About 90% of Americans consume sodium, a mineral and one of the chemical elements found in salt, at levels higher than those recommended by the 2015-2020 Dietary Guidelines for Americans. Reducing sodium intake at the population level can help lower blood pressure, which may be important in preventing cardiovascular disease, the leading cause of death in the United States. It has been reported that most dietary sodium is obtained from prepackaged foods. Therefore, importance has been attached to food labeling and consumer education campaigns to reduce the sodium intake of the population. Identifying foods that contribute to sodium intake at the population level is also important to encourage consumption of low-sodium foods and target reduction of sodium levels in foods.
Study: Major food sources of sodium in the American diet: using the National Health and Nutrition Examination Survey. Image Credit: Evan Lorne / Shutterstock
The National Health and Nutrition Examination Survey (NHANES) is a cross-sectional health and nutrition survey that is conducted annually and is comprised of non-institutionalized US residents. Analysis of 2015–2016 NHANES data indicated that the consumption of pizza, sandwiches, chicken, bread, mixed (Mexican) entrees, tortillas, and bagels were the top sources of sodium in the American diet. Additionally, food categories identified by the Dietary Guidelines Advisory Committee (DGAC) are also considered significant dietary contributors to dietary sodium, as well as other key nutrients and food groups. Therefore, understanding how the major dietary sources of sodium will contribute to nutrient, energy, and food group intakes will help monitor the quality of the national diet against recommended practices. However, research is required to analyze which major contributing food categories affect 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 major food categories that contribute 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 exam as well as a 24-hour Automated Multiple Pass Method (AMPM) dietary retreat in person at a Mobile Exam Center. Participants also had to complete a second 24-h dietary reminder by phone 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 the food categories within the 2017-2018 NHANES dietary intake data. Finally, all the FNDDS food codes were combined into 87 categories.
The results indicated that the top 15 food categories contribute 50.83 percent of sodium intake, which include bagels and buns, bread, pizza, burritos and tacos, soups, luncheon meats and sausages, poultry, salty snacks, side dishes, meat mixes, burgers, pasta combo plates, sausages, bacon, vegetables, frankfurters, cakes and brownies, biscuits and chicken nuggets.
The percentage sodium intake from these food categories was reported to range from 49.1% in men 51-70 years to 56.3% in men 9-13 years. The percentage contribution was found to be constant for all race and family income level groups. Burritos and tacos were reported to have the most daily sodium, while steaks and chicken nuggets had the least. Pizza was reported to have the highest mean sodium intake per capita, while vegetables had the lowest. However, average daily sodium intake was reported to be higher in deli meats and cured meats for some subgroups.
Thus, the current study showed that the top 15 contributing categories accounted for just over 50 percent of the total dietary intake of sodium for Americans. In addition, it helped to understand the main sources of sodium intake among the general US population and population subgroups. Therefore, the findings of this study can be used to reduce sodium intake and promote healthy eating in the United States.
The study has certain limitations. First, the results cannot be generalized to subpopulations not included in the NHANES. Second, information on dietary intake may be biased due to memory errors. Third, the 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 bias, as well as misestimation of serving sizes.