Souza Anissa Melo, Bezerra Ingrid Wilza Leal, Torres Karina Gomes, Pereira Gabriela Santana, Costa Raiane Medeiros, Oliveira Antonio Gouveia
Postgraduate Program in Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal 59078-900, RN, Brazil.
Nutrition Department, Health Sciences Center, Federal University of Rio Grande do Norte, Natal 59078-900, RN, Brazil.
Nutrients. 2025 Jul 29;17(15):2483. doi: 10.3390/nu17152483.
The sodium-to-potassium (Na:K) ratio in the diet is a critical biomarker for cardiovascular and metabolic health, yet global adherence to recommended levels remains poor.
The objective of this study was to identify dietary determinants of the dietary Na:K ratio and its associations with micronutrient intake and diet quality.
An observational cross-sectional survey was conducted in a representative sample of manufacturing workers through a combined stratified proportional and two-stage probability sampling plan, with strata defined by company size and industrial sector from the state of Rio Grande do Norte, Brazil. Dietary intake was assessed using 24 h recalls via the Multiple Pass Method, with Na:K ratios calculated from quantified food composition data. Diet quality was assessed with the Diet Quality Index-International (DQI-I). Multiple linear regression was used to analyze associations of Na:K ratio with the study variables.
The survey was conducted in the state of Rio Grande do Norte, Brazil, in 921 randomly selected manufacturing workers. The sample mean age was 38.2 ± 10.7 years, 55.9% males, mean BMI 27.2 ± 4.80 kg/m. The mean Na:K ratio was 1.97 ± 0.86, with only 0.54% of participants meeting the WHO recommended target (<0.57). Fast food (+3.29 mg/mg per serving, < 0.001), rice, bread, and red meat significantly increased the ratio, while fruits (-0.16 mg/mg), dairy, white meat, and coffee were protective. Higher Na:K ratios were associated with lower intake of calcium, magnesium, phosphorus, and vitamins C, D, and E, as well as poorer diet quality (DQI-I score: -0.026 per 1 mg/mg increase, < 0.001).
These findings highlight the critical role of processed foods in elevating Na:K ratios and the potential for dietary modifications to improve both electrolyte balance and micronutrient adequacy in industrial workers. The study underscores the need for workplace interventions that simultaneously address sodium reduction, potassium enhancement, and overall diet quality improvement tailored to socioeconomic and cultural contexts, a triple approach not previously tested in intervention studies. Future studies should further investigate nutritional consequences of imbalanced Na:K intake.
饮食中的钠钾比是心血管和代谢健康的关键生物标志物，但全球范围内对推荐水平的依从性仍然很差。
本研究的目的是确定饮食中钠钾比的饮食决定因素及其与微量营养素摄入量和饮食质量的关联。
通过分层比例抽样和两阶段概率抽样相结合的计划，对巴西北里奥格兰德州的制造业工人代表性样本进行了观察性横断面调查，分层依据公司规模和工业部门确定。使用多轮法通过24小时回顾法评估饮食摄入量，并根据量化的食物成分数据计算钠钾比。使用国际饮食质量指数（DQI-I）评估饮食质量。采用多元线性回归分析钠钾比与研究变量之间的关联。
该调查在巴西北里奥格兰德州对921名随机选择的制造业工人进行。样本平均年龄为38.2±10.7岁，男性占55.9%，平均BMI为27.2±4.80kg/m²。平均钠钾比为1.97±0.86，只有0.54%的参与者达到世界卫生组织推荐的目标（<0.57）。快餐（每份增加3.29mg/mg，<0.001）、大米、面包和红肉显著增加了该比例，而水果（-0.16mg/mg）、乳制品、白肉和咖啡具有保护作用。较高的钠钾比与钙、镁、磷以及维生素C、D和E的摄入量较低以及饮食质量较差有关（DQI-I评分：每增加1mg/mg降低0.026，<0.001）。
这些发现凸显了加工食品在提高钠钾比方面的关键作用，以及通过饮食调整改善产业工人电解质平衡和微量营养素充足性的潜力。该研究强调了开展工作场所干预措施的必要性，这些措施要根据社会经济和文化背景，同时解决减少钠摄入、增加钾摄入以及改善整体饮食质量的问题，这一三重方法此前未在干预研究中进行过测试。未来的研究应进一步调查钠钾摄入不平衡的营养后果。
