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Nepal’s political landing has been one of remarkable transformations but with persistent fragility. From constitutional monarchy to federal, secular republic, the country has continually redefined its system of governance. Yet, the outcomes remain uneven: political instability, fragmented coalitions, patronage-driven governance, economic interruption, diplomatic distrust and declining public trust. The repeated neglect in the people’s noise has brought about the recent GenZ uprising, which has exposed the urgency for a state that delivers stability, accountability and credibility—not just representation.

As Nepal reflects on its political destiny, it must explore a hybrid model of governance — blending the parliamentary accountability of the United Kingdom, the institutional discipline of the United States, and the executive balance of France’s semi-presidential system. Such a synthesis could deliver what neither pure parliamentary nor presidential models have achieved in Nepal: a government that is stable yet accountable, professional yet democratic, and credible at home and abroad.

The limits of the current system

Nepal’s 2015 Constitution institutionalized a parliamentary democracy with federalism, secularism and proportional representation. Yet, it has also produced coalition instability and administrative paralysis. Prime Ministers change with alarming frequency, political parties prioritize alliances over governance, and lawmakers double as ministers, often compromising both legislative oversight and executive efficiency.

In this model, the state has become top-heavy but underperforming. Parliament, intended to be the guardian of accountability, has become an arena of political bargaining. The public perceives politics as self-serving, and governance as synonymous with corruption or inertia. The structural question, therefore, is not just who governs, but how Nepal governs.

Learning from global models

Accountability thru parliament

The Westminster model offers robust parliamentary control but is vulnerable to instability when coalitions dominate. Nepal’s adaptation of this model has suffered from party fragmentation, weak discipline, and limited professionalization of ministers.

Separation and professionalism

The American system demonstrates how a strict separation between the executive and legislature enhances efficiency. Cabinet members are appointed from outside Congress, ensuring that ministers are professionals rather than politicians. This approach insulates governance from partisan instability and rewards expertise and performance.

Balance thru dual executive

France’s semi-presidential model combines a ceremonial President as head of state and a Prime Minister accountable to Parliament. This dualism provides balance and continuity, ensuring that no single institution monopolizes power. It also allows the executive to remain stable even amid political transitions.

For Nepal, the lessons are clear: parliamentary instability can be offset by executive professionalism and constitutional balance. A hybrid framework that draws from these three systems can be tailored to Nepal’s scale, political culture and aspirations.

A proposed model for Nepal

A House-elected chief executive

The Prime Minister would remain the head of the government, elected by a majority of parliament members for a fixed four or five-year term. To prevent excessive politicking, a no-confidence vote should be restricted within the first two years of tenure. The Prime Minister should not hold any party office, ensuring that governance remains above partisan maneuvering.

Subject experts as ministers

A critical innovation would be to separate lawmakers from the executive. Ministers should be drawn from outside Parliament—from academia, civil service, security, intelligentsia, business and other professional sectors—vetted by a parliamentary confirmation committee. This professional cabinet would reflect meritocracy rather than political patronage. It would also help address public disillusionment with political elites and bring expertise into governance.

A lean, unicameral legislature

Nepal could abolish the National Assembly and operate with a unicameral Parliament of 125-150 members. The current size is costly and redundant, while duplication across two houses delays decision-making. A leaner legislature would enhance efficiency and focus on lawmaking and oversight. The electoral system could remain mixed—60 percent direct and 40 percent proportional—to preserve inclusivity.

A ceremonial prez

The President would serve as Head of State and constitutional guardian, with powers to ensure continuity during crises. Elected through an electoral college of Parliament and provincial assemblies, the President’s role would be symbolic but stabilizing—much like the German or Indian model.

Toward a system that works

Nepal could gradually move away from its costly and fragmented federal structure toward a union government system that retains local empowerment but restores national coherence. Federalism, though conceived to promote inclusion, has instead multiplied bureaucracy, diffused accountability, and strained public finances. A Union model—drawing lessons from Japan’s prefectural efficiency, France’s unitary yet decentralized administration, and the UK’s devolution framework—would streamline governance by abolishing redundant provincial layers while strengthening local bodies and professional administration. This approach would preserve representation where necessary but align authority, resources and responsibility under a unified executive and legislative framework, ensuring fiscal discipline, administrative clarity, and national stability.

