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Original Investigation
March 27, 2018

Estimated 24-Hour Urinary Sodium and Potassium Excretion in US Adults

Author Affiliations
  • 1National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
  • 2National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
  • 3National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
  • 4IHRC, Atlanta, Georgia
  • 5National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
  • 6National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
  • 7Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins School of Medicine, Baltimore, Maryland
  • 8Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
JAMA. 2018;319(12):1209-1220. doi:10.1001/jama.2018.1156
Key Points

Question  How much dietary sodium do US adults consume?

Findings  In this nationally representative survey of 827 US adults aged 20 to 69 years, mean 24-hour urinary sodium excretion was 3608 mg overall, and was significantly higher among men (4205 mg) than women (3039 mg). Mean 24-hour urinary potassium excretion was 2155 mg overall.

Meaning  These findings may provide a benchmark for future studies.

Abstract

Importance  In 2010, the Institute of Medicine (now the National Academy of Medicine) recommended collecting 24-hour urine to estimate US sodium intake because previous studies indicated 90% of sodium consumed was excreted in urine.

Objective  To estimate mean population sodium intake and describe urinary potassium excretion among US adults.

Design, Setting, and Participants  In a nationally representative cross-sectional survey of the US noninstitutionalized population, 827 of 1103 (75%) randomly selected, nonpregnant participants aged 20 to 69 years in the examination component of the National Health and Nutrition Examination Survey (NHANES) collected at least one 24-hour urine specimen in 2014. The overall survey response rate for the 24-hour urine collection was approximately 50% (75% [24-hour urine component response rate] × 66% [examination component response rate]).

Exposures  24-hour collection of urine.

Main Outcomes and Measures  Mean 24-hour urinary sodium and potassium excretion. Weighted national estimates of demographic and health characteristics and mean electrolyte excretion accounting for the complex survey design, selection probabilities, and nonresponse.

Results  The study sample (n = 827) represented a population of whom 48.8% were men; 63.7% were non-Hispanic white, 15.8% Hispanic, 11.9% non-Hispanic black, and 5.6% non-Hispanic Asian; 43.5% had hypertension (according to 2017 hypertension guidelines); and 10.0% reported a diagnosis of diabetes. Overall mean 24-hour urinary sodium excretion was 3608 mg (95% CI, 3414-3803). The overall median was 3320 mg (interquartile range, 2308-4524). In secondary analyses by sex, mean sodium excretion was 4205 mg (95% CI, 3959-4452) in men (n = 421) and 3039 mg (95% CI, 2844-3234) in women (n = 406). By age group, mean sodium excretion was 3699 mg (95% CI, 3449-3949) in adults aged 20 to 44 years (n = 432) and 3507 mg (95% CI, 3266-3748) in adults aged 45 to 69 years (n = 395). Overall mean 24-hour urinary potassium excretion was 2155 mg (95% CI, 2030-2280); by sex, 2399 mg (95% CI, 2253-2545) in men and 1922 mg (95% CI, 1757-2086) in women; and by age, 1986 mg (95% CI, 1878-2094) in adults aged 20 to 44 years and 2343 mg (95% CI, 2151-2534) in adults aged 45 to 69 years.

Conclusions and Relevance  In cross-sectional data from a 2014 sample of US adults, estimated mean sodium intake was 3608 mg per day. The findings provide a benchmark for future studies.

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