Estimated 24-Hour Urinary Sodium and Potassium Excretion in US Adults

Cogswell, Mary E.; Loria, Catherine M.; Terry, Ana L; Zhao, Lixia; Wang, Chia‐Yih; Chen, Te Ching; Wright, Jacqueline D.; Pfeiffer, Christine M.; Merritt, Robert; Moy, Claudia S.; Appel, Lawrence J.

doi:10.1001/jama.2018.1156

Cited by 144 publications

(141 citation statements)

References 27 publications

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“…In this study, the Na:K by urine excretion was 1.9; and consequently this increases an individual's risk of CVD [14,15]. Na:K > 1 have also been reported in other adult populations in Australia [18,19,48] and the US [49,50]. Examination of nationally representative data in 2011-2012 from NHANES revealed that only approximately 10% of US adults have a Na:K consistent with WHO guidelines and therefore may have reduced risk of CVD-related mortality [49].…”

Section: Na:ksupporting

confidence: 75%

Dietary Intake and Sources of Potassium in a Cross-Sectional Study of Australian Adults

et al. 2019

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A diet rich in potassium is important to reduce the risk of cardiovascular disease. This study assessed potassium intake; food sources of potassium (including NOVA level of processing, purchase origin of these foods); and sodium-to-potassium ratio (Na:K) in a cross-section of Australian adults. Data collection included 24-h urines (n = 338) and a 24-h diet recall (subsample n = 142). The mean (SD) age of participants was 41.2 (13.9) years and 56% were females. Mean potassium (95%CI) 24-h urinary excretion was 76.8 (73.0–80.5) mmol/day compared to 92.9 (86.6–99.1) by 24-h diet recall. Na:K was 1.9 (1.8–2.0) from the urine excretion and 1.4 (1.2–1.7) from diet recall. Foods contributing most to potassium were potatoes (8%), dairy milk (6%), dishes where cereal is the main ingredient (6%) and coffee/coffee substitutes (5%). Over half of potassium (56%) came from minimally processed foods, with 22% from processed and 22% from ultraprocessed foods. Almost two-thirds of potassium consumed was from foods purchased from food stores (58%), then food service sector (15%), and fresh food markets (13%). Overall, potassium levels were lower than recommended to reduce chronic disease risk. Multifaceted efforts are required for population-wide intervention—aimed at increasing fruit, vegetable, and other key sources of potassium intake; reducing consumption of processed foods; and working in supermarket/food service sector settings to improve the healthiness of foods available.

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Section: Na:ksupporting

confidence: 75%

Dietary Intake and Sources of Potassium in a Cross-Sectional Study of Australian Adults

et al. 2019

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“…The weekly search identified 4141 citations over the period from April 3 to October 30, 2018, of which 19 studies including dietary sodium and health outcomes met the criteria for full review (Table ). These included systematic review and meta‐analyses (n = 2), randomized controlled trials (n = 3, including one post hoc analysis of a randomized controlled trial), a non‐randomized controlled trial (n = 1), prospective cohort studies (n = 4), a retrospective cohort study using population data (n = 1), and cross‐sectional studies (n = 8) . Two studies assessed mortality outcomes, four studies assessed morbidity outcomes, and one study assessed symptoms/quality of life/functional status outcomes .…”

Section: Resultsmentioning

confidence: 99%

“…These included systematic review and meta-analyses (n = 2), 22,23 randomized controlled trials (n = 3, including one post hoc analysis of a randomized controlled trial), [24][25][26] a non-randomized controlled trial (n = 1), 27 prospective cohort studies (n = 4), [28][29][30][31] a retrospective cohort study using population data (n = 1), 32 and cross-sectional studies (n = 8). [33][34][35][36][37][38][39][40] Two studies assessed mortality outcomes, 28,29 four studies assessed morbidity outcomes, [30][31][32][33] and one study assessed symptoms/quality of life/functional status outcomes. 22 Eight studies assessed clinical surrogate outcomes, [23][24][25][26][27][34][35][36] one study assessed physiologic surrogate outcomes, 37 and three studies assessed other outcomes [38][39][40] according to our pre-specified categories.…”

