Reducing Sodium Intake in Children: A Public Health Investment

Abstract

The antecedents of elevated blood pressure (BP) and its major consequences (cardiovascular disease and stroke) begin in childhood. Higher levels of BP early in life track into adulthood and are associated with subclinical target organ damage in children and adults. Diet behaviors, including the choice of high sodium containing foods, are established during childhood. On average, children, ages 2‐19, consume more than 3,100 mg of sodium per day, with substantially greater sodium intakes in boys than girls. Importantly, studies show that lowering sodium intake in children lowers blood pressure. In view of this evidence, US Dietary Guidelines recommend a reduced sodium intake in children. Current federal nutrition standards include a step‐wise reduction in the sodium levels of school meals. The ultimate goal is to help children achieve daily sodium intakes that do not exceed upper levels recommended by the Institute of Medicine and the Dietary Guidelines for Americans. In summary, available data are sufficiently strong to recommend a lower sodium intake beginning in early in life as an effective and well‐tolerated approach to reducing BP in children. Current efforts to weaken nutrition standards for school meals undermine an effective strategy aimed at improving the health of our children and our nation.

Dietary sodium, dietary potassium, and systolic blood pressure in US adolescents

“…For example, consuming two bananas, one baked potato, or a single cup of tomato sauce or black beans would be sufficient to provide more than 700 mg/d of potassium. Given the well‐studied relationship between dietary sodium and hypertension, substantial public investment has been made in the efforts to reduce sodium intake . While further study is required, if increased potassium is in fact protective against sodium excess, then it is possible that efforts to increase potassium intake or lower the Na + /K + may also have a public health benefit.…”

Changes in School Food Preparation Methods Result in Healthier Cafeteria Lunches in Elementary Schools

“…Current data indicate that the majority of children in the U.S. consume too much sodium in their diets. 17 According to the 2010 Dietary Guidelines of America, children should consume less than 2,300 mg of sodium per day. 18 Typically, children aged 2-19 years will consume more than 3,100 mg of sodium daily.…”

Is too much salt harmful? Yes

“…The aim of TOHP I was to assess the effect of several, non-pharmacological interventions (weight loss, sodium reduction, stress management, and nutritional supplements) on BP reduction. Subjects were comprised of adults with prehypertension (diastolic BP 80-89 Table 1 Sodium intake recommendation for children and adolescents made by the National Academy of Medicine (USA) [8] Age (years)…”

“…Since children have a lower need for sodium, their daily dietary sodium intake is different from that of adults. Recommended sodium intakes vary by age; the reference values from the National Academy of Medicine (USA) are listed in Table 1 [8].…”