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Why and how to implement sodium, potassium, calcium, and magnesium changes in food items and diets?


The present average sodium intakes, approximately 3000–4500 mg/day in various industrialised populations, are very high, that is, 2–3-fold in comparison with the current Dietary Reference Intake (DRI) of 1500 mg. The sodium intakes markedly exceed even the level of 2500 mg, which has been recently given as the maximum level of daily intake that is likely to pose no risk of adverse effects on blood pressure or otherwise. By contrast, the present average potassium, calcium, and magnesium intakes are remarkably lower than the recommended intake levels (DRI). In USA, for example, the average intake of these mineral nutrients is only 35–50% of the recommended intakes. There is convincing evidence, which indicates that this imbalance, that is, the high intake of sodium on one hand and the low intakes of potassium, calcium, and magnesium on the other hand, produce and maintain elevated blood pressure in a big proportion of the population. Decreased intakes of sodium alone, and increased intakes of potassium, calcium, and magnesium each alone decrease elevated blood pressure. A combination of all these factors, that is, decrease of sodium, and increase of potassium, calcium, and magnesium intakes, which are characteristic of the so-called Dietary Approaches to Stop Hypertension diets, has an excellent blood pressure lowering effect. For the prevention and basic treatment of elevated blood pressure, various methods to decrease the intake of sodium and to increase the intakes of potassium, calcium, and magnesium should be comprehensively applied in the communities. The so-called ‘functional food/nutraceutical/food-ceutical’ approach, which corrects the mineral nutrient composition of extensively used processed foods, is likely to be particularly effective in producing immediate beneficial effects. The European Union and various governments should promote the availability and use of such healthier food compositions by tax reductions and other policies, which make the healthier choices cheaper than the conventional ones. They should also introduce and promote the use of tempting nutrition and health claims on the packages of healthier food choices, which have an increased content of potassium, calcium, and/or magnesium and a lowered content of sodium. Such pricing and claim methods would help the consumers to choose healthier food alternatives, and make composition improvements tempting also for the food industry.

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This work was commissioned by the Factors Affecting Hypertension Task Force of the European branch of the International Life Sciences Institute (ILSI Europe). At the time of the workshop, industry members of this task force were Frito Lay, Kellog, RHM Technology, Unilever and Valio. Further information about ILSI Europe can be obtained through or tel. +32 (0) 2 771 0014.

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Karppanen, H., Karppanen, P. & Mervaala, E. Why and how to implement sodium, potassium, calcium, and magnesium changes in food items and diets?. J Hum Hypertens 19 (Suppl 3), S10–S19 (2005).

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