Section: Re Sultsmentioning

confidence: 99%

“…[33][34][35][36][37][38][39][40] Two studies assessed mortality outcomes, 28,29 four studies assessed morbidity outcomes, [30][31][32][33] and one study assessed symptoms/quality of life/functional status outcomes. 22 Eight studies assessed clinical surrogate outcomes, [23][24][25][26][27][34][35][36] one study assessed physiologic surrogate outcomes, 37 and three studies assessed other outcomes [38][39][40] according to our pre-specified categories. Of these, three studies met the minimum methodological criteria for detailed critical appraisal.…”

Section: Re Sultsmentioning

confidence: 99%

See 1 more Smart Citation

Science of Salt: A regularly updated systematic review of salt and health outcomes studies (April to October 2018)

McLean

Petersen

Arcand

et al. 2019

J of Clinical Hypertension

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The Science of Salt reviews identify, summarize, and critically appraise published studies on dietary salt and health outcomes according to pre‐specified methods. This review covers the period April 3 to October 30, 2018. Here, nineteen studies that fit pre‐specified criteria for review and summary are included. Three of these, one prospective cohort study, one randomized controlled trial, and a post hoc analysis of the Dietary Approaches to Stop Hypertension (DASH) sodium trial fulfilled the quality criteria for detailed critical appraisal, including risk of bias assessment, and commentary. Two trials demonstrated a positive association between salt intake and blood pressure. In a cohort of older Italians, increased risk of total mortality was observed with salt intake less than ~16 g/d (6300 mg sodium/d) at baseline; no association existed for incident cardiovascular disease (CVD) or CVD mortality. The paucity of published studies which met our criteria for methodological quality is of concern.

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“…The proportion of males and females were nearly equal across all studies, and age ranged between 18 and 90 years. The majority of studies used 24-hour urine volume and creatinine to assess the completeness of 24-hour urine collection 16,17,[19][20][21][22][23][24][25][26][27] ; while two studies used para-amino benzoic acid (PABA). 28,29 Details on the representativeness of each study are presented in Table 1 (with references).…”

Section: Description Of Studiesmentioning

confidence: 99%

The Science of Salt: Updating the evidence on global estimates of salt intake

Thout

Santos

McKenzie

et al. 2019

J of Clinical Hypertension

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The Global Burden of Disease (GBD) 2010 study estimated national salt intake for 187 countries based on data available up to 2010. The purpose of this review was to identify studies that have measured salt intake in a nationally representative population using the 24‐hour urine collection method since 2010, with a view to updating evidence on population salt intake globally. Studies published from January 2011 to September 2018 were searched for from MEDLINE, Scopus, and Embase databases using relevant terms. Studies that provided nationally representative estimates of salt intake among the healthy adult population based on the 24‐hour urine collection were included. Measured salt intake was extracted and compared with the GBD estimates. Of the 115 identified studies assessed for eligibility, 13 studies were included: Four studies were from Europe, and one each from the United States, Canada, Benin, India, Samoa, Fiji, Barbados, Australia, and New Zealand. Mean daily salt intake ranged from 6.75 g/d in Barbados to 10.66 g/d in Portugal. Measured mean population salt intake in Italy, England, Canada, and Barbados was lower, and in Fiji, Samoa, and Benin was higher, in recent surveys compared to the GBD 2010 estimates. Despite global targets to reduce population salt intake, only 13 countries have published nationally representative salt intake data since the GBD 2010 study. In all countries, salt intake levels remain higher than the World Health Organization's recommendation, highlighting the need for additional global efforts to lower salt intake and monitor salt reduction strategies.

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Estimated 24-Hour Urinary Sodium and Potassium Excretion in US Adults

Abstract: In cross-sectional data from a 2014 sample of US adults, estimated mean sodium intake was 3608 mg per day. The findings provide a benchmark for future studies.

Cited by 144 publications

References 27 publications

Dietary Intake and Sources of Potassium in a Cross-Sectional Study of Australian Adults

Dietary Intake and Sources of Potassium in a Cross-Sectional Study of Australian Adults

Science of Salt: A regularly updated systematic review of salt and health outcomes studies (April to October 2018)

The Science of Salt: Updating the evidence on global estimates of salt intake

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