Modeling dietary patterns to assess sodium recommendations for nutrient adequacy
Open accessAbstract
Background The 2010 Dietary Guidelines Advisory Committee report contained dietary patterns developed by using nutrient-dense foods. In most cases, low-sodium forms of foods were incorporated into the patterns.Objectives We wanted to determine whether choosing lower-sodium foods could lower the sodium content to 1500 mg without compromising nutrient adequacy. We also explored the effect of choosing typical foods (more calories with higher sodium) and the feasibility of implementing sodium recommendations on a density basis (mg Na/kcal).Design Food patterns developed during the 2010 Dietary Guidelines development process were used as the base for this analysis. Modeling was then used to analyze the effect of substituting lower-sodium foods on nutrient adequacy.Results Sodium amounts in the base model varied directly with energy level (1.0 mg Na/kcal) and ranged from 996 to 3176 mg/d. Amounts in the lowest-sodium model also varied with energy level (~0.5 mg/kcal) and ranged from 500 to 1250 mg/d. A comparison of sodium density for the base and the lowest sodium models showed that sodium in the lowest model is ~50% of the base. For typical food choices, sodium amounts were much higher (1.6-2.0 mg/kcal and 1715-5078 mg/d). Comparison of sodium density for the base and the typical food choice models showed that amounts were 1.6-2.0 times greater than the base.Conclusions By choosing only low-sodium foods, it was possible to construct nutritionally adequate dietary patterns with 1500 mg Na/d. Sodium density (mg Na/kcal) is a practical approach for expressing sodium recommendations.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Cites
Sacks, F. M., Svetkey, L. P., Vollmer, W. M., Appel, L. J., Bray, G. A., Harsha, D., Obarzanek, E., Conlin, P. R., Miller, E. R., Simons-Morton, D. G., et al. (2001) · New England Journal of Medicine · doi:10.1056/nejm200101043440101 · Cited by 5,638 · see citing works
Self-citationDietary Guidelines for Americans, 2010
Marshall, T. A. (2011) · The Journal of the American Dental Association · doi:10.14219/jada.archive.2011.0248 · Cited by 1,401 · see citing works
USDA National Nutrient Database for Standard Reference, Release 22
(2018) · Cited by 1,284 · see citing works
Dietary Guidelines for Americans 2005
SKOLNIK, N., & King, M. (2005) · Family Practice News · doi:10.1016/s0300-7073(05)71075-6 · Cited by 1,072 · see citing works
Strategies to Reduce Sodium Intake in the United States
Institute of Medicine (2010) · National Academies Press eBooks · doi:10.17226/12818 · Cited by 519 · see citing works
MacGregor, G. A., Sagnella, G. A., Markandu, N. D., Singer, D. R. J., & Cappuccio, F. P. (1989) · The Lancet · doi:10.1016/s0140-6736(89)91852-7 · Cited by 270 · see citing works
The DASH Diet, Sodium Intake and Blood Pressure Trial (DASH-Sodium)
SVETKEY, L. P., SACKS, F. M., OBARZANEK, E., VOLLMER, W. M., APPEL, L. J., LIN, P.-H., KARANJA, N. M., HARSHA, D. W., BRAY, G. A., AICKIN, M., et al. (1999) · Journal of the American Dietetic Association · doi:10.1016/s0002-8223(99)00423-x · Cited by 203 · see citing works
Self-citationVital signs: food categories contributing the most to sodium consumption - United States, 2007-2008.
