Abstract
This cross-sectional study aimed to assess 24-h urinary sodium and potassium excretion in children and the relationships with their family excretion. Using the baseline data of a randomized trial conducted in three cities of China in 2018, a total of 590 children (mean age 8.6 ± 0.4 years) and 1180 adults (mean age 45.8 ± 12.9 years) from 592 families had one or two complete 24-h urine collections. The average sodium, potassium excretion and sodium-to-potassium molar ratio of children were 2180.9 ± 787.1 mg/d (equivalent to 5.5 ± 2.0 g/d of salt), 955.6 ± 310.1 mg/d and 4.2 ± 1.7 respectively, with 77.1% of the participants exceeding the sodium recommendation and 100% below the proposed potassium intake. In mixed models adjusting for confounders, every 1 mg/d increase in sodium excretion of adult family members was associated with a 0.11 mg/d (95% CI: 0.06 to 0.16, p < 0.0001) increase in sodium excretion of children. The family-child regression coefficient corresponds to 0.20 mg/d (95% CI: 0.15 to 0.26, p < 0.0001) per 1 mg/d in potassium and to 0.36 (95% CI: 0.26 to 0.45, p < 0.0001) in sodium-to-potassium molar ratio. Children in China are consuming too much sodium and significantly inadequate potassium. The sodium, potassium excretion and sodium-to-potassium ratio of children are associated with their family excretions in small to moderate extent. Efforts are warranted to support salt reduction and potassium enhancement in children through comprehensive strategies engaging with families, schools and food environments.
Highlights
Using data from a study with two consecutive 24-h urine collections for both children and their adult family members, this study aims to measure the levels of sodium and potassium intake of children and to investigate their correlations within the family so as to provide references for improving the nutrient intake of children in China
This study showed that the mean sodium excretion in children averagely aged
8.6 years was about 2181 mg/d, the mean potassium excretion was about 956 mg/d and the sodium-to-potassium molar ratio was 4.2, with 77.1% above the recommended levels of sodium intake and 100% below the proposed potassium intakes for this age group. This high sodium and low potassium excretion status in children was highly in accordance with the situation in adults, with over 11 g/d salt intake (93.5% above recommended intake) and under 1600 mg/d potassium intake (99.0% under recommended intake) and 5 of sodium-to-potassium ratio in our previous study in adults, indicating that excess sodium and inadequate potassium were prevalent across the whole population in China [4]
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. High blood pressure increases the risk of cardiovascular disease, which is the leading cause of non-communicable diseases, responsible for 31% of all deaths worldwide [1]. Excess dietary sodium intake is an important risk factor of increased blood pressure, while high potassium intake is related to lower blood pressure [2,3]. Our previous study has shown a typical high sodium and low potassium intake pattern in Chinese adults, with sodium positively and potassium inversely related to both systolic and diastolic blood pressure [4]. A recent meta-analysis including the 24-h urine collections of about
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