Abstract
Introduction: Current guidelines for sodium reduction focus on total daily sodium consumption (<2300 mg/d) for an intake of 2100 kcal. However, calorie consumption varies substantially. Here, we quantify mean sodium intake, calorie intake, and sodium density across demographic groups in the US and over time. Hypothesis: We hypothesized that, compared to sodium density, total sodium may overestimate adherence to sodium recommendations, especially in older adults. Methods: In the National Health and Nutrition Examination Survey (NHANES), weighted mean sodium and energy intake was estimated in US adults as the average of two 24-hour dietary recalls. Sodium density was calculated as the mg of sodium per 1,000 kcal consumed. The prevalence of adherence to sodium intake (<2300 mg/d) and sodium density (<1.1 mg/kcal) limits was quantified by age group, self-reported sex, self-reported race/ethnicity, Calorie level (<2100 kcal, ≥2100 kcal), and self-reported high blood pressure. Adherence prevalence estimates were compared between 2005-2006 and 2015-2016 survey periods by logistic regression adjusted for age, sex, and race/ethnicity. Methods: In 2015-2016, 24.8% of the US population (mean age 38 yr, 51% female, 12% black) adhered to the recommended <2300 mg/d sodium intake, but only 5.6% achieved the recommended 1.1 mg/kcal sodium density (Table). In 2005-2006, these figures were 26.5% and 8.9%, respectively. While there was no change in adherence by total sodium consumption (P = 0.11), adherence by sodium density was significantly lower in 2015-2016 than 2005-2006 (P < 0.001). The difference in adherence between total sodium and sodium density goals was greater among older adults (≥70 years), women, Hispanic adults, and adults consuming <2100 kcal per day. Conclusions: In 2015-2016, <6% of US adults consumed sodium densities at recommended levels. The prevalence of those achieving these goals is lower compared to 10 years prior. Further efforts to regulate population sodium intake are urgently needed.
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