Abstract
An individual’s sodium to potassium intake ratio (Na:K) has been shown to be an important predictor of hypertension. The aim of this study was to estimate the mean 24 h urinary Na, K and Na:K of Irish adults and to identify the foods that determine Na:K in a nationally representative sample of Irish adults. This study was based on data from the Irish National Adult Nutrition Survey (2008–2010) (NANS), which collected spot urine samples and dietary data in a nationally representative sample of Irish adults aged 18+ years. The mean urinary molar Na:K of Irish men and women was 1.90 and 2.15, respectively, which exceed target molar ratios of ≤1.0 and ≤2.0. The mean estimated 24-h urinary excretion of Na was 4631 mg for men and 3525 mg for women, which exceed target maximum population intakes for all gender and age groups. The mean estimated 24-h urinary excretion of K was 3894 mg for men and 2686 mg for women, with intakes in women of all ages and older men (65+ years) below current recommendations. The key foods positively associated with a lower Na:K were fruits, vegetables, potatoes, breakfast cereals, milk, yogurt and fresh meat, while the foods negatively associated with a lower Na:K were breads, cured and processed meats and butters and fat spreads. Strategies to reduce sodium and increase potassium intakes are necessary to lower population Na:K, which may help to reduce the burden of hypertension-related diseases in the Irish population.
Highlights
A diet low in sodium (Na) and high in potassium (K) is widely recommended as a strategy to lower blood pressure and to reduce the risk of cardiovascular disease (CVD), as high blood pressure is a primary risk factor for CVD [1]
This study found that reductions in Na:K had a greater effect on reducing blood pressure than the individual effects of sodium or potassium alone and suggested that lowering of population Na:K would lead to reductions in blood pressure that would enable significant reductions in CVD and mortality rates [9]
The mean 24-h urinary excretion of Na was 4631 mg for men and 3525 mg for women, equivalent to a salt excretion of 11.6 g for men and 8.8 g for women, which are higher than the European Food Safety Authority (EFSA) adequate intake (AI) of 2.0 g/d for sodium and target maximum population salt intakes (
Summary
A diet low in sodium (Na) and high in potassium (K) is widely recommended as a strategy to lower blood pressure and to reduce the risk of cardiovascular disease (CVD), as high blood pressure (hypertension) is a primary risk factor for CVD [1]. The EFSA has set an AI of 3.5 g/d for adults of all ages [6], based on studies showing the blood pressure lowering effects of potassium, with intakes below 3.5 g/d being associated with a higher risk of stroke [7]. While the individual effects of sodium and potassium on blood pressure have been long established, there is a consensus that an individual’s sodium to potassium intake ratio (Na:K) is a more important predictor of hypertension than either sodium or potassium intake alone [1,8,9] This hypothesis is supported by a large body of evidence including findings from INTERSALT; a large world-wide epidemiological study (consisting of over 10,000 adults aged 20–59 years across 32 countries). This study found that reductions in Na:K had a greater effect on reducing blood pressure than the individual effects of sodium or potassium alone and suggested that lowering of population Na:K would lead to reductions in blood pressure that would enable significant reductions in CVD and mortality rates [9]
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