(2012) · PubMed · Cited by 144 · see citing works
Johnson, A. G., Nguyen, T. V., & Davis, D. (2001) · Journal of Hypertension · doi:10.1097/00004872-200106000-00009 · Cited by 126 · see citing works
DIGRADO, F., Mendes, F. T., & SCHROEDER, E. (1964) · The Lancet · doi:10.1016/s0140-6736(64)92628-5 · Cited by 104 · see citing works
Freedman, L. S., Guenther, P. M., Krebs‐Smith, S. M., Dodd, K. W., & Midthune, D. (2010) · Journal of Nutrition · doi:10.3945/jn.110.124594 · Cited by 61 · see citing works
Self-citationUpdated US Department of Agriculture Food Patterns Meet Goals of the 2010 Dietary Guidelines
Britten, P., Cleveland, L., Koegel, K. L., Kuczynski, K. J., & Nickols‐Richardson, S. M. (2012) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2012.05.021 · Cited by 53 · see citing works
Windham, C. T., Wyse, B. W., & Hansen, R. G. (1983) · Journal of the American Dietetic Association · doi:10.1016/s0002-8223(21)00005-5 · Cited by 25 · see citing works
Britten, P., Cleveland, L., Koegel, K. L., Kuczynski, K. J., & Nickols‐Richardson, S. M. (2012) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2012.06.360 · Cited by 18 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Mozaffarian, D. (2016) · Circulation · doi:10.1161/circulationaha.115.018585 · Cited by 2,216 · see citing works
Zhang, Z., Cogswell, M. E., Gillespie, C., Fang, J., Loustalot, F. V., Dai, S., Carriquiry, A. L., Kuklina, E. V., Hong, Y., Merritt, R. K., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0075289 · Cited by 146 · see citing works
Maalouf, J., Cogswell, M. E., Bates, M., Yuan, K., Scanlon, K. S., Pehrsson, P. R., Gunn, J. P., & Merritt, R. K. (2017) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.116.142653 · Cited by 112 · see citing works
Sodium and Sugar in Complementary Infant and Toddler Foods Sold in the United States
Cogswell, M. E., Gunn, J. P., Yuan, K., Park, S., & Merritt, R. K. (2015) · PEDIATRICS · doi:10.1542/peds.2014-3251 · Cited by 74 · see citing works
Trends in the prevalence of excess dietary sodium intake - United States, 2003-2010.
Carriquiry, A. L., Moshfegh, A. J., Steinfeldt, L. C., Cogswell, M. E., Loustalot, F. V., Zhang, Z., Yang, Q., & Tian, N. (2013) · PubMed Central · Cited by 60 · see citing works
Relationship of Sodium Intake and Blood Pressure Varies With Energy Intake
Murtaugh, M. A., Beasley, J. M., Appel, L. J., Guenther, P. M., McFadden, M., Greene, T., & Tooze, J. A. (2018) · Hypertension · doi:10.1161/hypertensionaha.117.10602 · Cited by 58 · see citing works
Self-citationSodium and potassium intakes among US infants and preschool children, 2003–2010
Tian, N., Zhang, Z., Loustalot, F. V., Yang, Q., & Cogswell, M. E. (2013) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.113.060012 · Cited by 55 · see citing works
Jachimowicz-Rogowska, K., & Winiarska‐Mieczan, A. (2023) · Nutrients · doi:10.3390/nu15102393 · Cited by 54 · see citing works
Quader, Z. S., Gillespie, C., Sliwa, S. A., Ahuja, J. K. C., Burdg, J., Moshfegh, A. J., Pehrsson, P. R., Gunn, J. P., Mugavero, K., & Cogswell, M. E. (2016) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2016.09.010 · Cited by 44 · see citing works
Sodium Reduction in US Households’ Packaged Food and Beverage Purchases, 2000 to 2014
Poti, J. M., Dunford, E., & Popkin, B. M. (2017) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2017.1407 · Cited by 36 · see citing works
Ortiz, S. E., Zimmerman, F. J., & Adler, G. J. (2016) · Social Science & Medicine · doi:10.1016/j.socscimed.2016.02.042 · Cited by 35 · see citing works