Strengthened oversight institutions

Parliamentary committees—especially Public Accounts, National Security and Ethics—must become more independent and professional. The judiciary should retain constitutional independence, and the Constitutional Council should include respected professionals, not only party appointees.

Why this model fits Nepal

Stability thru structure:

A fixed-term Prime Minister and a professional cabinet would end the cycle of frequent government collapses. Continuity of governance would allow long-term planning—particularly for infrastructure, economic reforms and foreign policy.

Professionalism over patronage:

By selecting ministers from outside Parliament, Nepal would cultivate an executive focused on performance and delivery. This mirrors the US cabinet system, where expertise outweighs party loyalty. It also reduces corruption by severing the link between lawmaking and resource control.

Accountability sans instability:

Legislative oversight remains robust through committees, but the executive retains autonomy in implementation. This ensures accountability without paralyzing governance.

Efficiency and cost reduction:

A smaller, unicameral Parliament would save public expenditure and improve efficiency — vital for a small, resource-constrained nation.

Institutional balance:

A ceremonial president, an empowered parliament and a professional executive would together prevent both authoritarian drift and chaotic populism. The structure would encourage responsible governance rather than perpetual negotiation.

Challenges to reform

Reforming the Constitution will not be easy. Political elites are unlikely to give up ministerial privileges or the leverage that comes from coalition bargaining. Civil society must therefore drive the national conversation on governance reform—framing it not as a partisan debate but as a strategic necessity.

Another challenge lies in bureaucratic resistance. A professionalized cabinet must work with a reformed civil service, guided by clear performance metrics and ethical standards. Nepal’s success will depend on whether institutions—not individuals—become the true anchors of power.

Finally, there must be a cultural shift in how politics is practiced. Political parties should evolve from patronage machines into programmatic institutions that shape policy and national vision, not appointments and benefits.

Reimagining governance for credibility

Nepal’s quest for stability is not about replacing one form of government with another, but about refining its governance architecture to reflect its realities. The hybrid model offers a balance between democratic representation and administrative efficiency.

It is a model where Parliament governs through oversight, not occupation; where ministers serve through expertise, not entitlement; and where the people measure democracy not by rhetoric, but by delivery.

If Nepal succeeds in building such a system, it would set a regional example—a small state navigating complex politics through institutional strength and meritocratic governance. This would also complement India’s and China’s neighborhood strategies by ensuring Nepal’s internal credibility, which remains the foundation of any external stability.

Toward a governance compact

Nepal can no longer afford the cyclical instability that has eroded public faith and economic opportunity. It needs a Governance Compact 2040—an understanding across parties, provinces, and society that stability, merit and accountability must define the next political generation.

A hybrid constitutional model drawing from the discipline of the United Kingdom, the professional governance of the United States, and the executive balance of France could suit Nepal’s unique needs.

It would keep democracy accountable, insulate administration from partisan capture, and restore credibility to governance. Reimagining governance is not a rejection of democracy but its renewal. A hybrid model—where Parliament elects the Prime Minister, ministers are drawn from merit, and a lean structure is lean and functional that ensures efficiency—could transform Nepal toward “stability and integrity” from a state of perpetual transition to one of strategic coherence and credible democracy.

Nepal’s future stability will depend not on who rules, but on how it chooses to govern.

The author is Maj Gen (Retd) and a strategic affairs analyst based in Kathmandu. He writes on South Asian geopolitics, national security, and the intersection of governance, diplomacy, and stability

Nepal is one of the most disaster-prone countries in the world. The question is not whether a disaster will occur, but which type and when. Marking this week as Disaster Risk Reduction Week in continuation of the International Day for Disaster Risk Reduction observed on Oct 13, Looking at past disasters from a retrospective perspective, in addition to recurring events such as earthquakes, floods, and landslides, we can also identify unique incidents such as the Armala sinkhole in Pokhara, the tornado in southern Nepal, the recent sinkhole in Hetauda, and the outburst of a supraglacial lake in Tibet that caused floods in Rasuwa.

