โพแทสเซียมในอาหาร คุณประโยชน์และข้อควรระวัง

A type of mineral essential to the body, playing an important role in normal body functions as follows:
<ul>
<li>Helps control the nervous system and muscles, especially the heart muscle</li>
<li>Regulates electrolyte balance and acid-base balance</li>
<li>In chronic kidney disease patients, the efficiency of potassium excretion decreases, leading to potassium accumulation in the blood</li>
</ul>
<h2>Criteria for Classifying Potassium Levels</h2>
<table>
<tbody>
<tr>
<td width="205">
Blood Potassium Level
</td>
<td width="205">
Meaning
</td>
<td width="205">
Symptoms
</td>
</tr>
<tr>
<td width="205">&lt;3.5 *mEq/L</td>
<td width="205">Low blood potassium level (Hypokalemia)</td>
<td width="205">Muscle weakness, cramps, arrhythmia</td>
</tr>
<tr>
<td width="205">&gt;5.0 *mEq/L</td>
<td width="205">High blood potassium level (Hyperkalemia)</td>
<td width="205">Muscle weakness, cardiac arrest</td>
</tr>
</tbody>
</table>
<h2>To Prevent the Condition</h2>
<ul>
<li>Potassium intake from food should be limited to 2,000 milligrams/day</li>
<li>Maintain blood potassium levels within the range of 3.5 – 5.0 mEq/L</li>
</ul>
<h2>How Can We Control Blood Potassium Levels?</h2>
<ul>
<li>Control</li>
<li>Diuretics</li>
<li>Dialysis</li>
</ul>
<h2>Potassium in Food is Divided into 2 Types</h2>
<table>
<tbody>
<tr>
<td width="308">
Source
</td>
<td width="308">
Synthetic Compounds from Added Potassium Compounds
</td>
</tr>
<tr>
<td width="308">Vegetables</td>
<td width="308">Potassium chloride, low sodium seasonings</td>
</tr>
<tr>
<td width="308">Fruits</td>
<td width="308">Potassium carbonate, instant noodles</td>
</tr>
<tr>
<td width="308">Milk</td>
<td width="308">Potassium phosphate, powdered milk, powdered cream, ice cream</td>
</tr>
<tr>
<td width="308">Grains</td>
<td width="308">Potassium bitartrate, baking powder in baked goods</td>
</tr>
</tbody>
</table>
&nbsp;
<h2>Vegetable Category</h2>
One serving of vegetables equals 1 tablespoon of cooked vegetables or 2 tablespoons of raw vegetables (100 grams)
<table>
<tbody>
<tr>
<td width="308">
Vegetables with low to moderate potassium content
(100-200 milligrams per serving)
</td>
<td width="308">
Vegetables with high potassium content
(250-350 milligrams per serving)
</td>
</tr>
<tr>
<td width="308">Cucumber
Thai cucumber
Winter melon
Chayote
Loofah
Bitter melon
Eggplant
Raw papaya
Green beans
Onion
Cabbage
Iceberg lettuce
Leaf lettuce
Bell pepper
Sweet pepper</td>
<td width="308">Mushrooms
Asparagus
Broccoli
Cauliflower
Carrot
Brussels sprouts
Spinach
Water spinach
Napa cabbage
Kale
Chinese kale
Chayote shoots
Acacia leaves
Celery leaves
Sweet potato
Potato
Pumpkin
Avocado
Carrot juice
Tomato juice
Roselle
Banana flower
Bamboo shoots</td>
</tr>
</tbody>
</table>
 
