Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts, USA.
Am J Hypertens. 2020 Sep 10;33(9):825-830. doi: 10.1093/ajh/hpaa104.
In the United States, current guidelines recommend a total sodium intake <2,300 mg/day, a guideline which does not consider kilocalorie intake. However, kilocalorie intake varies substantially by age and sex. We hypothesized that compared with sodium density, total sodium intake overestimates adherence to sodium recommendations, especially in adults consuming fewer kilocalories.
In the National Health and Nutrition Examination Survey (NHANES), we estimated the prevalence of adherence to sodium intake recommendations (<2,300 mg/day) and corresponding sodium density intake (<1.1 mg/kcal = 2,300 mg at 2,100 kcal) by sex, age, race/ethnicity, and kilocalorie level. Adherence estimates were compared between the 2005-2006 (n = 5,060) and 2015-2016 (n = 5,266) survey periods.
In 2005-2006, 23.1% (95% confidence interval [CI]: 21.5, 24.9) of the US population consumed <2,300 mg of sodium/day, but only 8.5% (CI: 7.6, 9.4) consumed <1.1 mg/kcal in sodium density. In 2015-2016, these figures were 20.9% (CI: 18.8, 23.2) and 5.1% (CI: 4.4, 6.0), respectively. In 2015-2016, compared with 2005-2006, adherence by sodium density decreased more substantially (odds ratio = 0.59; CI: 0.48, 0.72; P < 0.001) than adherence by total sodium consumption (odds ratio = 0.85; CI: 0.73, 0.98; P = 0.03). The difference in adherence between total sodium and sodium density goals was greater among those with lower kilocalorie intake, namely, older adults, women, and Hispanic adults.
Adherence estimated by sodium density is substantially less than adherence estimated by total sodium intake, especially among persons with lower kilocalorie intake. Further efforts to achieve population-wide reduction in sodium density intake are urgently needed.
在美国，目前的指南建议总钠摄入量<2300mg/天，该指南未考虑千卡摄入量。然而，千卡摄入量因年龄和性别而异。我们假设与钠密度相比，总钠摄入量高估了对钠摄入量建议的依从性，尤其是在摄入较少千卡的成年人中。
在全国健康和营养检查调查（NHANES）中，我们按性别、年龄、种族/族裔和千卡水平估计了遵守钠摄入量建议（<2300mg/天）和相应的钠密度摄入量（<1.1mg/kcal=2300mg/2100kcal）的流行率。比较了 2005-2006 年（n=5060）和 2015-2016 年（n=5266）调查期间的依从性估计值。
在 2005-2006 年，美国 23.1%（95%置信区间[CI]：21.5，24.9）的人口每天摄入<2300mg 的钠，但只有 8.5%（CI：7.6，9.4）的人在钠密度中摄入<1.1mg/kcal。在 2015-2016 年，这些数字分别为 20.9%（CI：18.8，23.2）和 5.1%（CI：4.4，6.0）。在 2015-2016 年，与 2005-2006 年相比，钠密度的依从性下降幅度更大（比值比=0.59；CI：0.48，0.72；P<0.001），而总钠摄入量的依从性下降幅度较小（比值比=0.85；CI：0.73，0.98；P=0.03）。在总钠和钠密度目标之间，依从性的差异在热量摄入较低的人群中更大，即老年人、女性和西班牙裔成年人。
与总钠摄入量相比，钠密度估计的依从性要低得多，尤其是在热量摄入较低的人群中。迫切需要进一步努力实现全民减少钠密度摄入量。
