US Americans do not meet the joint recommendations for sodium and potassium intake

According to a new US study, dietary guidelines urging people to decrease their sodium intake and simultaneously increase their potassium intake are currently only met by very few of the adult population.

Based on the NHANES 2003–2008 dietary intake data of 12,038 adult men and women aged over 20 years, the study identified those subpopulations to whom the recommended daily 1500 mg and 2300 mg sodium intakes applied and estimated their compliance with joint dietary sodium and potassium intake targets over two 24-hour dietary recalls (1). The study showed that of those recommended to consume below 2300 mg sodium per day, less than 0.12% jointly met the sodium and potassium guidelines. In the 1500-mg/day group, the guidelines were jointly met by less than 0.015% of participants.

The researchers commented that the current analyses seem to point to the difficulty of complying with mul-tiple nutrient requirements simultaneously. In addition, it was judged a potential problem that the potassium and sodium intake targets were formulated in terms of milligrams per person per day, regardless of energy needs. Dealing with a 99.985% non-compliance rate will be a challenge for public health practitioners, while reducing the sodium content of the US diet may be a big challenge for the food industry.

Adult Americans consume too much sodium and not enough potassium (2). Current sodium consumption is estimated at 2300–4500 mg/day, whereas potassium consumption is estimated at 2400–3200 mg/day, de-pending on age and sex. The health consequences of excessive sodium intake and a high sodium/potassium ratio are severe, leading to high blood pressure, heart disease, and stroke (3,4) and a higher risk of all-cause mortality and death as a result of cardiovascular disease (5). Public health recommendations have stressed a reduction in sodium and a simultaneous increase in potassium intake (2). The 2010 Dietary Guidelines advise adult Americans to reduce daily sodium intake to less than 2300 mg per person, with an even lower target of 1500 mg for people over 51, non-Hispanic blacks, and those with diabetes, hyperten-sion, or chronic kidney disease. Current targets relating to potassium intake stand at 4700 mg/day per person (2).

1. Drewnowski A. et al. Reducing the sodium-potassium ratio in the US diet: a challenge for public health. Am J Clin Nutr. Published online July 2012.
   
   
2. US Department of Agriculture, US Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th ed. Washington, DC: US Government Printing Office, 2010.
   
   
3. Cook N. R. et al. Trials of Hypertension Prevention Collaborative Research Group. Joint effects of sodium and potassium intake on subsequent cardiovascular disease: the Trials of Hypertension Prevention Follow-up Study. Arch Intern Med. 2009; 169:32–40.
   
   
4. Strazzullo P. Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. BMJ. 2009; 339:b4567.
   
   
5. Yang Q. et al. Sodium and potassium intake and mortality among US adults: prospective data from the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2011; 171:1183–1191.