title: Reducing the sodium-potassium ratio in the US diet: a challenge for public health.
abstract: BACKGROUND
  The 2010 Dietary Guidelines emphasized that dietary sodium should be limited to 2300 mg/d, with a lower limit of 1500 mg/d for adults aged >50 y, non-Hispanic blacks, and those with diabetes, hypertension, or chronic kidney disease. The potassium goal remained at 4700 mg/d.
  
  
  OBJECTIVE
  The objective was to identify subpopulations for whom the 1500- or 2300-mg Na/d goals applied and to examine the joint sodium and potassium intakes for these persons.
  
  
  METHODS
  The analyses were based on NHANES 2003-2008 data for 12,038 adult men and women aged ≥20 y. Persons aged >50 y, non-Hispanic blacks, and persons with hypertension, diabetes, and chronic kidney disease were identified. Mean sodium, potassium, and energy intakes were obtained from 2 nonconsecutive 24-h dietary recalls. Historical analyses of the sodium-potassium ratios in the American diet were based on NHANES 1971-2006.
  
  
  RESULTS
  Among persons recommended to consume <2300 mg Na/d, <0.12% jointly met the sodium and potassium guidelines. In the 1500-mg/d group, the guidelines were jointly met by <0.015%. Based on Dietary Guidelines, the corresponding dietary sodium-potassium ratio was either 0.49 (2300/4700) or 0.32 (1500/4700). Historical analyses of NHANES data by age-sex groups from 1971 to 2006 showed that sodium-potassium ratios were never <0.83.
  
  
  CONCLUSIONS
  Joint dietary guidelines for sodium and potassium, intended for most American adults, are currently being met by ≤0.015% of the population. Extraordinary efforts will be needed to meet the recommendations of the Dietary Guidelines.
authors: Nutritional Sciences Program, School of Public Health, University of Washington, Seattle, USA. adamdrew@uw.edu
authors: Adam
authors: A
authors: Drewnowski
authors: Matthieu
authors: M
authors: Maillot
authors: Colin
authors: C
authors: Rehm
mesh_terms: D000328:Adult; D000368:Aged; D016208:Databases, Factual; D004032:Diet; D002149:Energy Intake; D005006:Ethnicity; D005247:Feeding Behavior; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009751:Nutritional Requirements; D017419:Potassium, Dietary / Q000008:administration & dosage / Q000097:blood*; D011634:Public Health; D012982:Sodium, Dietary / Q000008:administration & dosage / Q000097:blood*; D014481:United States; D055815:Young Adult
chemical_list: D017419:Potassium, Dietary; D012982:Sodium, Dietary