Trends in Sodium Intake in Children and Adolescents in the US and the Impact of US Department of Agriculture Guidelines: NHANES 2003-2016

Abstract

To examine trends in sodium intake and the impact of nutritional guidelines in the US pediatric population. Sodium intake data collected between 2003 and 2016 in the US National Health and Nutrition Examination Surveys (NHANES) were analyzed. Trends in intake for individuals aged 4-17years and subgroups based on age, sex, and race and ethnicity were examined. Adherence to US Department of Agriculture guidelines was assessed. A total of 16 013 individuals (50.6% male) were included in the analysis. The median sodium intake was2840mg/day (95% CI, 2805-2875mg/day), decreasing from 2912mg/day (95% CI 2848-2961mg/day) in 2003-2004 to 2787mg/day (95% CI, 2677-2867mg/day) in 2015-2016 (P=.005). Intake increased with age (2507mg/day for individuals aged 4-8, 2934mg/day for those aged 9-13 years, and 3124mg/day for those aged 14-17 years; P<.001) and was greater in males than in females (3053mg/day vs 2624mg/day; P<.001). Caucasians, Hispanics, and African Americans consumed 2860, 2733, and 2880mg/day, respectively (P<.001). Population adherence to US Department of Agriculture recommendations was 25.0% in 2003-2010 and 25.5% in 2011-2016 (P=.677). No age, sex, or racial/ethnicity subgroup had an adherence rate >30% after implementation of pediatric guidelines in2010. Sodium intake remains elevated in all pediatric population segments, and guideline adherence ispoor. A greater effort to reduce sodium consumption is needed to mitigate future cardiovascular disease risk.