What levels are you talking about? The article published in Nature mentions that the general population does not consume enough of it:
> Potassium (K+) is an extremely important mineral, as supported by National Academy of Science, Engineering, and Medicine Dietary Reference Intakes (DRI), and has been designated as a “nutrient of public health concern” due to its general under consumption [3]. In 2004, the Food and Nutrition Board of the Institute of Medicine established recommended intake levels of 4700 mg/day of K+ [4]. Despite these recommendations, data from National Health and Nutrition Examination Survey (NHANES) 2007–2008 estimated mean intakes in the United States to be 2290 mg/day for women and 3026 mg/day for men, substantially lower than the suggested values [5]. This relative “deficiency” is even more noteworthy when one considers the K+ intake of prehistoric man was estimated to be 15,000 mg/day, which actually exceeds the NHANES recommendations by a factor greater than 4 [6]. Despite studies demonstrating blood pressure lowering effects of increasing K+ intake, the 2019 DRI concluded more evidence is required to support a DRI for K+ [7].
For potassium there is normally no need for supplements. It is enough to eat more vegetables. The general population, especially in USA, is likely to eat not enough vegetables, so they may have low potassium because of that.
Nevertheless there are old people who may eliminate too easy the potassium from the body. Those at risk to have this are typically old women who have taken during many years medication for high blood pressure. For old men taking medication for high blood pressure, the risks also exist, but they are much lower than for women.
Those belonging to this risk group would better have a few times per year a blood test for electrolytes, especially for the sodium and the potassium concentrations in blood.
Only when the potassium concentration in blood is found to be low even with a healthy diet rich in vegetables, then potassium supplements are needed.
If potassium supplements are taken, chloride is not a good choice, because it provides excess chloride that is not useful. The salt eaten provides enough chloride. Better supplements are based on organic salts of potassium, e.g. lactate or citrate, which provide only potassium without anything else that might have unintended effects.
Source: my mother belonged to this risk group. She developed hyponatremia & hypokalemia and it was a very tough job to determine appropriate doses per day of salt and potassium supplements while maintaining the blood pressure at acceptable levels with only small doses of blood pressure medication, as that increased the rate of elimination for sodium & potassium.
I think your points are valid, I see them as orthogonal to my comments. Just one remark: If part of the sodium intake is replaced with potassium, then chloride should be fine.
While what you say is correct, it is still better to use potassium supplements without chloride, because that gives you the freedom to adjust the sodium and potassium doses independently, without worrying about chloride.
The daily requirements for sodium and chloride are strongly correlated, because their main use is to ensure correct concentrations of ions in the extracellular liquids, where sodium and chloride are the most abundant ions and they are used in proportional quantities.
The main purpose of potassium is as as a positive ion in the intracellular liquids, needed to compensate the charge of the organic acids and phosphoric acid.
Because of that, the quantity of potassium needed by the body is not correlated with the quantity of chloride needed, except weakly and indirectly, due to the normal range of ratios between the quantities of extracellular and intracellular liquids and the similar rates of renal losses.
thats interesting, online there are lots of articles (including webmd etc) about eating foods with potassium such as black beans, bananas, sweet potatoes etc + lowering sodium intake for hypertension... are you saying thats actually dangerous?
(sorry if the question seems weird, but im genuinely curious)
K/Na metabolism is tricky. Both are fundamental but in a very different way (Na levels are higher and with more tolerance in fluctuations, hypo/hyper-K can easily stop the heart).
The pressumed effect of K in BP is mainly that K pushes Na outside of renal tubules in an 1:1 analogy, which could be better achieved by not consuming Na in the first place.
In practice for a healthy adult below a certain age K intake is healthy (as it is contained in healthy foods) but otherwise risks arise. Certainly blind suggestion to the public is not warranted and K substitutes are used ONLY on demand (hypo-K, diarrhea etc)
Eating enough vegetables has many good effects, including providing an adequate quantity of potassium.
Eating too little salt is as dangerous as eating too much salt. The usual recommendation is to eat about 4 to 5 grams of salt per day.
The salt consumption can be a problem when instead of cooking your food with known quantities of salt you buy already processed food, which almost always contains excessive quantities of salt and sugar, because these are very cheap ingredients, which not only reduce the production cost, but they also improve the taste.
So for those buying already prepared food, the normal risk is to eat too much salt. Those who make their own food, must also take care to not eat too little salt.
Due to the much more frequent cases of excessive salt consumption, the minimum recommended daily quantities are not emphasized, but I have direct experience with the effects of too low salt consumption.
After having a stroke many years earlier, my mother was very concerned about HBP and she consumed low quantities of salt.
That eventually caused serious neurological problems and many months were wasted because she was not diagnosed correctly in the beginning, the various symptoms being attributed to completely different causes.
When the real cause was identified in the end, she very narrowly escaped death.
4 to 5 g/day is expected to be centered in the optimal range of daily salt consumption.
The minimum daily salt consumption under which health problems may appear is obviously much lower, probably under 1 g/day.
However, nobody has done any tests to determine the minimum requirements for humans, so the minimum threshold is not known, like also for all the other required nutrients for humans, because such tests would be dangerous for the test subjects.
