Top Food Category Contributors to Sodium and Potassium Intake - United States, 2015-2016

Authors: WOODRUFF, RWBCCA - Centers For Disease Control And Prevention (CDC) - United States; ZHAO, LIXIA - Centers For Disease Control And Prevention (CDC) - United States; Ahuja, Jaspreet; GILLESPIE, CATHLEEN - Centers For Disease Control And Prevention (CDC) - United States; Goldman, Joseph; HARRIS, DIANE - Centers For Disease Control And Prevention (CDC) - United States; JACKSON, SANDRA L - Centers For Disease Control And Prevention (CDC) - United States; Moshfegh, Alanna; Rhodes, Donna; Sebastian, Rhonda; TERRY, ANA - Centers For Disease Control And Prevention (CDC) - United States; COGSWELL, MARY - Centers For Disease Control And Prevention (CDC) - United States

Submitted to: Morbidity and Mortality Weekly Reports
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/15/2020
Publication Date: 8/14/2020
Citation: Woodruff, R.C., Zhao, L., Ahuja, J.K., Gillespie, C., Goldman, J.D., Harris, D.M., Jackson, S., Moshfegh, A.J., Rhodes, D.G., Sebastian, R.S., Terry, A., Cogswell, M. 2020. Top Food Category Contributors to Sodium and Potassium Intake - United States, 2015-2016. Morbidity and Mortality Weekly Reports. 69(32):1064-1069. https://doi.org/10.15585/mmwr.mm6932a3.
DOI: https://doi.org/10.15585/mmwr.mm6932a3

Interpretive Summary: Most Americans consume too much sodium and too little potassium, increasing cardiovascular disease risk. Data about top food contributors may guide interventions. Using dietary intake data from What We Eat In America, National Health and Nutrition Examination Survey 2015-2016, the average U.S. sodium intake was 3,397 mg/day (excluding salt added at the table) among persons aged =1 year. Approximately 40% of intake came from 10 food categories, with intake ranging from 2.7-6.3% across these categories, and mainly included prepared foods with added sodium (e.g., deli meat sandwiches, pizza, burritos and tacos). Average U.S. potassium intake was 2,497 mg/day, and ~43% of intake came from 10 food categories, with intake ranging from 2.9-6.4% across these categories, and included foods naturally low in sodium (e.g., unflavored milk, fruit, vegetables) and prepared foods. Replacing foods that are high in sodium with those naturally low in sodium (e.g., fruits and vegetables without added sodium) may have dual benefits of decreasing sodium and increasing potassium intakes. Monitoring the food categories contributing to their intake may inform cardiovascular disease prevention and control initiatives by public health agencies.

Technical Abstract: Most Americans consume too much sodium and too little potassium, increasing cardiovascular disease risk. Monitoring the top food categories contributing to sodium and potassium intake is needed, as these categories may change over time with changes in the food supply and consumer behavior. Data about top food contributors may guide interventions. We used 2015-2016 What We Eat In America (WWEIA), National Health and Nutrition Examination Survey, a nationally representative survey. Of the 9,165 individuals aged =1 year who completed the survey and examination (62% unweighted response rate), 7,976 were included in this analysis. The 24-hour dietary recall was collected in person by trained interviewers using USDA’s Automated Multiple-Pass Method and food models. Each reported food or beverage was assigned one or more food codes with corresponding nutrient profiles, and total daily intake of energy, sodium, and potassium of respondents were calculated. For this analysis, food codes were grouped into 87 mutually exclusive categories adapted from the WWEIA Food Categories. Sodium and potassium concentration (mg/100 g) was considered in forming these categories. In 2015-2016, average U.S. sodium intake was 3,397 mg/day (excluding salt added at the table) among persons aged =1 year. Approximately 40% of intake came from 10 food categories, with intake ranging from 2.7-6.3% across these categories, and mainly included prepared foods with added sodium (e.g., deli meat sandwiches, pizza, burritos and tacos). Average U.S. potassium intake was 2,497 mg/day, and ~43% of intake came from 10 food categories, with intake ranging from 2.9-6.4% across these categories, and included foods naturally low in sodium (e.g., unflavored milk, fruit, vegetables) and prepared foods. Our results show that dietary sodium and potassium come from a wide variety of commonly consumed foods, suggesting the need for consumer education and changes in the food supply to help consumers improve intake and reduce cardiovascular disease risk.