Does Changing the Ratio of Dietary Sodium-to-Potassium Intake Affect Bone Mineral Density?

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Korean J Fam Med. 2023;44(1):1-1
Publication date (electronic) : 2023 January 19
doi :
Department of Family Medicine, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
Corresponding Author: Soo Young Kim Tel: +82-2-2224-2409, Fax: +82-2-2224-2409, E-mail:

It is well known that various nutritional factors, such as calcium, vitamin D, and iron [1], as well as dietary factors, such as milk intake [2], affect the level of bone mineral density (BMD). It is possible that salt and potassium intake also play an essential role. As a result, it is possible that the ratio of two nutrients, salt and potassium, influences BMD.

In the present issue, Lee et al. [3] investigated the relationship between dietary Na/K ratio and BMD in middle-aged Korean women. The authors found that the dietary Na+/K+ ratio decreased total femur and lumbar spine BMD from Q1 to Q4 (Pvalue for trend: 0.044 for total femur BMD and 0.002 for lumbar spine BMD). Based on the results of this study, a higher dietary Na+/K+ ratio may be linked to lower BMD.

The Na+/K+ ratio is well known to be closely related to hypertension, stroke, and cardiovascular disease [4,5]. A hypothesis regarding the relationship between the Na+/K+ ratio and osteoporosis was proposed implying that the dietary Na+/K+ balance has the potential to affect various health conditions and chronic diseases more than is currently known [6].

However, since the relationship between dietary sodium and potassium intake and BMD shown in this study was only proven in a cross-sectional study, it would be necessary to first establish this hypothesis through a cohort study.



No potential conflict of interest relevant to this article was reported.


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3. Choi SS, Kim YA, Kim HJ, Cho YJ, Lee GH. The relationship between dietary Na/K ratio and bone mineral density in Korean middle-aged women. Korean J Fam Med 2023;44:21–7.
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