On July 8, a sudden flash flood triggered by the rapid discharge of a supraglacial lake on the Purepu Glacier in Tibet caused widespread devastation along the Bhotekoshi River in Rasuwa, Nepal. The event claimed at least 11 lives and left 18 people missing. At the same time, Nepal experienced drought in the Tarai within a span of just 150–200 kilometers, underscoring the complex reality of disaster exposure in the country. Earlier, on May 2, a road in Gairigaun, Hetauda, suddenly caved in, swallowing a vehicle into a swamp-like sinkhole. The vehicle remains missing despite search operations. These two recent events, one a transboundary disaster and the other a unique local hazard, prompt the author to revisit unique past disasters in Nepal rather than recurring ones. Starting with the May 2012 Seti River flood, the author reviewed all unique disasters and their impacts in the country.

On 5 May 2012, a massive avalanche from Annapurna IV triggered a sudden flood in the Seti River, Kaski District, killing 72 people, displacing many families, and causing heavy property loss. Dwivedi & Neupane (2013) reported that approximately 32,000 m² of ridge collapsed from 6,850 meters to 4,500 meters, pulverizing ice, rock, and sediment. The impact generated a brown cloud, strong vibrations, and seismicity equivalent to 3.8–4.0 Richter Scale, recorded in Nepal and even in Tibet. The debris rushed downslope into the Seti River, transforming into a debris flow that traveled 20 km downstream at speeds of about 12 m/s within 28 minutes. Although minor rainfall had occurred a day earlier, it was not linked to the avalanche. 

During Nov 2013, major sinkholes formed in Armala, Pokhara. The region, where the Pokhara and Ghachock formations meet, consists of fluvio-lacustrine terraces with mixed sediments of gravel, limestone, quartz, gneiss, calcareous silt, clay, and fine sand. Between 2013 and 2017, over 200 sinkholes formed in Armala, creating severe challenges for residents. On 31 March 2019, strong winds and hailstorms hit Bara and Parsa districts, killing 30 people, injuring more than 1,150, and making over 2,890 families homeless. Infrastructure, utility services, agricultural land, and businesses were damaged. Research suggested this was the first officially recorded tornado in Nepal, though some classified it as a windstorm. Regardless, such wind events on this scale are unusual in the country.

On 15 June 2021, a disastrous debris flow occurred along the Melamchi River in central Nepal and caused enormous loss of life and property. At least 350 residential buildings, six bridges, and numerous infrastructures were affected. According to the World Bank and GFDRR, the flood resulted from the combined effect of heavy rainfall, temperature changes at the snow line, erosion in the end moraine of Pemdan Lake, a possible breach of the natural dam responsible for the lake, and cascading effects of the dam breach, along with erosion and a series of landslides along the Melamchi River.

In Oct 2021, the Mahakali, Karnali, and Seti rivers recorded the highest flows in decades due to unseasonal rainfall, hitting Sudurpaschim Province hardest. The disaster caused 88 fatalities, 30 missing persons, and 10 injuries. 

On 13 Aug 2023, heavy rains caused floods in Muktinath, Kagbeni village of Mustang. About 31 buildings, two permanent and three temporary bridges, were destroyed. According to Fort et al. (2024), Kagbeni (2,810 meters) lies in the north Himalayan rain-shadow area and normally receives little rainfall (<300 mm/yr). 

However, for several years, the trend has been toward increased rainfall, leading to more landslides and floods. Although rainfall data from the nearest monitoring station, Jomsom (2,720 meters), showed high rainfall, there is no detailed information about rainfall amounts at Jhong (3,600 meters) and Muktinath (3,760 meters), the source area of the Kagbeni flood. The flood was likely a landslide lake outburst, but the difficult terrain has limited detailed study.

Nepal has also recently experienced heat extremes. On 30 May 2024, Nepalgunj reached 44.2°C and Dhangadhi 44.1°C, closer to the highest ever recorded data of 46.4°C in Dipayal on 5 June 1995.

On 8 July 2024, the cloudburst event occurred, where Dodhara Chandani in Kanchanpur recorded the heaviest 24-hour rainfall in the 77-year history of rainfall measurement in Nepal, with a recording of 624 mm. Other nearby stations recorded similar extreme rainfall, surpassing previous records from 1993.

