Potassium2026-10

Regional effect of population-based programs promoting salt reduction and potassium intake in Hokkaido: a post hoc analysis of the PoSPIP.

Sakuma Hirofumi, Yoshita Katsushi, Takemi Yukari, Hisamatsu Takashi et al. — Hypertension research : official journal of the Japanese Society of Hypertension

Summary

This study looked at how different levels of support in a public health program affected salt and potassium intake in two Japanese communities. Researchers found that a more intensive program, including immediate feedback on salt levels, led to greater salt reduction. However, the intensive program did not show a significant difference in potassium intake or blood pressure changes compared to standard support.

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Key points

An intensive community program in Japan helped people reduce their salt intake more effectively than standard support.
This intensive program involved immediate feedback on salt levels and repeated health guidance.
However, the study did not find that the intensive program led to a greater increase in potassium intake or better blood pressure control.
Targeted support can be effective for reducing salt, but increasing potassium intake might require different strategies.

What the study looked at

**What question did this study ask?** This study investigated whether an intensive community-based program, designed to promote both salt reduction and potassium intake, would be more effective than standard support in improving these dietary habits and related health markers in specific regions of Hokkaido, Japan. **How was it studied?** Researchers conducted a follow-up analysis of an existing public health program called PoSPIP. They compared two communities: one received standard support, while the other received intensive support. The intensive support included on-site urine tests to measure salt and potassium levels, immediate feedback, repeated health guidance, and efforts to improve the food environment. Over 400 participants from both communities were tracked for one year, with their estimated salt and potassium intake, and blood pressure measured. **What did it find?** The study found that participants in the intensive support group significantly reduced their estimated salt intake more than those in the standard support group. However, there was no significant difference between the groups in terms of changes to estimated potassium intake or blood pressure levels. This suggests that while intensive support can be effective for salt reduction, its impact on potassium intake and blood pressure may not be greater than standard approaches.

Dietary takeaway

While this study highlights the effectiveness of intensive programs in reducing salt intake, it suggests that simply promoting potassium might not be enough to significantly increase its consumption or impact blood pressure more than standard advice. To boost your potassium intake, focus on incorporating more whole, unprocessed foods like fruits (bananas, oranges), vegetables (spinach, potatoes), legumes, and nuts into your daily meals. Remember, this is just one study, and dietary changes should always be discussed with a healthcare professional.

Abstract

The Population-based Sodium/Potassium Improvement Program is a nonrandomized population-based intervention implemented by the Japanese Society of Hypertension across multiple municipalities and workplaces in Japan. This post hoc regional analysis focused on two municipalities in Hokkaido-namely, Higashikagura, which received standard support, and Mashike, which received intensive support consisting of on-site urinary sodium-to-potassium (Na/K) ratio measurement, immediate feedback, repeated health guidance, and food-environment improvement. A total of 431 participants who underwent annual health checkups in 2021 and 2022 and had urinary Na/K ratio data at both time points (standard support group, n = 218; intensive support group, n = 213) were included. One-year changes in the urinary Na/K ratio, estimated salt and potassium intakes, blood pressure (BP), and other clinical measures were compared between the groups using multivariable linear regression. The proportion of participants achieving urinary Na/K ratio targets increased in the intensive support group. A significant group-by-time interaction was observed for the <2 threshold (OR 2.62, 95% CI: 1.25-5.50), but not for the <4 threshold. After adjustment for covariates, estimated salt intake decreased more in the intensive support group than in the standard support group (adjusted group difference: -0.53 g/day, 95% confidence interval: -0.95 to -0.12). Changes in the urinary Na/K ratio, estimated potassium intake, and systolic and diastolic BP did not significantly differ between the groups. Intensive support incorporating urinary Na/K ratio measurement, immediate feedback, and repeated multidisciplinary guidance may promote salt reduction in local community settings.

View on PubMed →DOI: 10.1038/s41440-026-02846-8