A Comprehensive Analysis of Sodium Levels in the Canadian Packaged Food Supply
Arcand, J., Au, J., Schermel, A., & L’Abbé, M. R. (2014) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2014.01.012 · Cited by 35 · see citing works
Sodium content in major brands of US packaged foods, 2009
Gillespie, C., Maalouf, J., Yuan, K., Cogswell, M. E., Gunn, J. P., Levings, J. L., Moshfegh, A. J., Ahuja, J. K. C., & Merritt, R. K. (2014) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.113.078980 · Cited by 32 · see citing works
Optimisation Modelling to Assess Cost of Dietary Improvement in Remote Aboriginal Australia
Brimblecombe, J. K., Ferguson, M., Liberato, S., O’Dea, K., & Riley, M. D. (2013) · PLoS ONE · doi:10.1371/journal.pone.0083587 · Cited by 18 · see citing works
Sebastian, R. S., Enns, C. W., Goldman, J. D., Hoy, M. K., & Moshfegh, A. J. (2014) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2014.07.034 · Cited by 17 · see citing works
Dietary Sodium Restriction in Heart Failure: A Recommendation Worth its Salt? ∗
Hummel, S. L., & Konerman, M. C. (2016) · JACC: Heart Failure · doi:10.1016/j.jchf.2015.10.003 · Cited by 14 · see citing works
Salt/Sodium Intake Estimation in Children and Adolescents of Costa Rica
Núñez-Rivas, H. P., Holst-Schumacher, I. I., Blanco‐Metzler, A., Montero-Campos, M. D. L. Á., Campos-Saborío, N., & Benavides-Aguilar, K. (2020) · Food and Nutrition Sciences · doi:10.4236/fns.2020.1110065 · Cited by 8 · see citing works
The association between dietary sodium density and Hashimoto’s thyroiditis in US adults
An, P., Wang, S., Liu, L., Li, X., & Lv, X. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1508195 · Cited by 4 · see citing works
Sodium Content in Packaged Foods by Census Division in the United States, 2009
Lee, A. K., Schieb, L. J., Yuan, K., Maalouf, J., Gillespie, C., & Cogswell, M. E. (2015) · Preventing Chronic Disease · doi:10.5888/pcd12.140500 · Cited by 3 · see citing works
Dwyer, J. T., & Bailey, R. L. (2016) · Springer eBooks · doi:10.1007/978-3-319-43027-0_2 · Cited by 2 · see citing works
Smith, J. L., Lennie, T. A., Chung, M. L., & Mudd‐Martin, G. (2019) · The Journal of Cardiovascular Nursing · doi:10.1097/jcn.0000000000000570 · Cited by 2 · see citing works
Appel, L. J., & Jacobs, D. R. (2017) · American Journal of Epidemiology · doi:10.1093/aje/kwx236 · Cited by 1 · see citing works
Self-citationAustin, I., Akujobi, I. C., & Ofoegbu, D. C. (2023) · Journal of Agriculture and Food Sciences · doi:10.4314/jafs.v20i2.10
- Authors
- Guenther, P. M., Lyon, J. M., & Appel, L. J.
- Affiliations
- Johns Hopkins University (US)
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2013-04
- Volume
- 97
- Issue
- 4
- Pages
- 842-847
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2143816350
- Cited by
- 23
- References
- 14
- Citations by year
- 2025: 1 · 2023: 2 · 2020: 1 · 2019: 1 · 2018: 1 · 2017: 3 · 2016: 4 · 2015: 3 · 2014: 3 · 2013: 4
- FWCI
- 4.31
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Life Sciences › Agricultural and Biological Sciences › Food Science › Nutrition, Health, and Society Studies
- Keywords
- dietary sodium, low-sodium foods, nutritional adequacy, sodium density, dietary habits, energy intake, sodium intake, dietary substitution
- MeSH terms
- Energy Intake, Diet, Feeding Behavior, Humans, Models, Biological, Nutritive Value, Sodium, Sodium, Dietary, Guidelines as Topic, Nutrition Policy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review