On 16 Aug 2024, a sudden flood carrying boulders devastated Thame village in Khumbu, destroying 60 buildings and damaging various structures. On that day, there was hardly any rainfall. It was later found that the flood was caused by an outburst from the Thyanbo glacial lake. Other significant events include the Birendra Lake overflow on 21 April 2024 with no human casualties. On 12 July 2024, A landslide struck two buses at Simaltal, Chitwan, sweeping them into the Trisuli River and causing the loss of 59 lives.

During 27–29 Sept 2024, extreme precipitation caused flooding, landslides, and inundation across different parts of Nepal. The Department of Hydrology and Meteorology (DHM) recorded rainfall at 222 stations nationwide, of which 77 stations reported heavy rainfall exceeding 200 mm on 28 September. Among the hydrological gauging stations, 23 recorded water levels surpassing the danger level, while another 14 recorded levels exceeding the warning threshold. The floods affected 518,403 households and a population of 2.59m, with an estimated economic loss of Rs 46.6bn. During this event, three buses were buried by a mudslide in Jhyaple Khola, Dhading, resulting in the loss of at least 35 lives.

On May 15, at around 10:30 pm, a sudden debris flow occurred in the Tiljung stream in Namkha, Humla. The incident affected the 15 kW micro-hydropower project, drinking water sources, cultivable land, irrigation canals, and the motorable bridge over the Til stream. According to field reports, this was likely caused by the melting of permafrost within the moraine, which developed into a cavity or piping system extending to the lakebed, ultimately resulting in the sudden drainage of the lakes. The Til flood does not resemble a typical GLOF, but a detailed study could classify it more accurately as a Thermokarst Flood or Permafrost-Release Flood. A massive flood in Upper Mustang on July 9, carrying mud and damaging six bridges, including four that were completely swept away.

Also, the cyclones that develop in the Arabian Sea and the Bay of Bengal have indirect impacts and sometimes cascading and compounding effects. For example, Cyclone Tauktae in May 2021 caused mild to light rainfall across western Nepal, with a flash flood in Ramaroshan in Achham District in Sudurpashim Province. Cyclone Yaas in May 2021 left various parts of Nepal drenched in rain and overcast conditions. On 14 Oct 2014, sudden weather changes caused by Cyclone Hudhud in Nepal reportedly triggered avalanches around Dhaulagiri and Annapurna. The avalanches and heavy snowfall killed at least 43 people in Nepal and caused heavy rainfall in major cities. 

Along with recurring events such as earthquakes, including the 2015 Gorkha Earthquake, the Doti Earthquake of 2022, and the Bajhang and Jajarkot earthquakes of 2023, as well as annually occurring monsoon disasters, and global pandemics such as Covid-19, unique disaster events have caused major damage to both life and property. These events have resulted in substantial economic losses and placed a heavy burden on reconstruction, rehabilitation, and recovery efforts, ultimately impacting Nepal’s overall GDP. Some of the above events include transboundary challenges in disaster management, where disasters originating in neighboring countries also cause loss of life and property in Nepal. 

In addition, the change in the pattern and intensity of rainfall, unseasonal droughts, increasing heatwaves and forest fires, along with various climate extremes, reflect the evolving risks caused by climate change. According to NDRRMA, although rainfall during the first 90 days of this year’s monsoon has been below average, monsoon-related disasters have already caused 63 deaths and left 22 people missing. As hydro-meteorological events and their effects increase, the early warning system for such hazards needs to be strengthened. In 2024, forecasts issued by the DHM were almost 70 percent accurate, but in 2025, accuracy appears to be lower, highlighting the need for technological improvements to enhance forecast reliability.

According to the National DRR Strategic Plan of Action (2018–2030), the target was to reduce annual disaster-related deaths to 300 by 2025. However, given the current situation, achieving this target seems challenging. Moving from disaster management to investing in risk reduction is more effective, more efficient, and fairer. This is also the message of the International Day for Disaster Risk Reduction: “Fund resilience, not disasters. Disaster risk financing strategies must also be strengthened, especially to protect agriculture and farming, while reducing the financial burden in the post-disaster phase. 

The Government of Karnali Province has already introduced good practices in risk transfer and insurance by launching the Natural Disaster Risk Group Insurance Program, which provides coverage of up to Rs 200,000 and has reached around 1.7m people. In addition, the Disaster Home Protection Program has supported 16,078 households with benefits worth Rs 8.8m as of the fiscal year 2024/25. It is also essential to engage and support community disaster management committees, local women’s and youth groups, so their involvement extends beyond formal channels and can be immediately mobilized after a disaster. 

