Dietary sodium and potassium patterns in adults with food insecurity in the context of hypertension risk

Authors: ONUGHA, ELIZABETH - Baylor College Of Medicine; BANERJEE, ANKONA - Baylor College Of Medicine; HORAHENAGE, D - University Of Nebraska; NOBLEZA, KENNETH - Baylor College Of Medicine; NGUYEN, DUC - Baylor College Of Medicine; RACETTE, SUSAN - Arizona State University; DAVE, JAYNA - Children'S Nutrition Research Center (CNRC)

Submitted to: Nutrition and Health
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/9/2025
Publication Date: 1/12/2026
Citation: Onugha, E.A., Banerjee, A., Horahenage, D.V., Nobleza, K.J., Nguyen, D.T., Racette, S.B., Dave, J. 2026. Dietary sodium and potassium patterns in adults with food insecurity in the context of hypertension risk. Nutrition and Health. https://doi.org/10.1177/02601060251410454.
DOI: https://doi.org/10.1177/02601060251410454

Interpretive Summary: This study explored why food insecurity is consistently linked to This study explored why food insecurity is consistently linked to higher hypertension risk by examining the dietary pathways that may underline this association. Researchers examined nationally representative NHANES data and found that food-insecure adults consume significantly less potassium and are more likely to have a higher sodium-to-potassium ratio, a strong predictor of hypertension. Rather than sodium intake alone, this imbalance appears to drive elevated blood pressure risk. The study also suggests that dietary quality, particularly inadequate potassium intake, may be one mechanism through which food insecurity contributes to hypertension risk. Overall, the results indicate that addressing hypertension among food-insecure populations may therefore require interventions that improve access to affordable, potassium-rich foods which may be a critical lever for reducing blood pressure risk and improving cardiovascular outcomes in this group.

Technical Abstract: Food insecurity is associated with an increased risk of hypertension. The aim of this study was to evaluate the role of dietary sodium and potassium intake in the setting of food insecurity on hypertension risk. We performed a cross-sectional analysis of data from 17,015 adults aged 18–65 years who participated in the National Health and Nutrition Examination Survey (2011–2018). We examined the associations between food insecurity, hypertension, and dietary sodium and potassium levels using multivariable logistic regression. Mediation analysis was conducted to explore the potential influence of dietary sodium and potassium intake on the relationship between food insecurity influenced hypertension. Individuals experiencing food insecurity had a significantly lower mean potassium intake (2.5+/-0.03 g) compared to food-secure counterparts (2.74+/-0.02 g). Food insecurity status was significantly associated with an increased likelihood of a higher dietary sodium-to-potassium ratio, an established predictor for hypertension. Adults with food insecurity and hypertension were more likely to have lower dietary potassium intake. Increasing access to healthy foods, particularly potassium-rich foods, for individuals facing food insecurity may contribute to reducing the hypertension prevalence and improving cardiovascular outcomes.