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Trends in 24-h urinary sodium excretion in the United States, 1957–2003: a systematic review
Open accessAbstract
Background Few studies have examined temporal trends in sodium intake in the US population. Collections of 24-h urine sodium excretions are reliable markers for dietary sodium intake.Objective We examined temporal trends in 24-h urine sodium excretions to estimate temporal trends in sodium intake in the US population.Design We performed a systematic search of English-language articles in MEDLINE for studies that reported collections of 24-h urine sodium excretions in the United States. We estimated mean urine sodium excretions over time for all studies and demographic subgroups.Results We analyzed 38 studies, which dated from 1957 to 2003, and estimated a mean (± SE) 24-h urine sodium excretion per person of 3526 ± 75 mg Na. In a multivariate random-effects model with study year, sex, age, and race, the study year was not associated with any significant change in sodium excretions (coefficient = 154 mg Na · 24 h⁻¹ · 10 y⁻¹; 95% CI: -140, 448 mg Na · 24 h⁻¹ · 10 y⁻¹). In subgroup analyses, there was no significant temporal trend seen in male, female, black, or white study participants.Conclusion Sodium intake in the US adult population appears to be well above current guidelines and does not appear to have decreased with time.
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“it is rare for anyone to voluntarily follow a diet that low in sodium,19”
From Reducing Dietary Sodium to 1000 mg per Day Reduces Neurovascular Transduction Without Stimulating Sympathetic Outflow (2019) · cites this paper as [19]
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InfluentialMeasuring Population Sodium Intake: A Review of Methods
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“This finding is contrasts with a study by Bernstein and Willet which examined trends in sodium 24 h excretion in US between 1957 and 2003 showing no significant change in sodium excretion over this period [49].”
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“Unlike the trends in the United States, where sodium intake was stable between 1957 and 2003 (43), sodium intake decreased from 6.”
BackgroundResultSodium Intake in Populations: Assessment of Evidence
Strom, B. L., Yaktine, A. L., Oria, M. P., & Nutrition Board (2013) · Cited by 274
Sodium Intake and Cardiovascular Health
O’Donnell, M., Mente, A., & Yusuf, S. (2015) · Circulation Research · doi:10.1161/circresaha.116.303771 · Cited by 208
Body Fluid Dynamics: Back to the Future
Bhave, G., & Neilson, E. G. (2011) · Journal of the American Society of Nephrology · doi:10.1681/asn.2011080865 · Cited by 215
Mhurchú, C. N., Capelin, C., Dunford, E., Webster, J. L., Neal, B. C., & Jebb, S. A. (2010) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.110.004481 · Cited by 201
“However, there is little evidence of temporal decreases over the past several decades (8, 9).”
BackgroundDietary patterns and CVD: a systematic review and meta-analysis of observational studies
Rodríguez‐Monforte, M., Flores‐Mateo, G., & Sánchez, E. (2015) · British Journal Of Nutrition · doi:10.1017/s0007114515003177 · Cited by 181
“These three dietary components have been shown to directly or indirectly increase CVD risk (61 – 63) .”
Estimated 24-Hour Urinary Sodium and Potassium Excretion in US Adults
Cogswell, M. E., Loria, C. M., Terry, A. L., Zhao, L., Wang, C., Chen, T.-C., Wright, J. D., Pfeiffer, C. M., Merritt, R. K., Moy, C. S., et al. (2018) · JAMA · doi:10.1001/jama.2018.1156 · Cited by 172
Divergent trends for gastric cancer incidence by anatomical subsite in US adults
Camargo, M. C., Anderson, W. F., King, J. B., Correa, P., Thomas, C. C., Rosenberg, P. S., Eheman, C. R., & Rabkin, C. S. (2011) · Gut · doi:10.1136/gut.2010.236737 · Cited by 164
The USDA Automated Multiple-Pass Method accurately assesses population sodium intakes
Rhodes, D. G., Murayi, T., Clemens, J. C., Baer, D. J., Sebastian, R. S., & Moshfegh, A. J. (2013) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.112.044982 · Cited by 159
Dietary Sodium Intake in Heart Failure
Gupta, D., Georgiopoulou, V. V., Kalogeropoulos, A. P., Dunbar, S. B., Reilly, C. M., Sands, J. M., Fonarow, G. C., Jessup, M. L., Gheorghiade, M., Yancy, C. W., et al. (2012) · Circulation · doi:10.1161/circulationaha.111.062430 · Cited by 148
Salt intake and cardiovascular disease: why are the data inconsistent?
