Modeling dietary patterns to assess sodium recommendations for nutrient adequacy

Guenther, Patricia M.; Lyon, Joan; Appel, Lawrence J.

doi:10.3945/ajcn.112.047779

Cited by 20 publications

(18 citation statements)

References 8 publications

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“…26 However, Guenther and colleagues 27 have demonstrated that it is possible to choose nutritionally adequate diets at recommended sodium levels, and registered dietitian nutritionists may find their description of how they selected lowest-sodium items useful when determining options for healthier, lower-sodium sandwiches. For example, in creating their "lower-sodium model," they used no-salt-added foods when available, substituted cooked Sandwiches were defined as line items from the WWEIA, NHANES Individual Foods File that were assigned food codes that fell into the WWEIA Food Category "Mixed Dishes-sandwiches (single code)" 19 and/or consumed as part of a sandwich combination (indicated by a value of 5 for the "combination food type" variable 12 ).…”

Section: Resultsmentioning

confidence: 98%

Sandwiches Are Major Contributors of Sodium in the Diets of American Adults: Results from What We Eat in America, National Health and Nutrition Examination Survey 2009-2010

Sebastian¹,

Enns²,

Goldman³

et al. 2015

Journal of the Academy of Nutrition and Dietetics

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Section: Resultsmentioning

confidence: 98%

Sandwiches Are Major Contributors of Sodium in the Diets of American Adults: Results from What We Eat in America, National Health and Nutrition Examination Survey 2009-2010

Sebastian¹,

Enns²,

Goldman³

et al. 2015

Journal of the Academy of Nutrition and Dietetics

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“…In addition, the authors argued that this approach is not necessarily inconsistent with the Dietary Guidelines (37) given that current sodium intakes are so much higher than recommended amounts. Further research on the effects of early sodium intake on later hypertension would help inform the Dietary Guidelines, including efforts to support development of guidelines for children aged <2 y (38). …”

Section: Discussionmentioning

confidence: 99%

Sodium and potassium intakes among US infants and preschool children, 2003–2010

Tian¹,

Zhang²,

Loustalot³

et al. 2013

The American Journal of Clinical Nutrition

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Background Data are limited on usual sodium and potassium intakes relative to age-specific recommendations and the sodium:potassium ratio in infants and preschoolers, especially among those aged <2 y, who are black or breastfed. Objective The usual sodium intake above the Tolerable Upper Intake Levels (ULs), potassium intakes above Adequate Intakes (AIs), the sodium:potassium ratio, and sodium density (mg/kcal) among US infants and preschoolers by age group, as applicable, were estimated and compared by race-ethnicity and current breastfeeding status. Design Data were analyzed among 3 groups of children (aged 7–11 mo, 1–3 y, and 4–5 y) from the NHANES 2003–2010 by using measurement error models. Results Seventy-nine percent of children aged 1–3 y and 87% of those aged 4–5 y exceeded their sodium UL; among non-Hispanic black children, the estimates were 84% and 97%, respectively. For potassium, 97% of infants, 5% of children aged 1–3 y, and 0.4% aged 4–5 y met their AIs. Compared with non-Hispanic whites and Mexican Americans, non-Hispanic black infants and preschoolers had higher mean sodium density and sodium:potassium ratios. Currently breastfed infants and children consumed, on average, less sodium than those who were not breastfed (382 ± 53 compared with 538 ± 22 mg in those aged 7–11 mo and 1154 ± 88 compared with 1985 ± 24 mg in those aged 1–3 y, respectively), but the sodium:potassium ratio did not differ. Conclusions Most US preschoolers, particularly non-Hispanic blacks, consume too much sodium, and nearly all do not consume enough potassium. Data that suggest that currently breastfed infants consume less sodium than do those who are not breastfeeding merit further investigation.

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“…315 These include potential for incomplete 24-hour urine collections (leading to underestimation of sodium intake, and linked to less compliant, sicker individuals); reverse causation (at-risk subjects, such as those with higher BP or diabetes, actively lowering their sodium intake); confounding by physical activity (which increases total energy consumption, that is correlated with total sodium intake 316 ); and confounding by frailty and other consumption). These limitations together could explain the J-shapes seen in certain observational studies.…”

Section: Nutrients and Cardiometabolic Healthmentioning

confidence: 99%

Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity

2016

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Suboptimal nutrition is a leading cause of poor health. Nutrition and policy science have advanced rapidly, creating confusion yet also providing powerful opportunities to reduce the adverse health and economic impacts of poor diets. This review considers the history, new evidence, controversies, and corresponding lessons for modern dietary and policy priorities for cardiovascular diseases, obesity, and diabetes. Major identified themes include the importance of evaluating the full diversity of diet-related risk pathways, not just obesity and blood lipids; focusing on foods and overall diet patterns, rather than single isolated nutrients; recognizing the complex influences of different foods on long-term weight regulation, rather than simply counting calories; and characterizing and implementing evidence-based strategies, including policy approaches, for lifestyle change. Evidence-informed dietary priorities include increased fruits, nonstarchy vegetables, nuts, legumes, fish, vegetable oils, yogurt, and minimally processed whole grains; and fewer red meats, processed (e.g., sodium-preserved) meats, and foods rich in refined grains, starch, added sugars, salt, and trans fat. More investigation is needed on cardiometabolic effects of phenolics, dairy fat, probiotics, fermentation, coffee, tea, cocoa, eggs, specific vegetable and tropical oils, vitamin D, individual fatty acids, and diet-microbiome interactions. Little evidence to-date supports cardiometabolic relevance of other popular priorities: e.g., local, organic, grass-fed, farmed/wild, non-GMO. Evidence-based personalized nutrition appears to depend more on non-genetic characteristics (e.g., physical activity, abdominal adiposity, gender, socioeconomic status, culture) than genetic factors. Food choices must be strongly supported by clinical behavior change efforts, health systems reforms, novel technologies, and robust policy strategies, including those targeting economic incentives, schools and workplaces, neighborhood environments, and the food system. Scientific advances provide crucial new insights on optimal targets and best practices to reduce burdens of diet-related cardiometabolic diseases.

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Modeling dietary patterns to assess sodium recommendations for nutrient adequacy

Abstract: By choosing only low-sodium foods, it was possible to construct nutritionally adequate dietary patterns with 1500 mg Na/d. Sodium density (mg Na/kcal) is a practical approach for expressing sodium recommendations.

Cited by 20 publications

References 8 publications

Sandwiches Are Major Contributors of Sodium in the Diets of American Adults: Results from What We Eat in America, National Health and Nutrition Examination Survey 2009-2010

Sandwiches Are Major Contributors of Sodium in the Diets of American Adults: Results from What We Eat in America, National Health and Nutrition Examination Survey 2009-2010

Sodium and potassium intakes among US infants and preschool children, 2003–2010

Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity

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