Nearly All Americans Exceed Recommended Sodium Intake

Eighty-nine percent of adult Americans and more than 90% of children eat more than the recommended 2300 mg of sodium per day, according to results published in the January 8, 2016, issue of the Morbidity and Mortality Weekly Report.

The study also showed that although people with hypertension may be trying to follow their physician's advice to cut back on sodium, 86% of them still consume more than they should.

"During 2009–2012, despite some differences by age, sex, race/ethnicity, and hypertension status, the vast majority of Americans across all subpopulations exceeded recommendations for sodium intake," write Sandra Jackson, PhD, from the Epidemic Intelligence Service, Centers for Disease Control (CDC), Atlanta, Georgia, and colleagues.

Research has long shown that decreasing sodium intake can help prevent hypertension and associated risk for cardiovascular disease. The 2015 to 2020 Dietary Guidelines for Americans recommend that people aged 14 years and older should eat less than 2300 mg of sodium per day, and that youth aged 2 to 13 years should eat even less than that.

In the study, CDC researchers used the nationally representative National Health and Nutrition Examination Survey to analyze data from 14,728 people for the years 2009 to 2012. Children's sodium intake was assessed by proxy or assisted proxy.

Although results showed that the vast majority of Americans consume too much sodium, some groups consume more than others: Men consumed more sodium than women (98% vs 80%, respectively; P < .001), and adult whites consumed more than blacks (90% vs 85%; P = .02).

People aged 19 to 50 years had the highest sodium intake of all.

Among groups at high risk for cardiovascular disease, those older than 51 years, blacks, and adults with hypertension or prehypertension, three of four ate more than the recommended daily allowance of sodium.

Eighty-six percent of adults with hypertension ate more than the recommended amount of sodium per day compared with 91% of those with prehypertension (P < .001) and 90% of those without hypertension (P = .01).

The authors note that response and recall bias, as well as underreporting of foods and portion sizes, could have limited the study. In addition, estimates of sodium intake did not include salt added at the table or from dietary supplements such as antacids, which can make up 5% to 6% of sodium consumption.

The authors emphasize that heart disease still represents the top killer in the United States, and that these results indicate that American patterns of salt consumption have not changed much during the past decade.

They propose a "multifaceted" strategy to decrease Americans' sodium consumption, including lifestyle adjustments and changes in food production. The latter may be particularly important because added sodium from commercial processing and preparation accounts for the main source of excess sodium in American diets, they point out. Echoing recommendations from the Institute of Medicine, they stress that restaurants and manufacturers should reduce added sodium in their foods.

Several public health initiatives are currently addressing the need to cut back on dietary sodium as a means of preventing cardiovascular disease. These projects include the CDC's Sodium Reduction in Communities Program and the National Sodium Reduction Initiative, among others. In the latter, some corporations have promised to decrease the sodium content of certain foods.

The authors are employees of the Centers for Disease Control.


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Nearly All Americans Exceed Recommended Sodium Intake. Medscape. Jan 11, 2016.

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