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Potassium for muscle cramps? Not necessarily

Mar 08, 2010, 10:01 am.

Q. I am on high blood pressure meds and have noticed a lot of cramping in my legs. How much potassium in mgs should I be taking a day?

A. The Institute of Medicine established 4.7 grams (4700 mg) of potassium as the adequate intake (AI) for most healthy people. The average American gets between 2300 mg (women) and 3100 mg (men) from their diet. However, I wouldn't recommend that you start taking potassium supplements.

First of all, the general recommendation may or may not be appropriate for you. Some high blood pressure meds can increase potassium requirements, others can cause high potassium levels.

Secondly, I wouldn't assume that the cramps are caused by a lack of potassium. Imbalances in potassium, sodium, and/or magnesium can all lead to muscle cramps and any of these is a distinct possibility when someone is taking high blood pressure medications.

I strongly recommend that you report the muscle cramping to your physician (who knows what drugs you're taking) and ask for guidance. He or she can test your electrolyte levels to see what's really going on. The solution to the cramping might involve a change in medication, diet or lifestyle changes, or nutritional supplements. But this is not a time to do-it-yourself.

Will you keep us posted?

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How safe is imported fish?

Mar 05, 2010, 1:06 pm.

Q. Is imported frozen fish from countries like India and Vietnam safe? I
avoid buying any food imported from China but I bought frozen Swai Basa Fish (farmed) from Vietnam and frozen Squid
(caught wild) from India. They tasted really good and they were cheap,
but I’m wondering if we can trust those imports or they may be full of
some toxic stuff.

A. Theoretically, the safety of fish being sold in U.S. markets is monitored by federal agencies such as the FDA, whose job it is to be sure that the fish sold for human consumption in the U.S is “”safe, wholesome, and not misbranded or deceptively packaged.” (Institute of Medicine on Seafood Safety)

But as we’ve seen lately, the ability of the FDA to effectively police the food supply and enforce its regulations is in serious doubt. Just a few years ago, for example, there was a scandal in which salmon being sold for a premium as “wild-caught” in both wholesale and retail markets turned out to be cheap farmed salmon. ( Story from New York Times)

To make things even more challenging, fishing and farming practices are changing rapidly around the globe as demand for seafood increases. New restrictions and best practices are being implemented. But loopholes and work-arounds are also constantly being discovered and exploited. It’s a moving target!

The best resource I’ve found to keep up with these issues is Seafood Watch. These guys are working hard to stay on top of all of these issues and to provide up-to-date resources for consumers trying to make safe and responsible choices. They have a number of tools for consumers, including a mobile app for your smart phone or a low-tech wallet card, as well as in-depth reports.

I scanned Seafood Watch’s reports on both the fish you mentioned. In terms of toxins or contaminants, I didn’t see too much to worry about with the wild-caught squid, but these comments on farmed swai basa got my attention:

“Commercial aquaculture for finfish in Viet Nam continues to use relatively low technology and many operations continue to use homemade feeds…[with] little or no management of aquaculture operations…”

The safety of these fish as food obviously depends primarily on the water they’re raised in and the food they are fed. They might be perfectly fine, but it doesn’t look as if anyone is paying too much attention.

From a sustainability perspective, which is more about the long-term health of the oceans than the safety of the food, both wild-caught squid and farmed swai basa are considered “good alternatives” but not “best choices.”

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Why can’t I search for foods low in choline?

Mar 04, 2010, 11:03 am.

Q, I need to find foods that are low in choline but in the Nutrient Search tool, I can only search for foods highest in choline. Is there any way to do this?

A. The reason you're running into this is that choline hasn't been measured in all foods. The USDA has focused on evaluating foods that are thought to be significant sources of choline. So, to present a list of foods that are "lowest in choline" would be a little misleading. Only the foods that have been measured for choline can be included in the results and these foods will probably be higher in choline than
many other foods that haven't been measured. Make sense?

The USDA has published an extensive report on choline which you can access here. In that report, they have the following helpful table, which gives you an idea where most of the choline in your diet is found. As you can see, eggs (specifically, the yolks) are by far the most significant source of choline. Hope that helps!

Choline

Balancing a high sodium diet

Mar 02, 2010, 10:13 am.

Q. I’m a college student and while I definitely focus on maintaining a balanced diet I am concerned about my sodium intake. With the amount of processed foods in the school cafeteria, it’s almost impossible to maintain a low sodium diet. I’m healthy and active with a normal blood pressure and I’ve always considered sodium the least worrisome of the food evils (though high blood pressure does run in my family). My personal assumption has always been that as long as I increase my water intake along with sodium, everything will “balance out” in the body. Is there any truth to this? If so, how much water is necessary to offset 2400 mg sodium over the recommended daily value?

A. First, I congratulate you for making nutrition a priority! Secondly, I sympathize with your challenge of limiting sodium when faced with typical cafeteria food. Thirdly, I agree that because you are healthy, active, and have normal blood pressure, you may not need to worry too much about some extra sodium in your diet.

As for “balancing” the sodium intake, drinking more water will help mitigate excess water retention due to the high sodium diet. (Ironic, but true.) How much water it takes depends on all kinds of variables: your activity level, temperature and humidity of your environment, and so on. As a general rule, if you are urinating several times a day and your urine is pale in color, you are adequately hydrated. Keep in mind, however, that certain drugs and vitamin supplements can color the urine.

Many people also believe that increasing potassium is a good idea when sodium intake is high. See this post for more on that.

Finally, a couple of suggestions on how to keep your sodium intake sane, despite the challenges you describe.

1. Salad bar! Most cafeterias offer a salad bar and here, at least, the vegetables are not likely to be drenched in salt. As a bonus, vegetables are a great source of potassium and water! Watch out for salty add-ons like bacon, sunflower seeds, olives, three-bean salad, and mixed dressings. Most salad bars include cruets of oil and vinegar…use those for your dressing.

2. Say no to avoidable salt. You may have to live with a certain amount of sodium in the prepared foods in the cafeteria. But you can opt out of salty but nutritionally empty foods like chips and French fries, right?

3. Campaign for change! Talk to the cafeteria manager (or your student life rep or the school newspaper editor…) and ask if the food service can pay more attention to offering lower sodium options. With the huge public debate going on right now over reducing sodium intake, they should be a little more tuned in to your concern.

Hang in there! You’ll soon have more control over your food choices and it sounds as if you are motivated to make good ones.

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