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. 2020 Sep 10;33(9):825-830.
doi: 10.1093/ajh/hpaa104.

Dietary Sodium Intake and Sodium Density in the United States: Estimates From NHANES 2005-2006 and 2015-2016

Jiun-Ruey Hu  1 , Shivani Sahni  2 , Kenneth J Mukamal  3 , Courtney L Millar  2 , Yingfei Wu  4 , Lawrence J Appel  5 , Stephen P Juraschek  3
Affiliations

Dietary Sodium Intake and Sodium Density in the United States: Estimates From NHANES 2005-2006 and 2015-2016

Jiun-Ruey Hu et al. Am J Hypertens. .

Abstract

Background: In the United States, current guidelines recommend a total sodium intake <2,300 mg/day, a guideline which does not consider kilocalorie intake. However, kilocalorie intake varies substantially by age and sex. We hypothesized that compared with sodium density, total sodium intake overestimates adherence to sodium recommendations, especially in adults consuming fewer kilocalories.

Methods: In the National Health and Nutrition Examination Survey (NHANES), we estimated the prevalence of adherence to sodium intake recommendations (<2,300 mg/day) and corresponding sodium density intake (<1.1 mg/kcal = 2,300 mg at 2,100 kcal) by sex, age, race/ethnicity, and kilocalorie level. Adherence estimates were compared between the 2005-2006 (n = 5,060) and 2015-2016 (n = 5,266) survey periods.

Results: In 2005-2006, 23.1% (95% confidence interval [CI]: 21.5, 24.9) of the US population consumed <2,300 mg of sodium/day, but only 8.5% (CI: 7.6, 9.4) consumed <1.1 mg/kcal in sodium density. In 2015-2016, these figures were 20.9% (CI: 18.8, 23.2) and 5.1% (CI: 4.4, 6.0), respectively. In 2015-2016, compared with 2005-2006, adherence by sodium density decreased more substantially (odds ratio = 0.59; CI: 0.48, 0.72; P < 0.001) than adherence by total sodium consumption (odds ratio = 0.85; CI: 0.73, 0.98; P = 0.03). The difference in adherence between total sodium and sodium density goals was greater among those with lower kilocalorie intake, namely, older adults, women, and Hispanic adults.

Conclusions: Adherence estimated by sodium density is substantially less than adherence estimated by total sodium intake, especially among persons with lower kilocalorie intake. Further efforts to achieve population-wide reduction in sodium density intake are urgently needed.

Keywords: NHANES; blood pressure; health disparities; hypertension; sodium consumption; sodium density.

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References

    1. Aburto NJ, Ziolkovska A, Hooper L, Elliott P, Cappuccio FP, Meerpohl JJ. Effect of lower sodium intake on health: systematic review and meta-analyses. BMJ 2013; 346:f1326. - PMC - PubMed
    1. He FJ, Li J, Macgregor GA. Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials. BMJ 2013; 346:f1325. - PubMed
    1. Whelton PK, Appel LJ, Sacco RL, Anderson CA, Antman EM, Campbell N, Dunbar SB, Frohlich ED, Hall JE, Jessup M, Labarthe DR, MacGregor GA, Sacks FM, Stamler J, Vafiadis DK, Van Horn LV. Sodium, blood pressure, and cardiovascular disease: further evidence supporting the American Heart Association sodium reduction recommendations. Circulation 2012; 126:2880–2889. - PubMed
    1. US Department of Health and Human Services. 2015–2020 Dietary Guidelines for Americans. US Department of Health and Human Services: Washington, DC, 2015, p. 144.
    1. Henney JE, O’Hara JA 3rd, Taylor CL. Sodium-intake reduction and the food industry. N Engl J Med 2019; 381:201–203. - PubMed

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