Dietary reference values for sodium

Abstract

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) derived dietary reference values (DRVs) for sodium. Evidence from balance studies on sodium and on the relationship between sodium intake and health outcomes, in particular cardiovascular disease (CVD)-related endpoints and bone health, was reviewed. The data were not sufficient to enable an average requirement (AR) or population reference intake (PRI) to be derived. However, by integrating the available evidence and associated uncertainties, the Panel considers that a sodium intake of 2.0 g/day represents a level of sodium for which there is sufficient confidence in a reduced risk of CVD in the general adult population. In addition, a sodium intake of 2.0 g/day is likely to allow most of the general adult population to maintain sodium balance. Therefore, the Panel considers that 2.0 g sodium/day is a safe and adequate intake for the general EU population of adults. The same value applies to pregnant and lactating women. Sodium intakes that are considered safe and adequate for children are extrapolated from the value for adults, adjusting for their respective energy requirement and including a growth factor, and are as follows: 1.1 g/day for children aged 1-3 years, 1.3 g/day for children aged 4-6 years, 1.7 g/day for children aged 7-10 years and 2.0 g/day for children aged 11-17 years, respectively. For infants aged 7-11 months, an Adequate Intake (AI) of 0.2 g/day is proposed based on upwards extrapolation of the estimated sodium intake in exclusively breast-fed infants aged 0-6 months. SummaryFollowing a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver a Scientific Opinion on dietary reference values (DRVs) for the European population, including sodium.Sodium (Na + ) is the dominant cation in the extracellular fluid (ECF) of the body. The functions of sodium lie in its participation in the control of the volume and systemic distribution of total body water; enabling the cellular uptake of solutes; and the generation via interactions with potassium of transmembrane electrochemical potentials.Dietary sodium deficiency is rare in healthy European populations. Sodium chloride and other sodium salts are ubiquitous in the diet, and there are adaptive physiological mechanisms that reduce the losses of sodium in urine, faeces and sweat at low levels of sodium intake. Sodium chloride added during industrial food processing and discretionary use or food preservation is the major source of dietary sodium in Western diets. Other sources of sodium include inherently native sources and sodium-containing food additives, in which sodium may be associated with anions other than chloride.In healthy people, almost all dietary sodium is absorbed, even at very high level of intake. Following absorption, sodium ions are distributed by portal and systemic circulations, where their concentrations are maintained within a narrow range. Up to 95% o...

Dietary Intake and Lifestyle Habits of Children Aged 10–12 Years Enrolled in the School Lunch Program in Greece: A Cross Sectional Analysis

“…Intakes of total sugars were also higher than the 10% of the total daily energy recommended by WHO [ 27 ]. On the other hand, sodium intakes were below the 2g/day EFSA recommendation for the specific age-group [ 28 ]. Similarly, as shown in Table 4 , only meat intake is within the recommended levels and intakes of cereal-potatoes, legumes, vegetables, dairy, seafood and eggs should all be improved.…”

Microplastic contamination of salt intended for human consumption: a systematic review and meta-analysis

“…According to the World Health Organization [100], the daily consumption of sodium should be less than 2000 mg of sodium, which is roughly equivalent to 5 g of salt for adults (>16 years old) and adjusted downwards for children according to their energy needs. The European Food Safety Authority [101] recently agreed that an intake of 2000 mg should be the daily intake limit. Similarly, the U.S. Department of Health & Human Services (HHS) adopting the 2015-2020 Dietary Guidelines for Americans published by the U.S. Department of Health and Human Services and U.S. Department of Agriculture [102] recommends that adults should consume less than 2300 mg of sodium daily.…”

Blood Pressure Effects of Sodium Reduction

“…We defined the mean difference in BP after the intervention as the difference for either SBP or DBP at the end minus the corresponding baseline value in the active and control arms of the trial. We used a reference value of 87 mmol/d, which corresponds to 2 g of sodium (or 5 g of salt), the value recently defined as safe and adequate intake for the European adult population by the European Food Safety Authority 20 and not to be exceeded by World Health Organization 13 and European professional societies, 18 being also close to the slightly lower 14 , 17 and higher 19 values defined by US bodies. We assumed sodium excretion to be identical to sodium intake (or exposure) in this article, on the basis of the very small difference between the 2 values in individuals and populations.…”

“…We assumed sodium excretion to be identical to sodium intake (or exposure) in this article, on the basis of the very small difference between the 2 values in individuals and populations. 20 …”

“…The World Health Organization, professional societies, government agencies, and guidelines recommend sodium intake reduction for prevention and management of high BP. 13 – 20 However, the strength of the sodium–BP relationship has been challenged by some investigators, particularly in individuals without hypertension 3 , 21 and for DBP. 2 To our knowledge, no previous meta-analysis has been able to fully characterize the shape of the dose–response relationship throughout the entire range of dietary sodium exposure while adequately taking into account heterogeneity across the studies.…”