On recommended consumption and supply of potassium and magnesium to the population

In this article we will tell you:

1. Beneficial properties of potassium and its effect on the body
2. How much potassium does a person need?
3. How to determine potassium deficiency
4. Signs of excess potassium
5. What foods contain potassium?
6. Foods containing large amounts of potassium
7. Rules for preparing foods with potassium
8. Menu for a healthy heart

Potassium

- an important trace element and electrolyte. It maintains water-salt balance, promotes proper heart function, and regulates the activity of the central nervous system.

Deficiency of this microelement leads to various ailments. And first of all, it is recommended to reconsider your diet. From today's article you will learn what foods contain potassium, how to determine potassium deficiency, how much it is needed during the day and how to properly prepare foods with potassium to replenish it in the body.

Physiological role of potassium and magnesium

Potassium is
the main intracellular ion. The normal functioning of the body depends on the concentration of potassium inside the cell and in the intercellular fluid. Adequate intake of potassium from food ensures the conduction of an electrical impulse, which is necessary for the functioning of the heart and the contraction of smooth and striated muscles, the functioning of the brain and the peripheral nervous system; maintaining intracellular osmotic pressure; water balance. Potassium acts as an activator of certain enzymes; regulator of the activity of voltage-dependent channels; necessary to maintain vascular endothelial function; normal blood pressure (BP); acid-base balance in the body; influences the release of hormones (insulin) [1].

Magnesium

is the eighth most abundant element in the earth's crust, a vital mineral, the second predominant intracellular electrolyte after potassium, and the fourth most abundant cation in the body. Its content in the body of an adult is about 1000 mmol (or 24 g), i.e. 20 mmol/kg of lean body mass. The main depot of magnesium is bone tissue, which contains about 50–60% of its total amount, and about 40–50% in muscles and other soft tissues. It is necessary for muscle relaxation, regulates the mineralization of bone tissue, its uniform growth, flexibility, strength and increases the reparative potential of bones [2].

Approximately one third of bone magnesium is available to maintain levels outside the cell. Extracellular magnesium in the body (less than 2% of total magnesium) is found in blood plasma and erythrocytes [3].

Magnesium is present in all cells as a cofactor of more than 300 enzymes involved in glucose metabolism, the synthesis of proteins and nucleic acids, the formation and transfer of energy, the regulation of vascular smooth muscle tone and the function of endothelial cells, as a counterion for high-energy compounds (ATP) and nucleic acids, regulates transmembrane transport plays a role in maintaining the structure of proteins, DNA stabilization, synthesis and metabolism of catecholamines (norepinephrine), acetylcholine and other neurotransmitters, as well as neuropeptides in brain tissue [4].

Magnesium is necessary for maintaining the homeostasis of calcium, potassium and sodium, plays an important role in the metabolism of vitamin D and the synthesis of its hormonal form, since the activity of enzymes (hydroxylases) that hydroxylate vitamin D3 is magnesium-dependent [5–7].

pharmachologic effect

Calcium preparations compensate for the deficiency of calcium ions and eliminate the symptoms of its deficiency - increased bone fragility, muscle weakness, etc. In addition, calcium preparations have antiallergic, anti-inflammatory and hemostatic effects.

Magnesium hydroxide, magnesium oxide and magnesium carbonate neutralize free hydrochloric acid in the stomach, thereby providing an antacid effect.

Magnesium aspartate and magnesium gluconate, together with potassium supplements, normalize heart rhythm.

All magnesium preparations replenish the deficiency of this macroelement in the body when it is insufficient.

Provision of the population with potassium and magnesium

In different countries, the average consumption of potassium is less than 3000 mg/day, and magnesium is 350 mg/day, i.e. lower than recommended by WHO [8]. The average per capita consumption of potassium by the population of the Republic of Sakha (Yakutia) is 2107 mg, and magnesium - 224 mg. In the Sverdlovsk region, insufficient magnesium intake was found in 55% of schoolchildren and 78.8% of industrial workers (with potassium deficiency in 40.4%) [9, 10].