O'Donnell, M. J., Mente, A., Smyth, A., & Yusuf, S. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs409 · Cited by 125
“In countries such as the USA, there have been’ marked reductions in stroke rates over the last 25 years although the levels of sodium intake appear to have remained constant (perhaps due to the difficulties in implementing a society wide strategy).(62)”
BackgroundWang, C., Cogswell, M. E., Loria, C. M., Chen, T.-C., Pfeiffer, C. M., Swanson, C. A., Caldwell, K. L., Perrine, C. G., Carriquiry, A. L., Liu, K., et al. (2013) · Journal of Nutrition · doi:10.3945/jn.113.175927 · Cited by 122
“The mean urine volume in our study was comparable with that from participants in the Coronary Artery Disease in Young Adults study (C.M. Loria and K. Liu, unpublished data) and INTERSALT participants in Jackson, Mississippi (i.e., 1220 mL for black participants and 1630 mL for white participants) but higher than mean…”
MethodInfluentialKalogeropoulos, A. P., Georgiopoulou, V. V., Murphy, R. A., Newman, A. B., Bauer, D. C., Harris, T. B., Yang, Z., Applegate, W. B., & Kritchevsky, S. B. (2015) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2014.6278 · Cited by 116
DiNicolantonio, J. J., & Lucan, S. C. (2014) · Open Heart · doi:10.1136/openhrt-2014-000167 · Cited by 113
McCarron, D. A., Kazaks, A., Geerling, J. C., Stern, J. S., & Graudal, N. A. (2013) · American Journal of Hypertension · doi:10.1093/ajh/hpt139 · Cited by 105
Kim, H., Yang, T., Choi, S., Wang, Y.-J., Lin, M.-Y., & Liceaga, A. M. (2019) · Scientia Horticulturae · doi:10.1016/j.scienta.2019.108985 · Cited by 96
Longitudinal Change of Perceived Salt Intake and Stroke Risk in a Chinese Population
Li, Y., Huang, Z., Jin, C., Xing, A., Liu, Y., Huangfu, C., Lichtenstein, A. H., Tucker, K. L., Wu, S., & Gao, X. (2018) · Stroke · doi:10.1161/strokeaha.117.020277 · Cited by 92
Health effects of sodium and potassium in humans
Whelton, P. K., & He, J. (2013) · Current Opinion in Lipidology · doi:10.1097/mol.0000000000000033 · Cited by 91
“These high average intakes of dietary Na in the United States general population are consistent with prior experience, whether Na intake was estimated by 24-h dietary recall in a representative sample of the United States general population or by use of gold standard 24 h urinary excretion in nonrepresentative samples…”
BackgroundSodium, Potassium, Blood Pressure, and Cardiovascular Disease in Humans
Whelton, P. K. (2014) · Current Hypertension Reports · doi:10.1007/s11906-014-0465-5 · Cited by 91
Gutiérrez, O. M. (2013) · Advances in Chronic Kidney Disease · doi:10.1053/j.ackd.2012.10.008 · Cited by 96
“Excessive sodium and phosphorus intake has important links to cardiovascular and bone disease in CKD, making food additives a major nutritional risk factor for adverse clinical outcomes in individuals with CKD. Current laws classify sodium- and phosphorus-based food additives as generally safe for public consumption—e…”
BackgroundMüllens, W., Damman, K., Dhont, S., Banerjee, D., Bayés‐Genís, A., Cannata, A. N., Chioncel, O., Čikeš, M., Ezekowitz, J. A., Flammer, A. J., et al. (2024) · European Journal of Heart Failure · doi:10.1002/ejhf.3244 · Cited by 82
Zhou, B., Bentham, J., Cesare, M. D., Bixby, H., Danaei, G., Hajifathalian, K., Taddei, C., Carrillo-Larco, R. M., Djalalinia, S., Khatibzadeh, S., et al. (2018) · International Journal of Epidemiology · doi:10.1093/ije/dyy016 · Cited by 115
Grimes, C. A., Kelley, S.-J., Stanley, S., Bolam, B., Webster, J. L., Khokhar, D., & Nowson, C. A. (2017) · BMC Public Health · doi:10.1186/s12889-017-4451-0 · Cited by 72
“This is similar to other industrialised countries, including the USA and UK, where salt consumption is approximately 10 g/day in males and 8 g/day in females [6, 7].”
BackgroundDietary Sodium Intake and Cardiovascular Mortality: Controversy Resolved?
