#247 How to Optimize Your Sodium to Potassium Ratio for Longevity

How to Optimize Your Sodium to Potassium Ratio for Longevity

Could the secret to health and longevity come down to the ratio of how much sodium to potassium you eat each day?  In this article, I will teach you how to optimize your sodium to potassium ratio for health and longevity.

David’s Experience

David recently came to see me as a new patient for atrial fibrillation.  Like most patients, he wanted to know how he developed this condition.

As we discussed his diet, it was quickly apparent what the problem was.  David was living on the Standard American Diet.

For breakfast, it was typically cereal or bacon and eggs.  Lunch was a slice of pizza or a deli sandwich, a bag of chips, and a diet Coke.  For dinner, it was ribs, pasta, or a cheeseburger.  Of course, lunch and dinner were always topped off with a cookie or some other treat.

If he was honest, on a good day he was lucky to eat one or two servings of a vegetable and fruit.  For readers of this blog, a diet like this seems almost unbelievable.  However, this is what most Americans eat each day.

Quickly pulling out my calculator, I estimated that his sodium to potassium ratio was at least 2 to 1.  In other words, he ate two milligrams of sodium for every one milligram of potassium.  If he wanted any chance of naturally treating his atrial fibrillation, he would need to completely reverse this ratio to 1 mg of sodium for every 2 mg of potassium in his diet.

3 Bad Things that Happen from a High Sodium to Potassium Ratio

If your dietary sodium to potassium ratio is high, then you are putting yourself at high risk for a stroke, heart disease, or hypertension.  Indeed, one large study from Japan showed that a high sodium to potassium ratio resulted in up to a 57% increased risk of stroke, 39% more heart disease, and at least twice the risk for high blood pressure.

The Sodium to Potassium Ratio Trumps Sodium or Potassium Intake Alone

The push by the American Heart Association to get Americans to eat less salt may be misplaced.  Indeed, based on a study of 2,974 Americans, the sodium to potassium ratio may better predict your risk of a stroke, heart disease, or hypertension than the actual number of milligrams of sodium or potassium alone that you eat.  Thus, rather than restricting salt, we should instead focus on eating more potassium-rich foods.

Good News for Salt Lovers

As long as you are getting your salt from the salt shaker, rather than processed, prepared, or fast foods, then studies show that you can eat crazy amounts of salt and not put yourself at risk provided the milligrams of potassium you consume is higher than the milligrams of sodium you eat.

What is the Optimal Sodium to Potassium Ratio?

In a perfect world, people would get at least 1 mg of sodium for every 2 mg of potassium they eat.  By eating this way, their sodium to potassium ratio would be 1 to 2.  Considering that the average American consumes 3,300 mg of sodium and 2,600 mg of potassium daily, this ratio of 1 to 0.7 is far below minimally acceptable levels.

Interestingly, studies of our paleolithic ancestors have shown that their sodium to potassium ratio was somewhere in the range of 1 to 16.  One study even showed that among the primitive Yanomamo Indians in South America, who do not eat salt but do eat large amounts of bananas, the sodium to potassium ratio was in the range of 1 to 100.

Best 3 Ways to Lower Your Sodium Intake

Contrary to popular belief, you don’t have to get rid of your salt shaker to reduce your sodium intake.  In fact, I wish that blog readers would use their salt shakers more as that would indicate that they are probably eating more home-cooked meals.

The real enemy when it comes to sodium intake is processed, prepared, or fast foods.  Based on my calculations, at least 80% of sodium comes from these three sources.  Thus, to reduce your sodium, you need to eat more real food at home and less fake foods on the run.

Top 3 Ways to Boost Your Potassium Intake

When it comes to boosting your potassium intake, just remember three foods–Fruits, vegetables, and legumes.  If you can fill your plate with mostly fruits, vegetables, and legumes, then you should have no problem in optimizing your sodium to potassium ratio.

Who is at Risk from Too Much Potassium?

If you have kidney failure, then boosting your potassium intake is the wrong thing to do.  The reason for this is that your kidneys are responsible for optimizing potassium blood levels.  If the kidneys can’t do their job, then you could be at risk.

