Terra Sigillata

Florida Track Club.jpgWho knew?

As I am stuttering through recovery from LungMutiny2010, I am paying more attention to my diet. So, as I try to go out for my 10 min walk everyday, I still drink some sports drink – usually Gatorade made from the massive vat of powder you can buy here at Costco.

We tend to get plenty of sodium in our diet – far too much in the US, actually – but I always worry about potassium when I am sweating (Disclaimer: I am not an exercise physiologist or a cardiovascular or nephrology physician.).

I always thought that the widely-sold sports drinks were the best sources of potassium outside of eating bananas or some dried fruits.

So, I was surprised to learn that an 8-ounce serving of orange juice contains 18-fold more potassium than an 8-ounce serving of Gatorade® (450 mg vs. 25 mg).

I suspect that this is a Good Thing when exercising but perhaps a concern for hypertensive patients who must monitor their potassium levels.

Is there anyone with more practical knowledge about potassium and physiology willing to weigh in?

Is a dilute, no-pulp orange juice (maybe 1:1 with water) a good adjunct to a sports drink when carrying multiple bottles of beverages on a bike ride or trail run?

Comments

  1. #1 Darlene
    March 31, 2010

    I am not an expert, but I and my husband both run and we have researched this issue.

    Generally one doesn’t need a sports drink for exercise under one hour. If I’m going for a 45 minute run I bring water. If it is very hot out I might bring a half sport drink/water mix. Over an hour and I’ll sip from a sports drink.

    I have used OJ in lieu of a sports drink but it upset my stomach and tasted awful when warm.

    And I drink chocolate milk after exercise to replace proteins and carbs :)

  2. #2 k8
    March 31, 2010

    Orange juice makes my tummy hurt most of the time, so that’s not a good source of potassium for me. The surgeon I work for got amoebic dystentery when he went to India this year and when he got home, we found a homemade “electrolyte” drink that he found very useful. (Because no WAY was he going to drink pedialyte like I suggested. Sigh.)

    1 Liter of water
    1/2 teaspoon of salt
    4-10 teaspoons of sugar (adjust to taste)
    1/4 teaspoon of Calcium Chloride (no salt)
    1/4 teaspoon of baking soda

  3. #3 Colin
    March 31, 2010

    @2 k8: that formulation also does not contain potassium (table salt and baking soda are all Na+).

    My problem with “sports drinks” is that they are often loaded with carbs: Gatorade has milligrams of Na+ and K+ but *grams* of carbs. This is a good formulation for college football players (http://www.training-conditioning.com/2007/03/fueling_for_football.html) but your average Joe does not burn 10,000 kcal/day, which means the balance is wrong. Especially if your exercise goal is weight loss.

  4. #4 msphd
    April 3, 2010

    try adding one pinch each of ground cumin and coriander to your OJ.

  5. #5 Ellie
    April 4, 2010

    I’m on hydrochlorothiazide (for kidney stone prophylaxis, actually, not hypertension), and need to make sure I get enough potassium. Orange juice is my friend. So are dried peaches. And… coffee (I only have 1 cup per day, but most people don’t realize it has K+.)
    http://www.pamf.org/patients/pdf/potassium_count.pdf

    In general, in hypertension – with the exception of patients with kidney disease – a diet with a goodly amount of potassium is desirable. Hence the DASH diet guidelines.
    Certain antihypertensives will significantly increase serum potassium (ARBs, ACE I, aldosterone inhibitors), and then potassium may need to be restricted, particularly in cases of heart disease.

    Sodium is your major issue for oral rehydration therapy, not potassium. You’re much more likely to lose massive amounts of potassium via diarrhea or diuretics than through exercise. In those situations, orange juice (if you can tolerate it) is your friend. (And please ignore all this if one of the physiologists comes along and smacks me down.)

    All that said, I like to take skim milk in a frozen vacuum bottle, if I can, as a snack/drink, water for the rest, and if that isn’t an option, I usually just go for water and some dried peaches. Because the HCTZ? Yeah. I dump potassium to the point of muscle cramps. And the more I exercise, the more I drink and seem to pump through. But nephrology said we would try it, and – stone-free x 6+ years, so it’s worth it.

  6. #6 Joe
    April 5, 2010

    For high amounts of potassium, you might consider low-sodium V8 Juice (820mg/ 8oz.).

  7. #7 scribbler50
    April 5, 2010

    Ahhh, so THAT’S why Jackie Gleason was such a big fan of the Screwdriver… ’twas the potassium he was after! (Sorry, Abel, I couldn’t resist.)

    A belated Happy Easter, my friend.

  8. #8 thomas
    April 5, 2010

    Hyperkalemia from excessive dietary intake is rare in people with normal kidney function, even if they are taking ACE inhibitors or potassium-sparing diuretics. The big problem, as Ellie says, is in the other direction.

    (I’m not an MD or a renal physiologist, either, but I am a cardiovascular epidemiologist)

  9. #9 Pascale
    April 6, 2010

    I am a nephrologist who teaches pathophysiology.
    Most people not on diuretics and not working out like the Florida Gators do not require sports drinks for Na and K balance. Even on thiazide diuretics, most patients can maintain serum K through dietary sources like milk, fruits (and their juices), and potatoes (baked & fried, but not boiled).
    My kid’s baseball team? Drink the sports drinks in July when you sweat out your body weight. Most of us? Drink water or some juice; you really don’t lose that much K most of the time…

  10. #10 Abel Pharmboy
    April 7, 2010

    Once again, I am the beneficiary of my learned readers.

    And a belated Happy Easter to you, Brother Scrib!

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