The feasibility of meeting the WHO guidelines for sodium and potassium: a cross-national comparison study

Abstract

Objective: To determine joint compliance with the WHO sodium-potassium goals in four different countries, using data from nationally representative dietary surveys.

Setting: Compared to national and international recommendations and guidelines, the world's population consumes too much sodium and inadequate amounts of potassium. The WHO recommends consuming less than 2000 mg sodium (86 mmol) and at least 3510 mg potassium (90 mmol) per person per day.

Participants: Dietary surveillance data were obtained from the National Health and Nutrition Examination Survey (NHANES 2007-2010) for the USA; the Encuesta Nacional de Salud y Nutrición 2012 for Mexico; the Individual and National Study on Food Consumption (INCA2) for France; and the National Diet and Nutrition Survey (NDNS) for the UK.

Primary outcome measures: We estimated the proportion of adults meeting the joint WHO sodium-potassium goals in the USA, the UK, France and Mexico.

Results: The upper bounds of joint compliance with the WHO sodium-potassium goals were estimated at 0.3% in the USA, 0.15% in Mexico, 0.5% in France and 0.1% in the UK.

Conclusions: Given prevailing food consumption patterns and the current food supply, implementing WHO guidelines will be an enormous challenge for global public health.

Keywords: EPIDEMIOLOGY; PUBLIC HEALTH.

Figure 1

Distribution of sodium (x axis) and potassium intakes (y axis) in four countries relative to WHO sodium–potassium goals. The proportion of the population meeting the joint goals is shown in the top left hand quadrant of each panel.

Figure 2

Relation between WHO recommendations and survey-weighted medians for sodium and potassium intakes for the four countries. Error bars correspond to IQR (25th and 75th centile).