The average potassium intake by adult men in the Stavropol Territory is close to the norm and higher than that of women [11]. Magnesium consumption by persons with cardiovascular diseases (CVD) and obesity in the Moscow region was 326.5 mg, potassium - 3144 mg [12]. Among patients with metabolic syndrome and intestinal dysbiosis, the content of magnesium and potassium in the diet of women is noticeably lower than that of men (304 mg versus 424 mg and 2521 mg versus 3280 mg) [13].

The share of magnesium of aqueous origin in the diets of the population of Primorye is 2.0–7.5%. The use of household water purifiers without a mineralization unit increases the risk of developing magnesium deficiency [14].

Magnesium deficiency occurs in 2.5–15% of cases and is difficult to diagnose because the level in the blood does not reflect the content of intracellular magnesium. The causes of magnesium deficiency are a decrease in its content in food plants, the use of refined and highly processed foods, the presence of chronic diseases, and drug therapy [15].

Hypomagnesemia is diagnosed when the concentration of magnesium in the blood serum is <0.7 mmol/l, with a norm of 0.7–1 mmol/l [16]. In 2117 pregnant women over 18 years of age with clinical manifestations of magnesium deficiency (hypertonicity of the uterus, leg cramps, preeclampsia, neurasthenia), there was a lack of it in the diet in 78.4% of cases, and a reduced level in the blood in 80.9% [17].

Vitamin interactions

To support vitality and prevent a number of diseases, many people prefer to use multivitamin pharmaceuticals. When choosing such drugs, it is important to take into account the compatibility of the vitamins that are present in a particular drug. We can speak of a correct combination if 2 or more components interact with each other, and they enhance each other’s effect and have a positive effect.

With a deficiency of one or more nutrients, as well as with their excess, a person develops serious health problems.

To exclude such conditions, the combination of vitamins must be correct and balanced.

• A and E interact well with each other, but there should be less of the latter, otherwise the absorption of the former is impaired;
• B2 (riboflavin) and B6 (pyridoxine) are ideal with K;
• B12 can be combined with B5;
• P enhances the properties of vitamin C, E, B9 (folic acid);
• F enhances the properties of A, D, E, as well as group B;
• B6 (pyridoxine) and B2;
• B12 (cyanocobalamin) is recommended to be used in combination with B5, B9;
• Vitamin C increases the activity of vitamin E.

With the right combination, there will be a certain result, which will be different from if each component is taken separately.

Potassium and magnesium deficiency as risk factors for diseases

Potassium.

Arterial hypertension (HTN) is a major risk factor for the development of CVD, stroke and kidney damage and affects approximately 1 billion people worldwide. One of the reasons for the hypertension pandemic in Russia is high consumption of table salt and low consumption of potassium. The ratio of sodium and potassium in urine in hypertension exceeds 5.7 [18].

Moderate intake of potassium from food can lead to a decrease in blood pressure (BP) in people with hypertension, especially in the absence of drug therapy, consumption of large amounts of sodium and/or insufficient potassium (<3500 mg/day). Unlike sodium, potassium increases blood flow and promotes vasodilation as a result of hyperpolarization of the membranes of vascular smooth muscle cells after activation of Na+/K+-ATPase and potassium channels. K+ ions are also released by endothelial cells in response to neurohumoral mediators and contribute to the process of endothelium-dependent vascular relaxation [1].

An increase in potassium intake of 1.64 g may reduce the risk of stroke by 21% (p=0.0007) and CVD in general. Increasing plasma potassium concentrations improves ventricular repolarization and reduces the risk of arrhythmia in patients with hypertension taking non-potassium-sparing diuretics, which may impair glucose tolerance and increase the risk of developing type 2 diabetes mellitus (T2DM) by reducing insulin secretion in response to a glucose load [19]. , 20]. The administration of potassium supplements with thiazide diuretics avoids disturbances in insulin secretion in response to a glucose load [21].

Moderate dietary intake of potassium does not cause severe hyperkalemia or worsening renal function in people with normal renal function, even with renin-angiotensin-aldosterone system blockers. Particular caution should be exercised only in patients with severely impaired renal function [22]. Increased potassium intake is recommended for patients without impaired renal potassium metabolism to control high blood pressure and prevent stroke [23, 24].