<h2>Fruit Category</h2>
One serving of fruit depends on the type and size of the fruit (weight of the edible portion only)
<table>
<tbody>
<tr>
<td width="308">
Fruits with low to moderate potassium content
(100-200 milligrams per serving)
</td>
<td width="308">
Fruits with high potassium content
(250-350 milligrams per serving)
</td>
</tr>
<tr>
<td width="308">1 apple
5 pineapple chunks
8 longkong fruits
2 pomelo segments
4 rambutan fruits
2 rose apples
6 small jujubes
4 small mangosteens
15 small green grapes</td>
<td width="308">1 banana (Namwa)
1 small kiwi
8 cantaloupe pieces
5 ripe papaya chunks
1 tangerine
10 watermelon chunks
12 ripe/unripe mango pieces
5-6 dragon fruit pieces
1 small guava
12 glasses of vegetable and fruit juice
1/2 banana (cavendish)
1 medium dried banana piece
2 small jackfruit segments
1 small durian segment
1 medium sugar apple
1/2 santol fruit
5 longan fruits
1 medium persimmon
3 prunes
2 tablespoons raisins
1 starfruit
6 small Marian plums
2 sweet tamarind pods
1/8 honeydew melon
6 strawberries
20 grams dates</td>
</tr>
</tbody>
</table>
<h2>Food Category</h2>
Table showing potassium content per 100 grams of edible food
<table>
<tbody>
<tr>
<td width="205">Food Category</td>
<td width="205">Low to Moderate Potassium
(100 – 200 milligrams)</td>
<td width="205">High Potassium
(250-350 milligrams)</td>
</tr>
<tr>
<td width="205">Rice and Rice-based Products
from starch</td>
<td width="205">Rice noodles
White rice
Garlic bread
Steamed sticky rice
Wide rice noodles
Egg noodles</td>
<td width="205">Biscuits
Brown rice
Whole wheat bread</td>
</tr>
<tr>
<td width="205">Meat</td>
<td width="205">Oysters
Egg tofu
Mussels
Firm yellow tofu
Squid
Blood cockles
Chicken egg (yolk)
Chicken egg (white)
Red snapper
Chicken liver
Duck egg (whole)
Chicken breast</td>
<td width="205">Salted fish
Beef
Beef liver, pork liver
Pork leg, minced pork
White snapper
Pork sausage
Pomfret fish
Spanish mackerel
Fish roe
Snakehead fish
Short mackerel
Salmon
Ham</td>
</tr>
<tr>
<td width="205">Milk</td>
<td width="205">Ready-to-drink fermented milk
Yogurt
Skimmed milk</td>
<td width="205">Powdered milk</td>
</tr>
<tr>
<td width="205">Beans and Grains</td>
<td width="205"></td>
<td width="205">Macadamia, edamame
Ginkgo, almonds
Peanuts, pumpkin seeds, red beans
White beans, black beans, dried green beans
Cashew nuts, chestnuts</td>
</tr>
</tbody>
</table>
&nbsp;
<h2>Vegetables and Fruits to Avoid</h2>
<ul>
<li>High potassium fruits often have very sweet or very sour taste, dense and soft texture, or bright colors</li>
<li>Dried fruits, canned/processed fruits, and fruit juices have high potassium concentration</li>
<li>Vegetables with bright colors and tuber plants are fertilized with potassium to enhance color and fruiting, thus have high potassium</li>
</ul>
<h2>Warning!! Low Sodium Seasonings</h2>
<h2>Same Saltiness, Added “Potassium”</h2>
<table>
<tbody>
<tr>
<td width="205">
Low Sodium Seasoning
</td>
<td colspan="2" width="411">
Potassium/1 Tablespoon
</td>
</tr>
<tr>
<td width="205">40% Reduced Sodium Fish Sauce</td>
<td width="205">Milligrams</td>
<td width="205">Milliequivalents</td>
</tr>
<tr>
<td width="205">40% Reduced Sodium Soy Sauce</td>
<td width="205">875</td>
<td width="205">22.4</td>
</tr>
<tr>
<td width="205">40% Reduced Sodium Chicken Dipping Sauce</td>
<td width="205">700</td>
<td width="205">18</td>
</tr>
<tr>
<td width="205">40% Reduced Sodium Chili Sauce</td>
<td width="205">350</td>
<td width="205">9</td>
</tr>
<tr>
<td width="205">40% Reduced Sodium Ketchup</td>
<td width="205">210</td>
<td width="205">5.4<strong style="background-color: rgb(255 255 255 / var(--tw-bg-opacity)); color: var(--tw-prose-body); font-family: ui-sans-serif, system-ui, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, 'Helvetica Neue', Arial, 'Noto Sans', sans-serif, 'Apple Color Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol', 'Noto Color Emoji'; font-size: 1rem;"> </td>
</tr>
</tbody>
</table>
<h2>Avoid/Limit Use in Certain Stages of Kidney Disease Patients Who Cannot Excrete Potassium or Heart Disease Patients</h2>
<h2>Techniques to Reduce “Potassium”</h2>
<ol>
<li>Choose low to moderate potassium vegetables, totaling 3 tablespoons per day</li>
<li>Choose low to moderate potassium fruits, totaling 1-2 servings per day</li>
<li>Cut vegetables into small pieces and boil in water to reduce potassium content, as potassium is water-soluble; however, this method also causes loss of some vitamins due to water and heat. Frying does not reduce potassium.</li>
<li>Consuming large amounts of low to moderate potassium vegetables and fruits can still result in high potassium intake</li>
<li>High potassium vegetables can be used in very small amounts in some cases, e.g., sliced ginger as a garnish on rice porridge, garlic in stir-fried vegetables</li>
<li>Avoid vegetable and fruit juices, dried fruits, canned/processed fruits</li>
<li>Avoid using low sodium seasonings</li>
</ol>
** In some cases, doctors/dietitians may consider restricting vegetables and fruits if blood potassium levels exceed the limit
&nbsp;
<h2>References</h2>
<ol>
<li>Nutrition Division, Department of Health, Ministry of Public Health. Table of Thai Food Nutritional Values per 100 grams of Edible Portion. Bangkok.</li>
<li>Yaninee Jerdrungsee. Guide to Phosphorus Content in Food. Dietitians Association of Thailand.</li>
<li>Rin Charoensiri, Ratchanee Kongkachuychai. Nutrition and Vegetables. Bangkok: Sarakadee, 2011.</li>
<li>Thai Nephrology Association, Recommendations for Care of Chronic Kidney Disease Patients Before Renal Replacement Therapy, B.E.</li>
<li>Thai Kidney Association, National Health Security Office. Public Guide: How to Prevent Kidney Failure?. Bangkok.</li>
<li>Potassium and Your CKD Diet. National Kidney Foundation. Available https://www.kidney.org/atoz/content/potassium (Accessed 10 October 2019).</li>
</ol>
&nbsp;
Contact and Consultation
Nutrition Therapy Unit, Nutrition Department, Phyathai Hospital 2
Phone 0-2617-2444 ext. 3130 ( 08.00-18.00 hrs.)
&nbsp;
Dialysis Center, Phyathai Hospital 2, 14th Floor, Building A, Tel. 02-617-2444 ext. 1683, 1684
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<div dir="ltr" style="text-align: right;">Reference</div>
<div dir="ltr" style="text-align: right;">
Guide for Chronic Kidney Disease Patients
<div>Undergoing Hemodialysis</div>
</div>
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<div dir="ltr" style="text-align: right;">
<div>Prepared by</div>
</div>
<div dir="ltr" style="text-align: right;">Department of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Nephrology Unit, Department of Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society</div>
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It is a type of mineral essential to the body, playing an important role in allowing the body to function normally.

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