Likewise, many people with heart failure or high blood pressure may be taking medications that increase potassium levels or potassium supplements.  If you are on any prescription medications, or have any chronic medical conditions, please speak with your doctor first before increasing the potassium-rich foods in your diet.

David’s Experience Revisited

Once David gave up 99% of the processed, prepared, and fast foods he was eating, and started eating real food at home, his body transformed immediately.  Within just three months his weight dropped 30 pounds, his systolic blood pressure came down by 15 points, and his heart palpitations went away.  While eating a real food diet took more preparation and thought on his part, his increased energy levels more than compensated for the additional preparation time.

Practical Tips

As I have repeatedly shared on this blog, you are only as old as your arteries.  If you can keep your arteries, and your heart young, then you will likely live a long life free of medications and other chronic medical problems.

And when it comes to keeping your arteries young, the sodium to potassium ratio is critical.  While you could undoubtedly track every milligram of sodium and potassium you eat, there is a much simpler method.

Namely, eliminate 99% of processed, prepared, and fast foods and instead replace them with fruits, vegetables, and legumes.  This change alone should put your sodium to potassium ratio at the goal target of at least 1 to 2.

What is your sodium to potassium ratio?  I would love to hear from you.  Please leave your thoughts, comments, and questions below.

The comment period will be open for 30 days.  During this period of time, I will answer every question posted.

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Disclaimer Policy: This website is intended to give general information and does not provide medical advice. This website does not create a doctor-patient relationship between you and Dr. John Day. If you have a medical problem, immediately contact your healthcare provider. Information on this website is not intended to diagnose or treat any condition. Dr. John Day is not responsible for any losses, damages or claims that may result from your medical decisions.

  1. My blood results are:
    Sodium 145 mmol/L
    Potassium 4.6 mmol/L

    Can this be used to find a ratio?

    • Hi Joanne,

      Thanks for reading!

      The ratio is not the blood serum level but rather the amount eaten each day in your diet. Two great apps to track this are Healthwatch 360 or Cronometer. Both are free apps and have iPhone/Android versions.

      Hope this helps!


  2. I found this article very interesting. Since my transplant seems like my potassium is always high no matter how careful I am, while magnesium, Iron, Vit D etc always seem to be too low. As mentioned in the post, I know it is different with chronic issues Any suggestions? Much of the time the potassium is running in the high 5’s.

    • Hi Dawna,

      A potassium in the 5’s definitely isn’t optimal. For people with kidney challenges, or who are on prescription medications, it can sometimes be tough to control. In cases like these, you definitely need to work closely with your physicians.


  3. Hello, Dr. Day.

    Good easy to read article on the subject. However, there is one caveat from my experience that your article as well as most of what’s on the internet fails to mention. And, that is if you get rid of all the processed foods, one might have to work at getting enough sodium to avoid hyponatremia and a trip to the hospital. This is especially true for those who spend time outside in summer.

    • Hi Dan,

      You bring up an excellent point. If you have eliminated processed foods, and you are very physically active in the heat, then you will probably have to use the salt shaker.


  4. Dr. Day,
    I appreciate the insight in the article. I am a Type 2 Diabetic who actively works at blood sugar control. I am fairly successful. I do this by minimizing carbohydrate intake. I almost never eat fruit — when I do it is a small amount of whole fresh, never canned or only juice. I limit vegetable to mostly greens, and a few low carbohydrate types.

    On the occasions that I try to eat legumes, even in relatively small quantities (1/2 cup cooked) I get substantial spikes in my BG levels.

    Is a good, high potentancy supplement a reasonable way to increase my potassium intake?

    Thanks for the news letters and podcasts.

    • Hi Von,

      Unfortunately, there is not a good way to supplement with potassium. The potassium supplements that are available are all extremely low dose.

      The reason why supplement makers don’t offer higher doses is because of the potential risk of harm. If potassium levels get too high or too low it could cause a cardiac arrest.

      Thus, to boost potassium your potassium food intake in your case with blood sugar challenges vegetables will be the best way to go.

      Hope this helps!


  5. Thank you for your focus on diet. Usually doctors tell patients to be sure to take their prescriptions. Doctors are aware that their patients will not follow dietary advice. Humans diet choices are driven by fast food advertising.