Magnesium

is an essential cofactor of more than 40 enzymes necessary for carbohydrate metabolism (hexo- and glucokinase, phosphofructomutase, etc.) and more than 30 enzymes for lipid metabolism (medium-chain acyl-CoA synthetase and long-chain fatty acid ligase, lecithin cholesterol acyltransferase, etc.). Against the background of magnesium deficiency, the activity of these enzymes drops sharply, which contributes to an increase in fat mass, the risk of hypertension, obesity, cholelithiasis, etc. Thus, in patients with obesity and hypertension of the 3rd degree, the level of magnesium in the blood is lower than with hypertension of the 1st degree [25] .

The results of a large-scale Russian study revealed the presence of magnesium deficiency in 47.8% (n=2000) of people who applied to medical institutions. Only 6% of adult patients aged 18–50 years (n=1453) of medical organizations in the Central, North-Western, Northern and Siberian Federal Districts of Russia were provided with magnesium. Magnesium deficiency has been associated with hypercoagulability, neurological pathology (partial epilepsy, neuroses, alcohol dependence syndrome) and chronic inflammation (ulcerative colitis, allergies, coronary heart disease) [3].

Magnesium deficiency is associated with low bone mass and osteoporosis, disruption of the structure (dysplasia) of connective tissue due to destabilization of transport RNA, with a decrease in the activity of hyaluronan synthetases and an increase in the activity of metalloproteinases, hyaluronidases and lysine oxidase [2].

With chronic magnesium deficiency, the Mg2+:Ca2+ ratio is disrupted (normally 1:2) [7]. A higher dietary Mg2+:Ca2+ ratio corresponds to a lower incidence of osteoporosis and increased bone mineral density in men and women [2].

Hypomagnesemia is also a risk factor for obstructive pulmonary disease, metabolic syndrome, T2DM, Alzheimer's disease and CVD [26–31]. It has been shown that an increase in magnesium intake for every 100 mg/day is accompanied by a significant reduction in the risk of stroke by 7%, heart failure by 22%, T2DM by 19%, and overall mortality by 10% [32].

The randomized clinical trial PREDIMED (Prevention with the Mediterranean Diet) found an inverse relationship between dietary magnesium intake and the risk of all-cause and cancer-related mortality. Those with high magnesium intake had a 34% lower risk of death due to lower blood pressure, platelet aggregation, arterial calcification and remodeling; as well as anti-inflammatory effects, improving endothelial function. It acts as a natural calcium channel blocker by competing with sodium for binding sites on vascular smooth muscle cells, increasing prostaglandin E levels, binding to potassium, inducing endothelial-dependent vasodilation and lowering blood pressure. Magnesium is also a cofactor for the enzyme delta-6 desaturase, which limits the conversion of linoleic acid to gamma-linolenic acid, promoting the formation of prostaglandin E1. Its hypotensive effect is potentiated by combination with potassium [33].

By regulating the transmembrane transport of sodium and potassium ions and blocking calcium, magnesium can influence the frequency of cardiac arrhythmias. Its deficiency disrupts the functioning of membrane ATPase and the transfer of sodium from the cell and potassium into the cell. The vasodilating, anti-ischemic, antiplatelet, antiarrhythmic and anti-inflammatory properties of magnesium help reduce the risk of CVD and mortality from them [34].

Magnesium can play a preventive role, preventing the development of T2DM, osteoporosis, bronchial asthma, preeclampsia in pregnant women, migraine and CVD, the formation of kidney stones, the development of cataracts, depression, etc. [15, 35, 36].

Causes of potassium-magnesium deficiency

The lack of these two essential microelements can be caused by errors in nutrition (abuse of salty foods), severe forms of diarrhea and vomiting, and kidney pathologies. Potassium-magnesium deficiency is often observed in patients with type 2 diabetes mellitus. A lack of microelements can result from prolonged and/or uncontrolled use of certain medications.

Draw your attention to! This article is not a call for self-medication. It is written and published to improve the reader's knowledge about his own health and understanding of the treatment regimen prescribed by the doctor. If you experience similar symptoms, be sure to seek help from a doctor. Remember: self-medication can harm you.

The need to review potassium and magnesium intake standards

Table 1 presents the recommended intake values ​​(RNI) for potassium and magnesium adopted in different countries, which are periodically reviewed and clarified as scientific data accumulates.

Randomized controlled trials conducted in Europe indicate that potassium intake more than 3500 mg/day has a beneficial effect on blood pressure in adults, and less than 3500 mg/day is associated with a higher risk of stroke and other CVD [37, 38]. ].