Alderman, M. H., & Cohen, H. W. (2012) · American Journal of Hypertension · doi:10.1038/ajh.2012.52 · Cited by 68
Patik, J. C., Lennon, S. L., Farquhar, W. B., & Edwards, D. G. (2021) · Nutrients · doi:10.3390/nu13010270 · Cited by 73
“However, as the sodium intake in the United States has been stable since the middle of the twentieth century [74] and a large portion of the population has no interest in reducing their sodium consumption [75], it is crucial that scientists identify non-sodium centered lifestyle changes that may help to counteract the…”
BackgroundCoxson, P. G., Cook, N. R., Joffres, M., Hong, Y., Orenstein, D., Schmidt, S. M., & Bibbins-Domingo, K. (2013) · Hypertension · doi:10.1161/hypertensionaha.111.201293 · Cited by 65
Hundemer, G. L., Baudrand, R. F., Brown, J. M., Curhan, G. C., Williams, G. H., & Vaidya, A. (2017) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2016-3867 · Cited by 63
Reducing the sodium-potassium ratio in the US diet: a challenge for public health
Drewnowski, A., Maillot, M., & Rehm, C. D. (2012) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.111.025353 · Cited by 60
“Reducing the sodium content of the US diet may be a challenge for the food industry (7, 31, 37).”
BackgroundStrategies to Reduce Dietary Sodium Intake
Cobb, L. K., Appel, L. J., & Anderson, C. A. M. (2012) · Current Treatment Options in Cardiovascular Medicine · doi:10.1007/s11936-012-0182-9 · Cited by 67
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
Aldosterone Dysregulation With Aging Predicts Renal Vascular Function and Cardiovascular Risk
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“Average SBP and measures of total and high-density lipoprotein-cholesterol obtained on the LIB diet were used in FRS calculation because the LIB diet approximates the typical ad lib Western diet.(19)”
MethodIndividual efforts to reduce salt intake in China, Japan, UK, USA
Okuda, N., Stamler, J., Brown, I., Ueshima, H., Miura, K., Okayama, A., Saitoh, S., Nakagawa, H., Sakata, K., Yoshita, K., et al. (2014) · Journal of Hypertension · doi:10.1097/hjh.0000000000000341 · Cited by 56
“Bernstein AM, Willett WC. Trends in 24-h urinary sodium excretion in the United States, 1957–2003: a systematic review.”
BackgroundThe role of dietary salt in metabolism and energy balance: Insights beyond cardiovascular disease
Wu, Q., Burley, G., Li, L., Lin, S., & Shi, Y. (2023) · Diabetes Obesity and Metabolism · doi:10.1111/dom.14980 · Cited by 59
“5 = salt).(4) The general average intake of salt reached 10.”
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“Because dietary sodium intake in the US population is well above recommended levels (23), increased physical activity should play an important role in programs aimed at BP reduction in the US general population.”
Sevick, M. A., Piraino, B., St‐Jules, D. E., Hough, L. J., Hanlon, J. T., Marcum, Z. A., Zickmund, S. L., Snetselaar, L. G., Steenkiste, A. R., & Stone, R. A. (2016) · Journal of Renal Nutrition · doi:10.1053/j.jrn.2015.11.006 · Cited by 52
“5 times the tolerable upper intake level.(15,16) Adopting a lower sodium diet may be even more difficult for HD patients, as they may experience greater barriers to dietary change than does the general population (e.”
Firestone, M. J., Beasley, J. M., Kwon, S. C., Ahn, J., Trinh‐Shevrin, C., & Yi, S. S. (2017) · Ethnicity & Disease · doi:10.18865/ed.27.3.241 · Cited by 52
Dietary Sodium Intake and Cardiovascular Mortality: Controversy Resolved?
Alderman, M. H., & Cohen, H. W. (2012) · Current Hypertension Reports · doi:10.1007/s11906-012-0275-6 · Cited by 49
Bobowski, N. K. (2015) · Chemosensory Perception · doi:10.1007/s12078-015-9179-6 · Cited by 48
“…processed food intake than Americans (Intersalt Cooperative Research Group 1988), and (2) there is no data on salt intake prior to the 1950s that might suggest an increase in dietary salt occurred with an increase in consumption of processed foods (Bernstein and Willett 2010; McCarron et al. 2010).”
BackgroundGoldstein, P., & Leshem, M. (2014) · Appetite · doi:10.1016/j.appet.2014.04.008 · Cited by 47
“…decreased sodium in commercially prepared food, increased dietary advice, and product ingredient labeling, are effective in reducing salt intake (Bernstein & Willett, 2010; Bolhuis et al., 2011; Brown, Tzoulaki, Candeias, & Elliott, 2009; Du et al., 2014; He & MacGregor, 2010; Henney et al.,…”
BackgroundSalt, No Salt, or Less Salt for Patients With Heart Failure?
Khan, M. S., Jones, D. W., & Butler, J. (2019) · The American Journal of Medicine · doi:10.1016/j.amjmed.2019.07.034 · Cited by 44
Acute kidney injury in acute heart failure–when to worry and when not to worry?
Banerjee, D., Ali, M. A., Wang, A. Y.-M., & Jha, V. (2024) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfae146 · Cited by 43
“Management of diuretic resistance hence must be multi-faceted, including restriction of dietary sodium to 2–3 g/day [48 ].”
