Sodium and potassium intake, the sodium to potassium ratio, and associated characteristics in older adults, NHANES 2011-2016

Authors: VAUDIN, ANNA - University Of Maryland; WAMBOGO, EDWINA - University Of Maryland; Moshfegh, Alanna; SAHYOUN, NADINE - University Of Maryland

Submitted to: Journal of the Academy of Nutrition and Dietetics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/10/2021
Publication Date: 12/28/2021
Citation: Vaudin, A.M., Wambogo, E.A., Moshfegh, A.J., Sahyoun, N.R. 2021. Sodium and potassium intake, the sodium to potassium ratio, and associated characteristics in older adults, NHANES 2011-2016. Journal of the Academy of Nutrition and Dietetics. 122:(1):64-77. https://doi.org/10.1016/j.jand.2021.06.012.
DOI: https://doi.org/10.1016/j.jand.2021.06.012

Interpretive Summary: The objective of this research is to explore sociodemographic and economic factors associated with usual sodium and potassium intakes and the sodium to potassium ratio of 5,041 adults 50 years and older in the 2011-2012, 2013-14, and 2015-16 National Health and Nutrition Examination Survey (NHANES). It is one of the only studies to examine usual sodium and potassium intakes among older adults. Participants consumed too much sodium and not enough potassium, based on the current recommendations. Only 7.6% of participants consumed the recommended amount of sodium: 0.9% of men and 13.6% of women. Potassium recommendations were met by 29.0% of men and 38.7% of women. Less than 15% of participants consumed a sodium to potassium ratio less than 1.0. Those who were more likely to have a sodium to potassium ratio less than 1.0 included female gender, college education, lower body mass index, and lower blood pressure. A higher sodium to potassium ratio was significantly associated with characteristics that are established risk factors for cardiovascular disease. Education to improve cardiovascular health in older adults should focus not only on reducing sodium intake, but also on increasing potassium intake. The findings of this study may be useful to clinicians, policymakers, and entities focused on population health management to improve cardiovascular health of older adults in the U.S.

Technical Abstract: The objective of this research is to explore sociodemographic and economic factors associated with usual sodium and potassium intakes and the sodium to potassium ratio of 5,041 adults 50 years and older in the 2011-2012, 2013-14, and 2015-16 National Health and Nutrition Examination Survey (NHANES). Estimated usual sodium and potassium intakes were determined and presented as absolute intake, density (per 1000 Kcal) and ratio of usual sodium to potassium intake. Two-tailed t-tests were used to determine significant differences in usual sodium and potassium intakes by sociodemographic and economic characteristics. The Dunnett’s method of adjustment was used to adjust the critical value for sociodemographic and economic characteristics. Linear and logistic regression models were used to assess associations of characteristics with usual sodium and potassium intakes. Statistical hypotheses were tested at the p < 0.05 level of significance. Only 7.6% of participants consumed the recommended amount of sodium: 0.9% of men and 13.6% of women. Potassium recommendations were met by 29.0% of men and 38.7% of women. Less than 15% of participants consumed a sodium to potassium ratio less than 1.0. Characteristics of those who were more likely to have a sodium to potassium ratio less than 1.0 included female gender, college education, lower body mass index, and lower blood pressure. Participants consumed too much sodium and not enough potassium, based on the current recommendations. A higher sodium to potassium ratio was significantly associated with characteristics that are established risk factors for cardiovascular disease. Education to improve cardiovascular health in older adults should focus not only on reducing sodium intake, but also on increasing potassium intake.