Benefit and risk assessment of increasing potassium intake by replacement of sodium chloride with potassium chloride in industrial food products in Norway

Inger-Lise Steffensen; Wenche Frølich; Knut Helkås Dahl; Per Ole Iversen; Jan Ludvig Lyche; Inger Therese Laugsand Lillegaard; Jan Alexander

doi:10.1016/j.fct.2017.11.044

Benefit and risk assessment of increasing potassium intake by replacement of sodium chloride with potassium chloride in industrial food products in Norway

Food Chem Toxicol. 2018 Jan:111:329-340. doi: 10.1016/j.fct.2017.11.044. Epub 2017 Nov 22.

Authors

Inger-Lise Steffensen¹, Wenche Frølich², Knut Helkås Dahl³, Per Ole Iversen⁴, Jan Ludvig Lyche⁵, Inger Therese Laugsand Lillegaard⁶, Jan Alexander⁷

Affiliations

¹ Department of Toxicology and Risk Assessment, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, NO-0403 Oslo, Norway. Electronic address: inger-lise.steffensen@fhi.no.
² The Norwegian School of Hotel Management, University of Stavanger, P.O. Box 8600 Forus, N-4036 Stavanger, Norway. Electronic address: wenche.frolich@live.no.
³ Biosafe, Grønvoldvegen 675, NO-3830 Ulefoss, Norway. Electronic address: knut.dahl@biosafe.no.
⁴ Department of Nutrition, University of Oslo, P.O. Box 1046 Blindern, NO-0317 Oslo, Norway; Department of Hematology, Oslo University Hospital, P.O. Box 4950 Nydalen, NO-0424 Oslo, Norway. Electronic address: p.o.iversen@medisin.uio.no.
⁵ Department of Food Safety and Infection Biology, Norwegian University of Life Sciences, P.O. Box 8146 Dep, NO-0033 Oslo, Norway. Electronic address: jan.l.lyche@nmbu.no.
⁶ Norwegian Scientific Committee for Food Safety, P.O. Box 4404 Nydalen, NO-0403 Oslo, Norway. Electronic address: inger.therese.lillegaard@vkm.no.
⁷ Domain of Infection Control and Environmental Health, Office of the Director, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, NO-0403 Oslo, Norway. Electronic address: jan.alexander@fhi.no.

PMID: 29175183
DOI: 10.1016/j.fct.2017.11.044

Abstract

High sodium chloride (NaCl) intake is associated with health risks. NaCl may be replaced by potassium chloride (KCl) to decrease sodium intake. However, increased potassium may also have negative health effects. We conducted a benefit and risk assessment of increasing potassium by ratios of 30:70, 50:50, 70:30 (weight % K⁺: weight % Na⁺) in children, adolescents and adults in Norway, using intake data from national food consumption surveys and available literature on potassium health effects. An intake of at least 3.5 g/day of potassium decreases risk of stroke and hypertension, and this level was used in the benefit assessment of the healthy population. Three g/day of potassium added to mean food intake is assumed safe, and these levels were used in the risk assessment. Not all persons reached the protective level of potassium, and increasing numbers exceeded the safe levels, in these scenarios. In addition, elderly above 85 years and infants below one year of age, as well as several patient groups and medication users, are particularly vulnerable to hyperkalemia. In conclusion, the number of Norwegians facing increased risk is far greater than the number likely to benefit from this replacement of sodium with potassium in industrially produced food.

Keywords: Benefit and risk assessment; Intake estimates; Potassium; Sodium; Vulnerable groups.

MeSH terms

Adolescent
Adult
Aged
Child
Food Analysis
Food Handling
Food, Fortified
Humans
Infant
Norway
Potassium Chloride / administration & dosage*
Potassium, Dietary / administration & dosage*
Risk Assessment
Sodium Chloride / administration & dosage*
Sodium Chloride, Dietary

Substances

Potassium, Dietary
Sodium Chloride, Dietary
Sodium Chloride
Potassium Chloride