. In addition, there is no evidence that high intakes of dietary potassium have adverse effects. However, in people with impaired urinary potassium excretion due to chronic kidney disease or the use of certain medications, such as angiotensin converting enzyme ACE inhibitors or potassium-sparing diuretics, even dietary potassium intakes below the AI can cause hyperkalemia [ 1 ].

Hyperkalemia can also occur in people with type 1 diabetes, congestive heart failure, adrenal insufficiency, or liver disease [ 7 ]. Individuals at risk of hyperkalemia should consult a physician or registered dietitian about appropriate potassium intakes from all sources.

Information on low-potassium diets is also available from the National Kidney Disease Education Program. Although hyperkalemia can be asymptomatic, severe cases can cause muscle weakness, paralysis, heart palpitations, paresthesias a burning or prickling sensation in the extremities , and cardiac arrhythmias that could be life threatening [ 1 , 7 ].

Potassium from dietary supplements, salt substitutes, and medications Potassium supplements can cause minor gastrointestinal side effects [ 47 ]. Chronic ingestion of doses of potassium supplements e. The use of potassium salts in certain medications has been associated with small-bowel lesions, causing obstruction, hemorrhage, and perforation [ 20 , 73 ].

For this reason, the FDA requires some oral drugs providing more than 99 mg of potassium to be labeled with a warning. Several types of medications have the potential to affect potassium status in ways that could be dangerous.

A few examples are provided below. People taking these and other medications should discuss their potassium intakes and status with their healthcare providers. These medications reduce urinary potassium excretion, which can lead to hyperkalemia. Experts recommend monitoring potassium status in people taking ACE inhibitors or ARBs, especially if they have other risk factors for hyperkalemia, such as impaired kidney function [ 74 ]. Experts recommend monitoring potassium status in people taking these medications, especially if they have impaired kidney function or other risk factors for hyperkalemia [ 77 ].

Experts recommend monitoring potassium status in people taking these medications, and initiating potassium supplementation if warranted [ 76 ]. The federal government's — Dietary Guidelines for Americans notes that "Nutritional needs should be met primarily from foods. Foods in nutrient-dense forms contain essential vitamins and minerals and also dietary fiber and other naturally occurring substances that may have positive health effects.

In some cases, fortified foods and dietary supplements may be useful in providing one or more nutrients that otherwise may be consumed in less-than-recommended amounts. For more information about building a healthy diet, refer to the Dietary Guidelines for Americans and the U. Department of Agriculture's MyPlate. This fact sheet by the Office of Dietary Supplements ODS provides information that should not take the place of medical advice. We encourage you to talk to your healthcare providers doctor, registered dietitian, pharmacist, etc.

Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice. August 20, History of changes to this fact sheet. Strengthening Knowledge and Understanding of Dietary Supplements. Potassium Fact Sheet for Health Professionals. References Institute of Medicine. Potassium intake, bioavailability, hypertension, and glucose control.

Sodium, chloride, and potassium. Present Knowledge in Nutrition. The pharmacokinetics of potassium in humans is unusual. J Clin Pharmacol ; Water, electrolytes, and acid-based metabolism.

Modern Nutrition in Health and Disease. Can Med Assoc J ; Am Fam Physician ; N Engl J Med ; Assessment of body potassium stores. Potassium and risk of Type 2 diabetes.

Expert Rev Endocrinol Metab ;6: Department of Agriculture, Agricultural Research Service. Nutrient Data Laboratory Home Page, Food sources of energy and nutrients among adults in the US: Food sources of energy and nutrients among children in the United States: National Health and Nutrition Examination Survey Beneficial effects of potassium on human health. Food and Drug Administration.

A Food Labeling Guide. Revision of the Nutrition and Supplement Facts Labels. Federal Register 81 National Institutes of Health. Dietary Supplement Label Database.

Code of Federal Regulations Title Potassium salt preparations intended for oral ingestion by man. Council for Responsible Nutrition. Commission on Dietary Supplement Labels. Report of the Commission 0n Dietary Supplement Labels. Bioavailability of potassium from potatoes and potassium gluconate: Am J Clin Nutr ; The absorption of potassium chloride--liquid vs.

Department of Health and Human Services, U. What We Eat in America, Dietary supplement use is associated with higher intakes of minerals from food sources. Record linkage study of hypokalaemia in hospitalized patients. Postgrad Med J ; Intern Med J ; Hypokalemic myopathy in pregnancy caused by clay ingestion. Myopathy, hypokalaemia and pica geophagia in pregnancy.

Ulster Med J ; Encyclopedia of Dietary Supplements. London and New York: Huang CL, Kuo E. Mechanism of hypokalemia in magnesium deficiency. J Am Soc Nephrol ; Electrolyte and acid-base disorders in inflammatory bowel disease. Hypokalemic myopathy in inflammatory bowel diseases. J Crohns Colitis ;7: Health effects of sodium and potassium in humans. Curr Opin Lipidol ; Potassium intake, stroke, and cardiovascular disease a meta-analysis of prospective studies. The proposed classification scheme is offered as a tool for nutrition education and dietary guidance.

Defining PFV on the basis of nutrient and phytochemical constituents is suggested 1. However, uniform data on food phytochemicals and corresponding intake recommendations are lacking 2. This article describes a classification scheme defining PFV on the basis of 17 nutrients of public health importance per the Food and Agriculture Organization of the United Nations and Institute of Medicine ie, potassium, fiber, protein, calcium, iron, thiamin, riboflavin, niacin, folate, zinc, and vitamins A, B 6 , B 12 , C, D, E, and K 3.

This cross-sectional study identified PFV in a 3-step process. Berry fruits and allium vegetables were added in light of their associations with reduced risks for cardiovascular and neurodegenerative diseases and some cancers 8. For each, and for 4 items apples, bananas, corn, and potatoes described elsewhere as low-nutrient-dense 1 , information was collected in February on amounts of the 17 nutrients and kilocalories per g of food 9.

Because preparation methods can alter the nutrient content of foods 2 , nutrient data were for the items in raw form. Second, a nutrient density score was calculated for each food using the method of Darmon et al The scores were weighted using available data Table 1 based on the bioavailability of the nutrients As some foods are excellent sources of a particular nutrient but contain few other nutrients, percent DVs were capped at so that any one nutrient would not contribute unduly to the total score 3.

The denominator is the energy density of the food kilocalories per g: The score represents the mean of percent DVs per kcal of food. Because there are no standards defining good sources of a combination of nutrients-per-kilocalories, the FDA threshold was used for this purpose. The 4 low-nutrient-dense items were classified as non-PFV.

To validate the classification scheme, the Spearman correlation between nutrient density scores and powerhouse group was examined. The robustness of the scheme with respect to nutrients beneficial in chronic disease risk also was examined by comparing foods classified as PFV with those separately classified as such based on densities of 8 nutrients protective against cancer and heart disease ie, fiber, folate, zinc, and vitamins B 6 , B 12 , C, D, and E 2,4.

Of 47 foods studied, all but 6 raspberry, tangerine, cranberry, garlic, onion, and blueberry satisfied the powerhouse criterion Table 2. Nutrient density scores ranged from The proposed classification scheme is offered in response to the call to better define PFV and may aid in strengthening the powerhouse message to the public.

Messages might specify PFV to help consumers know what they are and choose them as part of their overall fruit and vegetable intake. As numeric descriptors of the amount of beneficial nutrients PFV contain relative to the energy they provide, the scores can serve as a platform for educating people on the concept of nutrient density. Expressing the nutrient desirability of foods in terms of the energy they provide may help focus consumers on their daily energy needs and getting the most nutrients from their foods.

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