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Review
. 2022 Nov 12;14(22):4785.
doi: 10.3390/nu14224785.

Dietary Potassium Intake and Risk of Diabetes: A Systematic Review and Meta-Analysis of Prospective Studies

Lanfranco D'Elia  1 , Maria Masulli  1 , Francesco P Cappuccio  2   3 , Aquilino F Zarrella  1 , Pasquale Strazzullo  1 , Ferruccio Galletti  1
Affiliations
Review

Dietary Potassium Intake and Risk of Diabetes: A Systematic Review and Meta-Analysis of Prospective Studies

Lanfranco D'Elia et al. Nutrients. .

Abstract

(1) Background: Dietary potassium intake is positively associated with reduction of cardiovascular risk. Several data are available on the relationship between dietary potassium intake, diabetes risk and glucose metabolism, but with inconsistent results. Therefore, we performed a meta-analysis of the prospective studies that explored the effect of dietary potassium intake on the risk of diabetes to overcome these limitations. (2) Methods: A random-effects dose-response meta-analysis was carried out for prospective studies. A potential non-linear relation was investigated using restricted cubic splines. (3) Results: A total of seven prospective studies met the inclusion criteria. Dose-response analysis detected a non-linear relationship between dietary potassium intake and diabetes risk, with significant inverse association starting from 2900 mg/day by questionnaire and between 2000 and 5000 mg/day by urinary excretion. There was high heterogeneity among studies, but no evidence of publication bias was found. (4) Conclusions: The results of this meta-analysis indicate that habitual dietary potassium consumption is associated with risk of diabetes by a non-linear dose-response relationship. The beneficial threshold found supports the campaigns in favour of an increase in dietary potassium intake to reduce the risk of morbidity and mortality. Further studies should be carried out to explore this topic.

Keywords: diabetes; dietary potassium; glucose metabolism; meta-analysis; potassium consumption; potassium intake.

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Conflict of interest statement

L.D. was a technical advisor to the World Health Organization and is a member of the scientific committee of the Italian Society of Human Nutrition. F.P.C. is a technical advisor to the World Health Organization, an unpaid member of Action on Salt and WASH and the Past-President of the British and Irish Hypertension Society. P.S. is the Past-President of the Italian Society of Human Nutrition. Other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Stepwise procedure for selection of the studies.
Figure 2
Figure 2
Dose–response association between potassium (K) intake and risk of diabetes (seven cohorts). Potassium intake was modelled with restricted cubic splines in a multivariate random-effects dose–response model (solid line). Dashed lines represent the 95% confidence intervals for the spline model.
Figure 3
Figure 3
Dose–response association between dietary potassium (K) intake by urinary excretion and risk of diabetes (two cohorts). Urinary potassium excretion was modelled with restricted cubic splines in a multivariate random-effects dose–response model (solid line). Dashed lines represent the 95% confidence intervals for the spline model.
Figure 4
Figure 4
Dose–response association between dietary potassium (K) intake by questionnaire and risk of diabetes (six cohorts). Dietary potassium intake was modelled with restricted cubic splines in a multivariate random-effects dose–response model (solid line). Dashed lines represent the 95% confidence intervals for the spline model.
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