Ask the doctor: Should I get more potassium from a salt substitute?
Q. You've emphasized that people generally eat too much sodium and not enough potassium. Could I solve both problems at once by replacing my regular table salt with a substitute containing potassium?
A. Many Americans do eat too much sodium and not enough potassium. Your condiment approach to the sodium/potassium balancing act might help, but most people's excessive sodium intake comes largely from processed and packaged foods. So a far better strategy would be to replace salt-saturated prepared foods with fresh fruits and vegetables, almost all of which are high in potassium and low in sodium, and which offer other health benefits as well.
This food-based approach is not only more satisfying, but also probably safer than trying to artificially supplement your potassium intake. Healthy people needn't worry about excessive potassium, because they simply excrete what their bodies don't use. But people with kidney disease and those with heart disease who take a potassium-sparing diuretic like spironolactone or an ACE inhibitor like lisinopril don't rid their bodies of potassium as easily. For them, too much potassium in the bloodstream can literally have heart-stopping consequences.