Taking into account that a daily potassium intake of less than 3500 mg is associated with an increased risk of stroke due to high blood pressure, the draft standards for physiological requirements for energy and nutrients (2020) for the population of the Russian Federation propose increasing the RDA for potassium from 2500 mg to 3500 mg /day

Due to the fact that magnesium deficiency can cause hypocalcemia and hypokalemia, disrupt the interaction with vitamin D [7] and other substances [38], and also taking into account the experience of the USA and France in the draft norms of physiological requirements for energy and nutrients (2020 .) the RDA for magnesium is expected to increase from 400 mg to 420 mg/day.

Rules for preparing foods with potassium

As you can see, there are many sources of potassium. But it is equally important to know how to properly prepare dishes so that the body retains and absorbs as much potassium as possible.

The main requirement for vegetables and fruits is freshness and absence of damage. There is noticeably less potassium in wilted fruits. It is best to store them in a dry and cool place.

The amount of nutrients in finished food is affected by the cooking temperature, interaction with oxygen, and the acidity level of the dish. Potassium, like most vitamins, is destroyed by strong heat, especially during prolonged cooking. Therefore, you need to cook quickly, trying to reduce the processing temperature as much as possible.

The component does not tolerate cooking or soaking - with this treatment, the mineral quickly passes into water.

After cooking vegetables, most of the potassium is not stored in the pulp, but goes into a decoction, which is usually poured out after cooking. Therefore, plant foods rich in potassium and magnesium are best baked or served raw.

For example, steamed spinach has 17% less potassium than fresh spinach. And when cooked, curly cabbage loses up to 50% of the valuable element it contains.

Food sources of magnesium and potassium

A simple and cost-effective strategy for correcting magnesium and potassium deficiency is to replace insufficient dietary intake [39]. Table 2 shows the amount of potassium and magnesium in foods and dishes, the consumption of which makes a significant contribution to providing the body with these minerals.

The main sources of potassium in the diet are potatoes, legumes, vegetables and fruits. Potassium is well absorbed, especially in the presence of pyridoxine (90–95%).

Sufficient intake of magnesium from food is provided by whole grains, green leafy vegetables, nuts, etc. It is also found in plant chlorophyll, sea and blue-green algae. Approximately 10% of the daily requirement for magnesium is met through drinking water [35]. High levels of magnesium in drinking water are an important factor in reducing the risk of death from coronary heart disease, especially among men. The lower limit of magnesium concentration, which is not associated with a risk of CVD, but predisposes to gastrointestinal pathology, is 22 mg/l [40].

Many natural chelators in food products (for example, phytic acid), forming a complex with magnesium, reduce its absorption. Bran bread contains significant amounts of phytic acid. Its content decreases when baking yeast bread, since during the fermentation process the level of phytates decreases significantly [8].

Magnesium absorption is also reduced when consuming vegetables with a high content of oxalic acid and its salts (spinach) compared to low content (cabbage). The absorption of magnesium and phosphates contained in sausages makes it difficult. Inulin promotes the absorption of magnesium. The digestibility of magnesium from mineral waters with its high content approaches 50%, and the absorption of magnesium from food is slightly less (40–45%) [8].

Signs of excess potassium

Not only a lack of potassium, but also too much potassium is dangerous.

Symptoms resemble microelement deficiency, so it is advisable to get tested

In such cases, the following symptoms occur

:

• increased excitability of the nervous system, irritability, anxiety;
• sweating;
• weakness;
• cardiopsychoneurosis;
• intestinal colic;
• frequent urination.

A healthy person should not worry about a possible overdose. Normally, excess microelement is excreted through the kidneys.

If a person is diagnosed with hyperkalemia, he is sent for examination.

The causes of excess potassium are

:

• renal failure;
• hemolytic anemia;
• malignant tumors;
• dehydration;
• anaphylactic shock;
• hypofunction of the adrenal cortex (Addison's disease).

If potassium levels are elevated, it is recommended to limit potassium-rich foods.

