Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/15/2016
Publication Date: 3/9/2016
Citation: Bailey, R.L., Parker, E.A., Rhodes, D.G., Goldman, J.D., Clemens, J.C., Moshfegh, A.J., Thuppal, S.V., Weaver, C.M. 2016. Estimating sodium and potassium intakes and their ratio in the American diet: Data from the 2011-2012 NHANES. Journal of Nutrition. 146:745-750.

Interpretive Summary: Most Americans consume too much sodium and too little potassium; furthermore, the balance between sodium and potassium intake may be more important than intake of either nutrient alone. In order to identify food choices that contribute to sodium and potassium intake of adults, dietary data from What We Eat in America, National Health and Nutrition Examination Survey 2011-2012 were analyzed. Sodium and potassium intakes and the sodium to potassium ratio varied by age, race/ethnicity, and gender. Adults with a sodium to potassium ratio less than 1 (individuals consuming more potassium than sodium) were more likely to consume vegetables, fruit and milk/dairy and less likely to consume mixed dishes and condiments compared to those with a ratio greater than or equal to 1. These data highlight food choices associated with improving sodium to potassium ratio among adults which may be useful in creating dietary interventions to improve health outcomes.

Technical Abstract: Few adults meet the recommendations for sodium or potassium intake, and recent research suggests that the dietary ratio of sodium to potassium (Na:K) is more strongly associated with health outcomes than either nutrient alone. Mean Na:K and food choices contributing to sodium and potassium were analyzed among a nationally-representative sample of U.S. adults aged 20 years and older (n=4,730) from What We Eat in America, National Health and Nutrition Examination Survey 2011-2012. When comparing by gender, females (1.32) had a significantly lower Na:K than males (1.45); Na:K decreased linearly as age increased. When comparing by race/ethnicity, non-Hispanic whites (1.34) had significantly lower Na:K ratios than non-Hispanic blacks (1.54) and Asians (1.49). Adults with Na:K <1.0 were less likely to consume mixed dishes and condiments and more likely to consume vegetables, fruit and milk and dairy than those with Na:K >=1. Mixed dishes and protein foods were the top contributors to sodium regardless of Na:K. Among adults with Na:K <1, nonalcoholic beverages and vegetables were the top contributors of potassium in the diet compared to mixed dishes and protein foods among those with Na:K >=1.0. These data highlight food choices associated with improving Na:K among adults.