Abstract

The 2010 US Dietary Guidelines recommended limiting intake of sodium to 1500 mg/d for people older than 50 years, African Americans, and those suffering from chronic disease. The guidelines recommended that all other people consume less than 2300 mg sodium and 4700 mg of potassium per day. The theoretical feasibility of meeting the sodium and potassium guidelines while simultaneously maintaining nutritional adequacy of the diet was tested using food pattern modeling based on linear programming. Dietary data from the National Health and Nutrition Examination Survey 2001-2002 were used to create optimized food patterns for 6 age-sex groups. Linear programming models determined the boundary conditions for the potassium and sodium content of the modeled food patterns that would also be compatible with other nutrient goals. Linear programming models also sought to determine the amounts of sodium and potassium that both would be consistent with the ratio of Na to K of 0.49 and would cause the least deviation from the existing food habits. The 6 sets of food patterns were created before and after an across-the-board 10% reduction in sodium content of all foods in the Food and Nutrition Database for Dietary Studies. Modeling analyses showed that the 2010 Dietary Guidelines for sodium were incompatible with potassium guidelines and with nutritionally adequate diets, even after reducing the sodium content of all US foods by 10%. Feasibility studies should precede or accompany the issuing of dietary guidelines to the public.

Highlights

  • Americans consume too much sodium and not enough potassium

  • Using a series of linear programming (LP) models, the allowable ranges of sodium and potassium in food patterns that met the ratio of Na-K constraint of 0.49 and met all nutrient recommendations for the 6 sex-age groups were identified and plotted as feasibility areas

  • For the remaining women and younger men, only a few Na-K combinations were compatible with nutritionally adequate diets; these sodium (2300 mg/d) and potassium (4700 mg/d) guidelines were feasible for some population subgroups

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Summary

Introduction

Americans consume too much sodium and not enough potassium. The high ratio of sodium to potassium (Na-K) has been linked to high blood pressure, heart disease, and stroke [1,2,3,4]. In recent analyses of the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) mortality data, higher ratios of Na-K were independently linked to a higher risk of cardiovascular diseases and to higher all-cause mortality [5]. Public health recommendations have stressed that a reduction in sodium intake should be accompanied by a simultaneous increase in potassium intake. The net effect would be to reduce the ratio of Na-K in the American diet.

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