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Additional sources of potassium and magnesium

In the diet of patients with chronic diseases, pregnant women and other groups of the population, specialized food products and biologically active food additives (BAA) containing significant amounts of potassium and magnesium can also be used [12]. Thus, long-term (more than 4 weeks) intake of potassium as part of dietary supplements by 1900 patients with hypertension contributed to a decrease in systolic blood pressure by 4.48 mm Hg. Art., and diastolic - by 2.96 mm Hg. Art. The most pronounced antihypertensive effect was observed with an initially low (<3500 mg/day) level of potassium intake, high sodium intake (≥4 g/day), a high Na/K ratio in the diet, and the absence of antihypertensive therapy [1].

One of the ways to compensate for the deficiency of potassium and magnesium is the preventive use of salt, in which part of the sodium chloride is replaced with potassium and magnesium salts (68% sodium chloride, 27% potassium chloride and 5% magnesium sulfate). This salt is used instead of regular salt for cooking and adding salt to food.

Dried mineralized seaweed Lithothamnium coralloides

and/or
Lithothamnium calcareum
(6.6%) with 30–34% calcium and 2.3–3.3% magnesium, corresponding to 400–600 mg/100 g soluble magnesium.
The edible seaweeds aosa ( Ulva pertusa
), kelp (
Laminaria japonica
) and others contain 400 to 600 mg of magnesium per 100 g. However, its bioavailability from algae is very low (less than 5%) [41].

In practical medicine, salts of inorganic acids (oxide containing 60% magnesium, carbonate - 28.6%, 7-aqueous sulfate - 9.7%, anhydrous sulfate - 20%), organic acids (magnesium citrate with 15 .8% magnesium, lactate - with 11.9%), chelates with amino acids (magnesium aspartate - magnesium complex 4-water contains 6.6% magnesium). When using inorganic magnesium salts, pregnant women often develop side effects: hot flashes, nausea, headache, decreased heart rate associated with incorrect dosage [8]. Therefore, it is preferable to use its chelates or salts with organic acids (magnesium citrate and magnesium lactate) [17]. Water-soluble citrate is one of the safe forms of magnesium, because it takes part in the Krebs cycle.

Along with single preparations containing potassium (potassium chloride, potassium orotate) or magnesium (magnesium lactate dihydrate, magnesium pidolate, magnesium orotate, magnesium sulfate), complex preparations are used that include both macroelements (potassium aspartate + magnesium aspartate: for example, the drug Panangin). Panangin (1 tablet contains potassium aspartate 158 mg and magnesium aspartate 140 mg) has been used for a long time in domestic and world practice, being one of the most studied and effective preparations of potassium and magnesium aspartate. The undoubted advantage of this drug is the combination of potassium and magnesium, which makes it possible to manifest their synergistic effect [42]. This combination is all the more justified since the metabolism of potassium and magnesium is closely related, and clinically significant hypomagnesemia usually develops against the background of hypokalemia. Aspartic acid, which is part of Panangin, is a natural amino acid that promotes the penetration of potassium and magnesium ions into cells, where it is included in metabolism, being part of many proteins, and also plays an important role in the metabolism of nitrogenous substances, transamination reactions and the formation of pyrimidine bases.

Despite the fact that Panangin contains nutritional substances, it is registered as a medicinal product, since its effectiveness has been confirmed in clinical studies. The maximum daily dose of Panangin in the complex treatment of CVD is 9 tablets, which provides an additional supply of 10% potassium and 27% magnesium from their recommended daily intake. For preventive purposes, the drug is used as a source of potassium and magnesium in a smaller dose (1–2 tablets 3 times a day) [42]. The small content of minerals in 1 tablet allows for fractional administration of this drug throughout the day, which increases the absorption of macroelements.

What foods contain potassium?

All products containing potassium (K) are usually classified taking into account the concentration of this useful mineral in them:

• low-potassium (100 mg of component per 100 g of product);
• with an average potassium content (150-200 mg per 100 g);
• with a high potassium content (260-400 mg per 100 g);
• saturated with potassium (more than 400 mg per 100 g).

Plant sources of potassium

Products of plant origin are a real storehouse of useful potassium compounds. Among them there is a wide variety of vegetables, fruits and berries containing this mineral.

For example, potassium in fruits is perfectly absorbed, since the combination of glucose and insulin is very effective, which promotes the transfer of potassium into cells.

Vegetables and fruits contain a lot of potassium and little sodium.