It is equally necessary to equip all security forces with the required personnel, rescue gear, and rapid response training needed for swift mobilization, and to explore the possibility of establishing a separate National Disaster Response Force, as the country needs regular human resources dedicated to disaster response. We are all aware that Nepal is one of the most disaster-prone countries in the world, but it is also time to explore potential hazards that may cause disasters, as past trends have shown unexpected events in the country. It is high time we ask ourselves and prepare for every possible disaster, since Nepal seems to be safe only from marine disasters.

The author is an earthquake engineer with over a decade of experience in practice and research in DRR, civil and earthquake engineering

Nature, in its raw complexity, offers more than ecological insight; it serves as a diagnostic mirror for human governance. In this piece, I, a field researcher at the University of Basel on governance and sustainability sciences, aim to draw parallels between the behavioral patterns of Dhole (the Asiatic wild dog, locally known as Bwanso) at Nepal’s Dhorpatan hunting reserve, predatory behavior of Nepal’s political institutions and a polity on the brink. 

Based on my field research at the reserve, I can say that the Dhole’s surplus aggression, killing beyond necessity, barking without cause and obsessively marking territory reflects a drive for dominance untethered from survival. 

Oversexed during the mating season (mating occurs up to 40 times a day), the lioness shows erratic shifts in her behavior. She growls and signals a breakdown in cooperative dynamics with her lion. These instinctual cycles of excess, fatigue and territorial assertion are not merely biological curiosities; they metaphorically shed light on the behavioral pathology of Nepal’s political institutions in chaos for over three decades.

A vicious cycle

Since Nepal’s political shift in 1990, governance has been under the domination of the Nepali Congress, UML/its factions and later the Maoists, each contributing to institutional decay. The Maoist insurgency, launched in the 90s with the promise of inclusion and anti-corruption, brought immense human, private properties and infrastructural losses but failed to deliver stated reforms. Successive governments engaged in corruption, enabled capture of public properties and weakened state institutions. 

Leaders such as Khadga Prasad Sharma Oli, Pushpa Kamal Dahal, Sher Bahadur Deuba, Madhav Kumar Nepal, Baburam Bhattarai, Jhalanath Khanal, and late Girija Prasad Koirala presided over regimes marked by impunity and performative politics. Oli, now UML chairman and a multi-term Prime Minister, increasingly defies institutional norms, positioning himself as a national savior while his party cadre applaud his witty lines. 

The bureaucracy has become a pawn for political groups, and public trust in this institution has eroded. Nepal’s political culture driven by dominance, exhaustion and erratic behavior mirrors the chaotic aggression of the lioness and the dhole. Lavish attention has led political figures to mistake flattery for stature, much like the donkey who, after receiving undue praise, believed itself to be a lion.

Economic paradoxes

The Ministry of Finance reveals that in 2023-24, Nepal’s total public debt (domestic and external combined) stood at Rs 2,434.57bn, rising to Rs 2,664.42bn in 2024-25, a 9.4 percent annual increase. Public revenue in 2024-25 totaled Rs 1,196.19bn, against a national budget of Rs 1,860.3bn.

Expenditures reached Rs 1,512.98bn, achieving an execution rate of 81.33 percent. Of this, current expenditures consumed most of the budget, while capital spending (18 percent) lagged far behind, reflecting a chronic inability to implement developmental projects effectively. On the trade front, imports reached Rs 1,841.20bn, dwarfing exports of only Rs 277bn. 

Remittance increased 19.2 percent and the total amount reached by Rs 1723.27bn in 2024-25, constituting 28.22 percent of the GDP.  The GDP increased modestly from Rs 5,705.10bn in 2023-24 to Rs 6,107.22bn in 2024-25, with agriculture contributing 25.6 percent, industry 12.4 percent, and services 62.2 percent. The overall economic growth rate of 4.61 percent is insufficient to absorb the expanding labor force or sustain developmental ambitions.

