Sodium intake among U.S. school-aged children - United States, 2009-2010

Authors: COGSWELL, MARY - Centers For Disease Control And Prevention (CDC) - United States; YUAN, KEMING - Centers For Disease Control And Prevention (CDC) - United States; GUNN, JANELLE - Centers For Disease Control And Prevention (CDC) - United States; GILLESPIE, CATHLEEN - Centers For Disease Control And Prevention (CDC) - United States; SLIWA, SARAH - Centers For Disease Control And Prevention (CDC) - United States; GALUSKA, DEBORAH - Centers For Disease Control And Prevention (CDC) - United States; Moshfegh, Alanna; Rhodes, Donna; Ahuja, Jaspreet; Pehrsson, Pamela; MERRITT, ROBERT - Centers For Disease Control And Prevention (CDC) - United States; BOWMAN, BARBARA - Centers For Disease Control And Prevention (CDC) - United States

Submitted to: Electronic Publication
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/20/2014
Publication Date: 9/12/2014
Citation: Cogswell, M.E., Yuan, K., Gunn, J.P., Gillespie, C., Sliwa, S., Galuska, D.A., Moshfegh, A.J., Rhodes, D.G., Ahuja, J.K., Pehrsson, P.R., Merritt, R., Bowman, B.A. 2014. Sodium intake among U.S. school-aged children - United States, 2009-2010. Electronic Publication. 63(36):789-797.

Interpretive Summary: Excessive sodium intake is linked to increased risk for hypertension in adults with emerging evidence that suggests a similar relationship in children. This report estimates average sodium intake, sodium consumed per calorie, sodium consumption from specific food categories and sources among 2,266 school-aged (6-18 years) participants in the What We Eat in America, NHANES 2009–2010. School-aged children consumed 3,279 mg of sodium daily with the highest total intake and intake per calorie among high school-aged children. Forty-three percent of sodium consumed by all children came from 10 food categories: pizza, bread and rolls, cold cuts/cured meats, savory snacks, sandwiches, cheese, chicken patties/nuggets/tenders, pasta mixed dishes, Mexican-mixed dishes, and soups. Sixty-five percent of sodium consumed came from foods (or ingredients) the participant obtained from the store (e.g., supermarket, warehouse store); 13% from fast food/pizza restaurants, and 9% from from the school cafeteria. Among participants who consumed a school meal, 26.0% of sodium came from school cafeteria foods. Sodium intake in school-aged children is much higher than recommended. This information will help health and nutrition professionals, educators, and policy officials in developing education programs and policy initiatives to lower sodium intake, and for monitoring changes in sodium intakes.

Technical Abstract: A national health objective is to reduce average U.S. sodium intake to 2,300 mg daily to help prevent high blood pressure, a major cause of heart disease and stroke. Identifying common contributors to sodium intake among children can help reduction efforts. Average sodium intake, sodium consumed per calorie, and population proportions of sodium from food categories, as well as place obtained, and eating occasion were estimated among 2,266 school-aged (6-18 years) participants in the What We Eat in America, National Health and Nutrition Examination Survey, 2009–2010. School-aged children consumed 3,279 mg of sodium daily with the highest total intake and intake per kcal among high school-aged children. Forty-three percent of sodium consumed by all children came from 10 food categories: pizza, bread and rolls, cold cuts/cured meats, savory snacks, sandwiches, cheese, chicken patties/nuggets/tenders, pasta mixed dishes, Mexican-mixed dishes, and soups. Among 14-18 vs. 6-10 and 11-13 year old children, 16% vs. 11% of total sodium intake came from fast food/pizza restaurants (P<0.05) and 1.8 vs. 1.5-1.6 mg of sodium per kcal consumed (P<0.05) came from school cafeteria foods. Among children who consumed school meal(s) on the day assessed, 26% of sodium intake came from school cafeteria foods. Thirty-nine percent of sodium was consumed at dinner, followed by lunch, snacks, and breakfast. Sodium intake among school-aged children is much higher than recommended. Multiple food categories, venues, meals, and snacks contribute to sodium intake among school-aged children supporting the importance of population-wide strategies to reduce sodium intake.