Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA.
Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD.
Am J Clin Nutr. 2017 Aug;106(2):530-540. doi: 10.3945/ajcn.116.145623. Epub 2017 Jul 12.
Approximately 2 in 3 US adults have prehypertension or hypertension that increases their risk of cardiovascular disease. Reducing sodium intake can decrease blood pressure and prevent hypertension. Approximately 9 in 10 Americans consume excess sodium (≥2300 mg/d). Voluntary sodium standards for commercially processed and prepared foods were established in North America, but their impact on sodium intake is unclear. We modelled the potential impact on US sodium intake of applying voluntary sodium standards for foods. We used NHANES 2007-2010 data for 17,933 participants aged ≥1 y to model predicted US daily mean sodium intake and the prevalence of excess sodium intake with the use of the standards of the New York City's National Salt Reduction Initiative (NSRI) and Health Canada for commercially processed and prepared foods. The Food and Nutrient Database for Dietary Studies food codes corresponding to foods reported by NHANES participants were matched to NSRI and Health Canada food categories, and the published sales-weighted mean percent reductions were applied. The US population aged ≥1 y could have reduced their usual daily mean sodium intake of 3417 mg by 698 mg (95% CI: 683, 714 mg) by applying NSRI 2014 targets and by 615 mg (95% CI: 597, 634 mg) by applying Health Canada's 2016 benchmarks. Significant reductions could have occurred, regardless of age, sex, race/ethnicity, income, education, or hypertension status, up to a mean reduction in sodium intake of 850 mg/d in men aged ≥19 y by applying NSRI targets. The proportion of adults aged ≥19 y who consume ≥2300 mg/d would decline from 88% (95% CI: 86%, 91%) to 71% (95% CI: 68%, 73%) by applying NSRI targets and to 74% (95% CI: 71%, 76%) by applying Health Canada benchmarks. If established sodium standards are applied to commercially processed and prepared foods, a significant reduction of US sodium intake could occur.
大约有 2/3 的美国成年人患有高血压前期或高血压,这增加了他们患心血管疾病的风险。减少钠的摄入量可以降低血压,预防高血压。大约有 9/10 的美国人摄入的钠过量(≥2300mg/d)。北美已经为商业加工和准备的食品制定了自愿钠标准,但它们对钠摄入量的影响尚不清楚。我们模拟了在食品中应用自愿钠标准对美国钠摄入量的潜在影响。我们使用了 NHANES 2007-2010 年的数据,该数据来自 17933 名年龄在 1 岁及以上的参与者,根据纽约市国家减盐倡议(NSRI)和加拿大卫生部的标准,对商业加工和准备食品的美国每日平均钠摄入量和过量钠摄入量的流行率进行建模。与 NHANES 参与者报告的食物相对应的食品和营养数据库膳食研究食品代码与 NSRI 和加拿大卫生部的食品类别相匹配,并应用了公布的销售加权平均百分比降低值。应用 NSRI 2014 目标,1 岁及以上的美国人口每天平均钠摄入量可减少 698 毫克(95%可信区间:683,714 毫克),应用加拿大卫生部 2016 年基准,每天平均钠摄入量可减少 615 毫克(95%可信区间:597,634 毫克)。无论年龄、性别、种族/民族、收入、教育程度或高血压状况如何,应用 NSRI 目标,男性年龄在 19 岁及以上的钠摄入量平均减少 850 毫克/天,都可能显著减少。应用 NSRI 目标,年龄在 19 岁及以上的成年人中,每天摄入≥2300 毫克钠的比例将从 88%(95%可信区间:86%,91%)下降到 71%(95%可信区间:68%,73%),应用加拿大卫生部基准将下降到 74%(95%可信区间:71%,76%)。如果将已建立的钠标准应用于商业加工和准备的食品,美国的钠摄入量可能会显著减少。