Despite modest growth, Nepal’s structural economy remains severely distorted. Infrastructure across economic, social and environmental sectors is deteriorating. The tourism industry continues to suffer from unreliable and costly connectivity systems. Domestic airfares remain disproportionately expensive, discouraging travel. Agricultural stagnation persists due to poor input supply, inadequate processing facilities, technologies and weak market linkages, despite heavy public spending. Each year, approximately half a million Nepalis enter the labor market, yet the domestic economy generates very few viable jobs. 

Consequently, labor migration remains the default escape, with an additional 250,000 renewing their work permits annually. The economy, therefore, is sustained not by innovation or productivity but by remittances. This condition stands in stark contrast to the insights of the 2025 Nobel Laureates in Economic Sciences: Prof Peter Howitt, Prof Joel Mokyr, and  Prof Philippe Aghion, who emphasises innovation-driven growth and institutional dynamism as the foundation of sustained prosperity that Nepal has already missed.

Myth of a directly elected chief 

Nepal’s political economy is deeply compromised by state capture, corruption and impunity conditions that have galvanized the GenZ movement. The electricity billing crisis exemplifies systemic injustice: while industrial elites evade payment through litigation, ordinary citizens face disconnection after brief delays. Illicit invoicing and bribery further erode the tax base and institutional capacity. 

GenZ activists have exposed the stark contrast between the opulence of political leaders with private gyms, swimming pools, stock of imported liquors, hoarded cash and the deprivation in rural communities lacking basic social/economic infrastructure, health, education and maternal care. Their call to bring the “Lion/Lioness and the Dhole to justice” reflects a broader demand for governance reform. 

Among their proposals, the push for a directly elected executive has sparked debate. While the appeal for decisive leadership is understandable, Nepal’s fragile state institutions, uneven education and diverse social fabric and wrongful political fragility make a directly elected executive risky. Without strong institutional checks and balances, the state could slide into totalitarian and authoritarianism. The crisis is not merely government structural but rooted in moral hazard, as political actors manipulate democratic processes for personal and political group gains. 

Nepal must first restore institutional integrity with strong checks and balances before mulling over a directly elected executive. The immediate priority is doing away with corruption, which is thriving due to the involvement of political groups and their leaders, and rebuilding public trust.

A moral and institutional renewal

Nepal’s salvation does not lie in adopting a new executive model but in undertaking a rigorous, impartial legal reckoning against widespread and unchecked corruption. The nation must confront the rooted networks of political and bureaucratic corruption that have hollowed out governance and state institutions. Only through the prosecution and removal of corrupt political leaders and officials, and the restoration of ethical governance can Nepal build a sustainable path toward peace, justice, inclusive development and prosperity. 

Until then, the nation’s political stage will continue to resemble the wild drama of the lion/lioness and Dhole marked by instinct, exhaustion and unrestrained appetite, rather than by reason, discipline and the pursuit of common goods.

Potassium? You may have heard of it, but you cannot put your finger on it.  Physicians advise taking 3,500 to 4,700 mg of potassium daily. The World Health Organization (WHO), too, recommends an intake of 3,510 mg per day.  Hang on, this does not mean you pop a potassium pill into your mouth every day! Plenty of foods are rich in this mineral compound to help you meet your daily requirements.

For our bodies to function correctly, we need a diverse range of nutrients, including carbohydrates, proteins, fats, vitamins, minerals, fiber, and water. They are essential for the growth of our bones, flesh, and organs, and for maintaining body metabolism. Moreover, we need them to keep diseases at bay and maintain overall good health. Potassium, as a macro-mineral, fulfills one of those essential nutrients.    

Mineral electrolyte

Electrolytes are essential minerals found in blood, sweat, and urine. Minerals such as sodium, chloride, calcium, magnesium, phosphate, and potassium form the electrolytes our body needs.

An electrolyte imbalance in the body occurs when we lose fluids due to persistent vomiting, diarrhea, excessive sweating, or fever. Other causes include: Medications such as steroids, diuretics, and laxatives.

Surprisingly, the fluids in your body—such as blood, sweat, and plasma—account for nearly 80 percent of your body's potassium requirement, while your bones and liver store the rest.  

Biomedical scientists explain that Potassium, as an agent, regulates fluid balance in our bodies and controls the electrical activity of the heart and body muscles. In short, it helps the cellular and electrical functions of our body. Potassium helps our nerves function, our muscles contract, maintain a regular heartbeat, and pump nutrients into our body cells while removing waste products.

