Rising Trend of Hypokalemia Prevalence in the US Population and Possible Food Causes

J Am Coll Nutr. 2021 Mar-Apr;40(3):273-279. doi: 10.1080/07315724.2020.1765893. Epub 2020 May 13.


Background: Potassium intake deficiency is a chronic issue in the US and many other countries. Possible causes of the deficiency are understudied.Objective: This study examined potassium deficiency in the US population and possible causes for the new trend.Methods: Serum potassium data of 28,379 men and 29,617 women between ages 12 and 80 years old who participated in the US National Health and Nutrition Examination Survey (NHANES) between 1999 and 2016 were examined. Blood samples were collected by NHANES and blood biochemistry data were measured in designed laboratories. The data were released bi-annually. Possible causes of low potassium intakes were explored.Results: There was an apparent decline of serum potassium in the US population between ages 12 and 80 years from 1999 to 2016. Annual average serum potassium concentrations changed from 4.14 ± 0.01 to 3.97 ± 0.01 mmol/l during this period. Hypokalemia prevalence in the US rose from 3.78%±0.68% to 11.06%±1.08% during this period with a higher hypokalemia prevalence in non-Hispanic black than in non-Hispanic white persons. It is possible that declining potassium concentration in food sources in the US contributed to lower potassium intake and increasing potassium deficiency.Conclusion: The rising trend of hypokalemia prevalence in the US population between 1999 and 2016 is alarming. Renewed efforts to reduce potassium intake deficiency in the US at population level are needed. The impact of possible decreasing crop available potassium levels and increasing consumption of processed food on the potassium deficit trend in the US are possible explanations for the rise in hypokalemia prevalence and require further study.

Keywords: Serum potassium; crop available potassium; hypokalemia; potassium deficit.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Female
  • Food
  • Humans
  • Hypokalemia* / epidemiology
  • Hypokalemia* / etiology
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Potassium
  • Prevalence
  • Young Adult


  • Potassium