About 90% of Americans consume sodium, a mineral and one of the chemicals found in salt, at levels higher than recommended by the 2015–2020 Dietary Guidelines for Americans. Reducing sodium intake at a population level can help lower blood pressure, which may be important for preventing cardiovascular disease, the leading cause of death in the United States. Most dietary sodium has been reported to be obtained from prepackaged foods. Therefore, food labeling and consumer education campaigns have been important to reduce sodium consumption by the population. The identification of foods that contribute to sodium consumption at a population level is also important to encourage the consumption of low-sodium foods and to aim at reducing sodium levels in foods.
Study: Top dietary sources of sodium in the American diet—using the National Health and Nutrition Survey. Image credit: Evan Lorne / Shutterstock
The National Health and Nutrition Examination Survey (NHANES) is a cross-sectional health and nutrition survey conducted annually and consists of non-institutionalized US residents. Analysis of NHANES data from 2015–2016 indicated that consumption of pizza, sandwiches, poultry, bread, mixed dishes (Mexican), tortillas, and rolls were the main sources of sodium in Americans’ diets. In addition, food categories identified by the Dietary Guidelines Advisory Committee (DGAC) are also considered to be important dietary contributors to dietary sodium, as well as other essential nutrients and food groups. Therefore, understanding how primary dietary sources of sodium will contribute to nutrient, energy and food group intake will help monitor the quality of the national diet according to recommended practices. However, research is needed to analyze which food categories contribute the most to sodium intake, as well as their effect on different population subgroups, for the development of effective sodium-related nutritional policies, reformulation strategies, and dietary guidance.
A new study in the journal Nutrients aimed to determine the top food category contributors to dietary sodium intake among the US population. It also aimed to provide overall quantitative estimates of sodium intake from these food categories, as well as by race, age, and household income level groups.
about the study
The study involved data from the 2017-2018 NHANES, where participants had to complete a general health screening as well as a 24-hour Automated Multiple Pass Method (AMPM) food recall in a Mobile Testing Center. Participants also had to complete a second 24-hour telephone food recall 3 to 10 days after the first visit to the Center. The amount of sodium in foods consumed by NHANES participants was determined using the United States Department of Agriculture (USDA) Food Composition Database.
The Food and Nutrient Database for Dietary Studies (FNDDS) was used to determine food categories within the NHANES 2017–2018 dietary intake data. Finally, all FNDDS food codes were combined into 87 categories.
Study results
Results indicated that the top 15 food categories contribute 50.83% of sodium intake, which includes rolls, breads, pizzas, burritos and tacos, soups, cold and cured meats, poultry, snacks, mixed meat dishes, hamburgers , mixed pasta dishes, sausages, bacon, vegetables, sausages, cakes and brownies, biscuits and chicken nuggets.
The percentage contribution of sodium by these food categories ranged from 49.1% in men aged 51 to 70 years to 56.3% in men aged 9 to 13 years. It was observed that the percentage contribution is consistent for all racial and family income groups. Burritos and tacos contributed the most daily sodium, while chicken tenders and nuggets contributed the least. Pizza was reported to have the highest average per capita sodium intake, while vegetables had the lowest. However, mean daily sodium intake was higher in cold cuts and cured meats for some subgroups.
Thus, the current study showed that the top 15 contributing categories accounted for about just over 50% of the total dietary sodium intake of Americans. In addition, it helped to understand the main sources of sodium intake among the general US population and population subgroups. Therefore, the results of this study can be used to reduce sodium intake as well as promote healthy eating in the United States.
Limitations
The study has some limitations. First, the results cannot be generalized to subpopulations not included in NHANES. Second, information about food intake can be biased due to recall errors. Third, food categories consist of some heterogeneity that may affect their contribution to dietary sodium intake. Fourth, there may be misreporting of certain foods due to social desirability biases as well as incorrect estimation of portion size.