Potassium content in nuts and seeds:

Potassium content in cereals and grain products:

Potassium content in legumes:

Potassium content in fruits, berries, dried fruits:

Potassium content in vegetables and herbs:

Animal products containing potassium

Do not neglect animal products - they also contain potassium reserves.

Potassium content in meat, fish and seafood:

Potassium content in dairy products and egg products:

Among all the listed products, we will highlight the TOP products in terms of potassium content, availability, ease of preparation and absorption by the body. Food products containing potassium in large quantities

1. Potato

   One medium potato contains 900 mg of potassium. By eating just one potato as a side dish for lunch, you can get a little more than 1/5 of your daily potassium requirement. To absorb potassium, give preference to baked potatoes.

   Potatoes also contain vitamin C, vitamin B6, iron, and fiber (especially in the skin). When cooled, potato starch nourishes beneficial intestinal microflora.

2. Sun-dried tomatoes

   Fresh tomatoes also contain potassium. But there is much more of it in dried tomatoes or tomato paste. It is better to prepare these products yourself or choose them in a store with a good composition - without added sugar and preservatives.

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   A cup of these tomatoes contains 1,800 mg of potassium, which is about 40% of the daily recommended amount.

   In addition, tomatoes contain a lot of fiber, vitamin C, vitamin E, improve the digestive and immune system and are good for the heart.

3. Beans

   Red and white beans are equally beneficial for the body. One cup of red beans contains 600 mg, white beans - 1,000 mg. Beans are high in fiber, protein and iron. It can be added to soups and salads.

4. Dried apricots

   The concentration of nutrients contained in fresh apricots increases when dried. Therefore, 100 grams of dried apricot contains 1.162 mg of potassium.

5. Prunes

   In addition to potassium (686 mg in ½ cup), prunes contain vitamins B1, B2, C, magnesium, phosphorus and iron.

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6. Avocado

   One avocado contains approximately 975 mg of potassium, as well as magnesium, phosphorus, iron, zinc, various vitamins and healthy fats, which are so important for heart health and good skin condition.

7. Salmon

   In 100 grams you can find 420 mg of potassium - this is more than in any other fish. In addition, red fish is rich in omega-3 and vitamin D.

8. Spinach

   An excellent side dish for fish and meat dishes, as well as a frequent ingredient in the most delicious smoothies, it contains 774 mg of potassium per 100 grams.

9. Pumpkin

   There are many varieties of pumpkin, and the amount of potassium depends on this. For example, 100 grams of cooked acorn squash contains 437 mg, and winter squash contains 448 mg.

10. Oranges

    In addition to vitamin C and B vitamins, folic acid, oranges also contain potassium. With one glass of juice you will get about 473 mg of potassium.

What vitamins cannot be combined

Good compatibility of vitamins can provide the body’s daily needs. If you take substances that interact poorly with each other, at best there will be no effect from such treatment, and at worst, the risk of developing side effects will increase.

Before you start taking vitamins, you should familiarize yourself with their compatibility with each other.

Poor compatibility can disrupt the absorption of one or more components.

• Vitamin D cannot be combined with A, since they neutralize each other’s effects;
• Vitamin B2 leads to the oxidation of B1;
• Vitamin B1, if combined with B12, can cause an allergic reaction;
• Vitamin D is not absorbed if taken with vitamin E;
• Vitamin B12 eliminates the properties of C and PP;
• Vitamins A and D neutralize each other;
• Vitamins E and D must be taken separately, since the first component is poorly absorbed under the influence of another substance;
• Oxidation of vitamin B1 occurs under the influence of vitamin B2.

Many multivitamins contain substances that interact poorly with each other, but their composition is selected in such a way that it does not have a negative effect on the human body.

Methods

The randomized, double-blind, placebo-controlled study included patients from Israel (February to October 2013). Patients received therapy for 4 weeks (placebo or magnesium oxide once a day in the evening). All individuals included in the analysis were ≥21 years of age and had 4 or more documented episodes of nocturnal leg cramps during the 2 weeks of screening.

The intention-to-treat analysis was conducted from March 2014 to April 2016.

The primary endpoint of the study was the difference in the number of episodes of night cramps per week after therapy. Secondary endpoints included seizure severity and duration, patient quality of life, and sleep quality.