Introduction:
The 2010 Dietary Guidelines recommend Americans reduce sodium intake and choose foods that contain potassium to decrease the risk of hypertension and subsequent heart disease and stroke. Limited data exist on the proportion of U.S. adults who meet the 2010 Dietary Guidelines for Americans for sodium and potassium.
Hypothesis:
We hypothesized that the majority of U.S. adults do not meet the 2010 Dietary Guidelines for sodium and potassium.
Methods:
We used 24-hour dietary recalls and other data from 12,581 non-institutionalized adults aged > 20 years who participated in the National Health and Nutrition Examination Survey in 2003–2008. We estimated the distributions of usual daily sodium and potassium intakes by sociodemographic and health characteristics relative to the 2010 Dietary Guidelines. Health characteristics included hypertension (use of anti-hypertensive medications, systolic blood pressure > 140 mm Hg or diastolic blood pressure > 90 mm Hg), diagnosed (self report) or undiagnosed diabetes (fasting plasma glucose > 126 mg/dL or glycohemoglobin > 6.5%), and chronic kidney disease (defined by estimated glomerular filtration rate <60 mL/min/1.73 m
2
or urine albumin-creatinine ratio > 30 mg/g). Estimates of usual sodium and potassium intake were adjusted for within-individual, day-to-day variation using measurement error models (Software for Intake Distribution Estimation) with two-24 hour diet recalls on 89.6% of our sample. Standard errors and ninety-five percent confidence intervals were assessed using jack-knife replicate weights.
Results:
Overall, 99.4% (95% confidence interval [CI], 99.3%, 99.5%) and 90.7% (89.6%, 91.8%) of U.S. adults consumed >1500 mg and > 2300 mg sodium daily, respectively. Among U.S. adults recommended to reduce sodium to 1500 mg daily (i.e., African-Americans, age >51 years, or persons with hypertension, diabetes, or chronic kidney disease), 98.8% (98.4%, 99.2%) consumed >1500 mg daily and 60.4% consumed more than double the recommendation, >3000 mg daily. Regardless of sex, age, race-ethnicity, income, education, body mass index, hypertension, diabetes, or chronic kidney disease more than 84% of adults consumed sodium in excess of guidelines. Overall, less than 2% of U.S. adults and ∼5% of U.S. men consumed > 4700 mg potassium daily, i.e., meeting 2010 Dietary Guidelines for potassium.
Conclusions:
Limitations of our analyses include estimation of nutrient intake from 24-hour diet recalls and inability to account for salt added at the table or from supplements, potentially resulting in an underestimation of sodium and potassium intake. In conclusion, most U.S. adults consume too much sodium and too little potassium.
Associations of Alcoholic Beverage Consumption with Dietary Intake, Waist Circumference, and Body Mass Index in US Adults: National Health and Nutrition Examination Survey 2003-2012