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without authorization.
New studies1 have shown that simultaneous intake of a potassium-rich diet and new potassium-rich food supplements can significantly reduce joint pain in
as an adjunct to RA.
The WHO Guidelines for Potassium Intake in Adults and Children2 recommend that adults should consume more potassium from food in order to reduce
for adults.
The Recommended Dietary Reference Intakes of Chinese Residents3 is 2000mg/d
for adults.
Most foods contain potassium, but legumes, vegetables and fruits are the best sources of potassium, and potassium-rich foods include soybeans, mushrooms, bamboo shoots, seaweed, etc
.
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that suffers from poor
quality of life.
Potassium is an essential trace element whose role in RA remains unclear
.
A recent food survey on RA reported lower potassium intake in patients with RA
.
To explore the effects of oral potassium supplementation in the adjuvant therapy of RA, Indian researchers conducted a randomized controlled trial, which was recently published in the journal medRxiv.
。
Study design
This review was a randomized, single-blind (evaluator), validly controlled, parallel-efficacy, 16-week trial involving 172 adult patients with RA (according to the 1987 ACR diagnostic criteria) with a disease duration of ≥ 6 months, divided into 3 treatment groups
.
Group A (n=57) consumed a potassium-rich diet, group B (n=57) consumed a potassium-rich diet and potassium-rich food supplements, and group C (n=58) was the control group, and the patients consumed daily diet
.
Participants continued to receive RA medication
during the study.
Choose from 4 types of foods (vegetables, fruits, legumes and cereals) with no fasting and no intake of any other kind of food, 3 times
a day.
Guided by India's Recommended Daily Intake (RDA), a potassium-rich diet provides at least 3500mg/d of potassium
.
Potassium-rich food supplements provide 1700-2000mg/d of potassium
.
In terms of efficacy, the primary endpoint was the Pain Visual Analogue Score (VAS).
Secondary endpoints were 66/68 joint swelling and pain/tenderness, revised Stanford Health Assessment Questionnaire (HAQ), ESR, etc
.
Assess security
.
Urine potassium and serum cortisol
are measured.
Efficacy and safety were assessed every 4 weeks, with a follow-up of 16 weeks
.
Analyze data
using chi-square tests, for example.
Research results
At baseline, the average daily potassium intake of patients in all groups was less than 2750 mg
.
The results of 16 weeks showed that the daily potassium intake of patients in group A and B increased, among which the daily potassium intake of group B increased by more than 3 times compared with baseline (5708.
5mg vs.
1863.
7mg), and all patients reached potassium RDA values
.
Potassium intake was ≥ 5000mg/day
for 46% of patients in group A, 84% in group B, and 30% in group C.
efficacy
The 16-week results showed a reduction in pain symptoms in all groups (Figure 1), and the mean change in pain VAS was significantly different from baseline (p=0.
039).
Among them, the mean change in pain VAS in group B (-2.
33, 95% confidence interval [CI] -2.
99, -1.
48) was significantly better than group A (-1.
31, 95% CI -2.
19, -0.
43, p=0.
02) and group C (-1.
25, 95% CI -2.
03, -0.
46, p=0.
04).
Fig.
1 Changes in average pain VAS in each group
The number of joint pain, HAQ score, general health and ESR of 68 patients in each group were improved, and the improvement of group B patients was more obvious
than that of group A and group C.
Safety and tolerability
Group A reported 14 AE cases, Group B reported 16 cases, and Group C reported 11 cases
.
AEs are mostly mild, mainly manifested as symptoms related to abdominal discomfort, and no severe AEs
occur.
Laboratory tests (
.
None of the
.
In addition, laboratory test results showed that there was no significant difference in urine potassium levels among the patients, and serum cortisol levels increased, with the most significant
increase in group B.
There was a significant but modest negative correlation between potassium intake and VAS (r=-0.
19).
Univariate analysis showed that potassium intake ≥ 5000 mg/day (odds ratio [OR] 3.
14) was significantly associated
with a low pain VAS score (≤4 cm).
Research conclusions and discussions
The results of this study showed that during the 16-week trial period, potassium-rich diet and new potassium-rich food supplements (group B) significantly reduced joint pain in patients with RA compared with intake of potassium-rich diet (group A) or daily diet (group C), and pain VAS scores were significantly different between groups (p=0.
039).
Group B had more significant
improvements in the number of pains, HAQ scores, general health, and ESR in 68 joints compared with Group A and Group C.
There was no significant difference in AE between groups (p=0.
67).
The results suggest that oral potassium supplementation is safe and effective
as an adjuvant therapy for patients with RA.
Potassium is beneficial
for bone health, cardiovascular function, and blood pressure control.
Diet is the preferred source of potassium supplementation, and the Dietary Reference Intakes for Chinese Residents3 recommends a potassium intake of 2000mg/d for adults, and the WHO Guidelines for Potassium Intake in Adults and Children2 conditionally recommend a potassium intake of at least 3510mg/d
for adults.
Due to safety concerns, the potassium content of food supplements is limited, and CAC/GL 55-2005 Codex Alimentarius Guidelines for Vitamins and Minerals for
of the FAO/WHO recommended daily intake for each vitamin and/or mineral.
When determining the maximum intake, in addition to safety factors, the intake of vitamins and minerals obtained from other diets, the reference intake
of the population should be properly considered.
The authors believe that further research is needed to revise current recommendations/guidelines
for potassium intake.
Studies have confirmed that the efficacy and safety of potassium are related
to the non-chloride form of potassium in vegetables and fruits.
Most foods contain potassium, but legumes, vegetables, and fruits are the best sources of potassium5
.
According to the "Chinese Encyclopedia of Nutritional Science", every 100g of cereals contains about 100-200mg of potassium, 600-800mg of beans, 200-500mg of vegetables and fruits, about 150-300mg of meat, and 200-300mg
of fish.
Foods with potassium content higher than 800mg per 100g of food include soybeans, broad beans, red beans, peas, mushrooms, bamboo shoots, seaweed, etc
.
Table 1 shows the potassium content in common foods6
.
Table 1 Potassium content in common foods (mg/100g)
The mechanism of potassium in reducing pain is unclear, and researchers speculate that increased potassium intake can cause an increase in endogenous steroids, thereby reducing pain and inflammation, and it has been reported that modulating potassium channels can control pain and immune-mediated inflammation and needs to be further studied
.
References:
1.
Toktam Kianifard, Manjit Saluja, Sanjeev Sarmukaddam.
Adjunct Therapeutic Role of Potassium in Rheumatoid
medRxiv.
2022.
06.
24.
22276843; doi:https://doi.
org/10.
1101/2022.
06.
24.
22276843
2.
WHO Potassium Intake for Adults and Children
3.
Cheng Yiyong.
Introduction to the 2013 revised edition of Dietary Reference Intakes for Chinese residents[J].
Acta Nutica Sinica, 2014, 36(04): 313-317.
DOI:10.
13325/j.
cnki.
acta.
nutr.
sin.
2014.
04.
002
4.
CAC/GL 55-2005 Codex Alimentarius Guidelines for Food Supplements with Vitamins and Minerals
5.
Ge Keyou.
Chinese Encyclopedia of Nutritional Science[M].
People's Medical Publishing House, 2004: 121
6.
YANG Yuexin, GE Keyou.
Chinese Encyclopedia of Nutrition Science(2nd Edition)[M].
People's Medical Publishing House, 2020: 354