As a mineral electrolyte, this wonderful compound helps reduce the high sodium content in our bodies. It is said to minimize the risk of stroke, high blood pressure, and the formation of kidney stones. It supports cardiovascular health, safeguards muscle mass, and preserves bone mineral density.

Potassium deficiency

Surprisingly, the CDC (Center for Disease Control and Prevention, USA), in a survey called NHANES (National Health and Nutrition Examination Survey), revealed a mind-boggling fact: in the United States alone, a whopping 98 percent of people fail to meet the daily requirement of 3,500 to 4,700 mg of Potassium.  

Catherine Collins, a dietician at St George's Hospital, Tooting, London, sheds light on Potassium by saying, “We use it to help generate an electrical charge which helps the cell function properly. It helps keep your heart rate steady, it helps trigger insulin release from the pancreas to help control blood sugars, and more importantly, keeps blood pressure in check.”

When the potassium level in our blood is low, it's called hypokalemia. The common symptoms of hypokalemia are fatigue, malaise, muscle aches/cramps, digestive disorders, nausea, vomiting, diarrhea, irregular palpitation, numbness of body parts, and breathing problems, among others.

Severe potassium deficiency occurs when an adult's potassium level falls below 3.6 millimoles per liter (mmol/L). In such cases, apart from the symptoms mentioned above, other symptoms may include low blood pressure, paralysis (resulting from muscle weakness), and respiratory failure.  A simple blood test can give you your exact potassium level.

Lima beans

The role of the kidneys. Rabin Nepali: While researching this write-up, I met Dr Rabin Nepali, who kindly explained the role of the kidneys in potassium regulation. To quote Dr Rabin: “The dietary intake of potassium ranges from less than 35 to more than 110 mmol/day in US adults.” “Despite this widespread variation in intake, homeostatic mechanisms serve to maintain plasma potassium precisely between 3.5 and 5.0 mmol/L. In a healthy individual at steady state, the entire daily intake of Potassium is excreted, approximately 90 percent in the urine and 10 percent in the stool.”

“More than 98 percent of total body potassium is intracellular, chiefly in muscle. The rapid exchange of intracellular Potassium with extracellular Potassium plays a crucial role in maintaining plasma potassium within such a narrow range; this is accomplished by overlapping and synergistic regulation of a number of renal and extra-renal transport pathways.”

“So, kidneys play a crucial role in maintaining a steady state in potassium metabolism, by excreting excess potassium or reabsorbing it as required by the body.” (Dr Rabin Nepali, DM Nephrology, Asst. Professor, Teaching Hospital, Maharajgunj, Kathmandu).

Food and not supplements

Yes, do not get taken in by supplements, even when they sound tempting. There are one too many that you can buy over the counter.  Go for dietary sources instead. There is an abundance of food rich in Potassium. Not processed food, though, as they are high in sodium.

Doctors of medicine argue that natural diets rich in Potassium are key to a lower risk of hypertension (high blood pressure), kidney stones, and osteoporosis. Our daily foods, such as meat, poultry, fish, fruits, nuts, and vegetables, not only provide various nutrients but also serve as excellent sources of Potassium.

Avocado

Beverages such as milk, coffee, and other nonalcoholic drinks also contain a liberal amount of Potassium. Let’s take a look at the following chart:  

Among the foods highest in Potassium are beet greens, white beans, soybeans, and Lima beans. The benefits of Potassium include:

Blood pressure and cardiovascular health

Today, hypertension or high blood pressure has become a commonplace health problem among old and young alike. If not addressed on time, it can lead to grave complications like stroke and heart disease.

Sodium, also known as salt, is closely linked to high blood pressure, and doctors recommend reducing salt intake. Now, Potassium is said to neutralize to a great extent the adverse effects of sodium. Our kidneys play a crucial role in regulating our blood pressure. They regulate the amount of fluid stored in our bodies to maintain a steady state. High blood pressure is associated with increased fluid volume in our bodies. Eating a potassium-rich diet helps counteract the effects of sodium and enables the kidneys to restore balance, ultimately lowering blood pressure to a healthy level.

