title: Elevated urinary Na/K ratio among Lebanese elementary school children is attributable to low K intake.
abstract: OBJECTIVE
  To estimate total sodium (Na) and potassium (K) intake using non-fasting morning urine specimens among Lebanese elementary (6-10 year old) schoolchildren.
  
  
  METHODS
  A national cross-sectional study was conducted. A multistage cluster sampling procedure was used to select a representative sample of 1403 healthy children from the eight districts of Lebanon. Age, anthropometric measurements, and urine samples were collected and analyzed for Na, K, and creatinine (Cr).
  
  
  RESULTS
  The ratios of Na and K to Cr were 23.93 ± 15.54 mM/mM (4.86 ± 3.16 mg/mg) and 11.48 ± 5.82 mM/mM (3.97 ± 2.01 mg/mg), respectively, and showed differences (P value <0.001) between age groups. No differences were found between boys and girls in all the measured Na and K parameters. The estimated mean Na intake was 96.57 ± 61.67 mM/day (2.220 ± 1.418 g/day or 5.69 ± 3.64 g NaCl/day) and exceeded the upper limit of intake in half the children. Estimated K intake was 46.6 ± 23.02 mM/day (1.822 ± 0.900 g/day), and almost all children failed to meet the recommended daily K intake. The high Na/K ratio (2.361 ± 1.67 mM/mM or 1.39 ± 0.98 mg/mg) resulted from a combination of high Na and low K intake but was mostly affected by K intake.
  
  
  CONCLUSIONS
  About 50 % of children exceeded the recommended daily upper intake for Na, while the majority was below K adequate intake. This unfavorable Na/K ratio is indicative of potentially negative health effects at later stages in life. Interventions aimed at reducing salt intake and increasing consumption of fruits and vegetables are warranted.
authors: Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon.
authors: Carla
authors: C
authors: El Mallah
authors: Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon.
authors: Karina
authors: K
authors: Merhi
authors: Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
authors: Hala
authors: H
authors: Ghattas
authors: Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon.
authors: Dareen
authors: D
authors: Shatila
authors: Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon.
authors: Sirine
authors: S
authors: Francis
authors: Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
authors: Sani
authors: S
authors: Hlais
authors: Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon.
authors: Imad
authors: I
authors: Toufeili
authors: Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon. omar.obeid@aub.edu.lb.
authors: Omar
authors: O
authors: Obeid
mesh_terms: D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007861:Lebanon; D008297:Male; D011188:Potassium / Q000652:urine*; D017419:Potassium, Dietary / Q000008:administration & dosage*; D064167:Recommended Dietary Allowances; D012964:Sodium / Q000652:urine*; D012982:Sodium, Dietary / Q000008:administration & dosage; D013048:Specimen Handling
chemical_list: D017419:Potassium, Dietary; D012982:Sodium, Dietary; D012964:Sodium; D003404:Creatinine; D011188:Potassium
keywords: Lebanese children; Potassium intake; Sodium intake; Urinary potassium-to-creatinine ratio; Urinary sodium-to-creatinine ratio