A diet high in salt and low in potassium may increase the risk of cognitive decline

A diet high in salt and low in potassium may increase the risk of cognitive decline

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Cognitive decline refers to the gradual decline in cognitive abilities such as memory, attention and problem solving. This is a natural part of aging, but it can also be caused by various medical conditions, such as Alzheimer’s disease and other forms of dementia. It can also be caused by certain lifestyle choices, such as poor diet, lack of physical activity and social isolation.

Dementia is a debilitating condition that affects a person’s ability to remember, think and make decisions, making it difficult for them to carry out everyday activities. It has become one of the leading causes of death and disability among the elderly worldwide. In China, which has both the largest elderly population and one of the fastest aging populations, dementia poses significant economic, health and social challenges.

Because dementia is irreversible and effective treatments are limited, prevention and early detection of cognitive decline is critical. Studies show that certain lifestyle factors such as physical activity, diet and sleep can affect cognitive function. However, the impact of dietary sodium and potassium on cognitive function remains poorly understood.

In a prospective study published in the journal KeAi Global transitions, a group of researchers from China looked at the effects of dietary sodium, potassium, sodium-to-potassium ratio, and salt on cognitive function in a group of elderly people in China. Participants numbered 4,213 and were at least 50 years old at baseline. Results are based on cognitive tests and participant self-report.

Salt, Potassium and Memory Chart

Association of mean sodium, potassium, sodium/potassium and salt intake and self-reported memory. Model 1 adjusted for age, sex, place of residence, region of residence, educational level, work status, marital status, physical activity levels, and smoking and drinking habits. Model 2 adjusted for energy, carbohydrate, protein, and fat intake (additionally adjusted potassium intake for the sodium model and sodium intake for the potassium model) based on Model 1. Model 3 adjusted for BMI, sleep time, cardiovascular and cerebrovascular disease and cognitive test scores at baseline based on Model 2. Abbreviations: Q1–Q4, quartile 1–quartile 4; OR, odds ratios; CI, confidence interval; and BMI, body mass index. Orange squares indicate significant association (P < 0.05). Credit: Xiaona Na

The research team found that high sodium intake (> 5593.2 mg/day) and high sodium-to-potassium ratio (> 3.8/day) increased the risk of memory impairment in the elderly. Conversely, higher levels of potassium intake (> 1653.3 mg/day) were associated with a higher cognitive score; mean cognitive test score (13.44 at baseline, total score was 27.00) increased by ∼1 point when 1000 mg/day of sodium was replaced by an equal intake of potassium.

In addition, the researchers build on previous studies by demonstrating that the effects of dietary sodium, sodium-to-potassium ratio, and potassium on cognitive function have the potential to be mediated by cardiovascular and cerebrovascular disease (CCVD), while the relationship between salt and cognitive function may be mediated by sleep.

Although China has been trying to limit salt and sodium in people’s diets for more than a decade, population intake remains alarmingly high, surpassing many other countries and the World Health Organization’s recommendation of a maximum of 1,400 mg/day of sodium for people aged 50-79 years and 5 g/day of salt. This high salt intake was generally accompanied by insufficient potassium consumption (1499.0 mg/day in this study versus China’s recommended level of 3600 mg/day).

The study results also confirm previous findings that the ratio of sodium to potassium in food may provide a better measure of how these elements affect cognitive function than looking at individual values ​​of sodium or potassium.

The corresponding author, Ai Zhao, adds: “Based on our findings, it is reasonable to assume that reducing sodium intake and appropriately increasing potassium intake is beneficial for cognitive function. Considering our results and the nutritional situation of the Chinese people, it will be important for future studies to focus on determining the optimal ratio of sodium to potassium in the diet in the elderly. In addition, developing strategies to improve the ratio of sodium to potassium in Chinese diets should be a priority.

Reference: “Association of Dietary Sodium, Potassium, Sodium/Potassium, and Salt with Objective and Subjective Cognitive Function among Chinese Elderly: A Prospective Cohort Study” by Xiaona Na, Menglu Xi, Yiguo Zhou, Jiaqi Yang, Jian Zhang, Yuandi Xi, Yucheng Yang, Haibing Yang and Ai Zhao, 3 November 2022, Global transitions.
DOI: 10.1016/j.glt.2022.10.002

The study was funded by the Sanming Project of Medicine.

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