Clinicians believe a diet high in Potassium can help cut systolic blood pressure by more than 10 points in people with high blood pressure.  Talking about heart health, according to the WHO, 17.9m people worldwide die of cardiovascular diseases (CVDs), which include coronary heart disease, cerebrovascular disease, rheumatic heart disease, and others. Four out of five CVD deaths fall under heart attacks and strokes.

WHO recommends increasing potassium intake from foods (not refined foods) to reduce blood pressure and lower the risk of cardiovascular disease, stroke, and coronary heart disease. Potassium helps reduce vascular calcification, which is the formation of mineral deposits on the walls of our arteries and veins. These mineral deposits form plaques, thereby increasing the risk of stroke and blood clots.

A scientific study carried out by medical experts found that “those who consumed 4,069 mg of potassium per day had a 49 percent lower risk of death from ischemic heart disease compared with those who consumed about 1,000 mg per day.”

Diabetes

Diabetes has turned into a global problem. The soaring prevalence of diabetes has burgeoned as “the epidemic of the century.” Once considered most common among older people, it now affects younger adults as well, owing to sedentary lifestyles and poor diets. According to the IDF (International Diabetes Federation), in 2017, the global number of adults with diabetes remained approximately 425m (20-79 years). IDF further stated that by 2045, the figure could reach a staggering 629m. 

Studies made by health care professionals have come to new findings that lower levels of Potassium in the body are also associated with a higher risk of diabetes. Patients with type 2 diabetes mellitus are at a high risk of ESRD (kidney failure or end-stage renal disease) and CVD (cardiovascular disease), both of which can result in life-threatening complications.  

A study by Dr Shin-ichi Araki and several of his co-researchers in the Clinical Journal of the American Society of Nephrology found that diets rich in Potassium may help protect heart and kidney health in patients with type 2 diabetes. The experiment included 623 Japanese people with type 2 diabetes.  The trial ran from 1996 to 2003 with a median follow-up period of 11 years. The results showed that higher levels of Potassium in participants' urine were associated with a lower risk of renal dysfunction and cardiovascular problems.

Bone and muscle maintenance

A diet high in Potassium is closely related to bone health. Potassium-rich foods generate alkali in the body to maintain acid-base balance. A high intake of protein-rich or acidifying foods, such as meat, dairy products, and processed cereals, can lead to acidosis, which can have adverse effects on our bones and muscles.

Metabolic acidosis leads to increased nitrogen excretion, resulting in loss of bone mineral density and muscle wasting. On the other hand, potassium-rich foods like vegetables and fruits help neutralize the adverse effects of acidosis buildup in our bodies. Older people, too, benefit from eating potassium-rich foods like fruits and vegetables, which preserve their muscle mass and enhance bone density as well.

Caveat

The intake of Potassium, as prescribed by a health care professional, is very beneficial to our overall health. Care should be taken, however, not to exceed the recommended daily dose of 4,700mg. Individuals with no health problems can easily eliminate excess amounts through their urine with no adverse effects. Food-related potassium toxicity is considered a rarity, but excessive consumption can lead to a complication called hyperkalemia. Our body cannot do without Potassium. However, it does not need to be in excess. The kidneys come to the rescue and reject the unwanted Potassium from the blood.

In kidney disease, excess Potassium can be dangerous because the kidneys fail to remove it, leaving it in the blood. Following this can have grave results, even life-threatening ones, and the condition is called hyperkalemia. All health care providers always advise against a high intake of Potassium, especially in patients who have dysfunctional kidney problems and are on supplements. Potassium levels between 5.1 and 6.0 mmol/L are considered high and need immediate consultation. Levels higher than 6.0 mmol/L are dangerous.

Beetroots

Bottom line

Diet, not supplements, is the best source of Potassium to meet your body’s requirements. “Let food be thy medicine, and let medicine be thy food.” Those words were said by the ancient Greek founder of Western medicine, Hippocrates of Kos, during the Classical Greek period in the 5th century BC. No further words sound true right to this day. Eat right, stay healthy!

Disclaimer: The views expressed in the above text are solely research-based, and the dietary information cited does not constitute any medical advice. The author solicits the reader’s discretion and cross-references or consultations with a healthcare practitioner for further substantiation. 

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