Soltani, S., Kolahdouz‐Mohammadi, R., Shab‐Bidar, S., Vafa, M., & Salehi‐Abargouei, A. (2017) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2017.1363710 · Cited by 44
Effects of salt mixtures on Spanish green table olive fermentation performance
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Beshaw, T., Demssie, K., Tefera, M., & Guadie, A. (2022) · Toxicology Reports · doi:10.1016/j.toxrep.2022.09.009 · Cited by 40
Balancing Sodium and Potassium: Estimates of Intake in a New Zealand Adult Population Sample
McLean, R. M., Edmonds, J., Williams, S., Mann, J. I., & Skeaff, S. A. (2015) · Nutrients · doi:10.3390/nu7115439 · Cited by 39
“Although it is disappointing that sodium intakes appear not to have decreased over this time, this pattern is consistent with estimates of sodium intakes in the United States and other countries over a similar time period [24,25].”
ResultDietary Sodium Adherence Is Poor in Chronic Heart Failure Patients
Basuray, A., Dolansky, M. A., Josephson, R., Sattar, A., Grady, E. M., Vehovec, A., Gunstad, J., Redle, J. D., Fang, J. C.-T., & Hughes, J. W. (2015) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2014.12.016 · Cited by 37
“12 Medical diagnoses were assigned points (1-4) with more severe conditions receiving higher points.”
BackgroundMetabolic rate regulation by the renin–angiotensin system: brain vs. body
Grobe, J. L., Rahmouni, K., Liu, X., & Sigmund, C. D. (2012) · Pflügers Archiv - European Journal of Physiology · doi:10.1007/s00424-012-1096-9 · Cited by 35
“Americans have consumed approximately 3,500 mg of sodium per day for at least the last half century, down from intakes approaching 20 g per day before the widespread use of refrigeration for food storage [5, 64].”
BackgroundGray, C., Gardiner, S. M., Elmes, M. J., & Gardner, D. S. (2015) · British Journal Of Nutrition · doi:10.1017/s0007114515004936 · Cited by 35
“ventricular developed pressure (males, 39 [17-45] vs.”
Kato, N., Kinugawa, K., Sano, M., Kogure, A., Sakuragi, F., Kobukata, K., Ohtsu, H., Wakita, S., Jaarsma, T., & Kazuma, K. (2016) · Patient Preference and Adherence · doi:10.2147/ppa.s100203 · Cited by 34
“…change is very important especially in Japan because the average salt intake of Japanese adults is relatively high (10.2 g /day, 4,017 mg sodium) compared with Western people (eg, Americans consume 8.2 g/day, 3,400 mg sodium), 26,27 and adherence to a low-salt diet was not sufficient in Japan.”
InfluentialGunn, J. P., Barron, J. L., Bowman, B. A., Merritt, R. K., Cogswell, M. E., Angell, S. Y., Bauer, U. E., & Frieden, T. R. (2013) · American Journal of Hypertension · doi:10.1093/ajh/hpt143 · Cited by 33
Kopp, W. (2018) · Nutrition and Metabolic Insights · doi:10.1177/1178638818773072 · Cited by 35
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“An analysis of 38 studies from 1957–2003 did not find any significant temporal trend in 24 h sodium excretion among males or females, or Blacks or Whites participants [28].”
BackgroundUrine Sodium Excretion Increased Slightly among U.S. Adults between 1988 and 2010
Pfeiffer, C. M., Hughes, J. P., Cogswell, M. E., Burt, V. L., Lacher, D. A., LaVoie, D. J., Rabinowitz, D. J., Johnson, C. L., & Pirkle, J. L. (2014) · Journal of Nutrition · doi:10.3945/jn.113.187914 · Cited by 32
“Recently, Bernstein andWillett (8) published results on trends in 24hUNa excretion from a systematic review of 38 U.”
Mason, B., ROSS, L. J., Gill, E., Healy, H. G., Juffs, P., & Kark, A. (2014) · Journal of Renal Nutrition · doi:10.1053/j.jrn.2013.10.004 · Cited by 33
“However, this method is time-consuming, costly, and burdensome, and results fluctuate with variable but small losses in sweat and feces.(28-36) Alternative methods include diet history interviews, which require a narrative description”
BackgroundComparing Sodium Intake Strategies in Heart Failure
Butler, J., Papadimitriou, L., Georgiopoulou, V. V., Skopicki, H. A., Dunbar, S. B., & Kalogeropoulos, A. P. (2015) · Circulation Heart Failure · doi:10.1161/circheartfailure.114.001700 · Cited by 31
Potassium and Hypertension: A State-of-the-Art Review
Sriperumbuduri, S., Welling, P. A., Ruzicka, M., Hundemer, G. L., & Hiremath, S. S. (2023) · American Journal of Hypertension · doi:10.1093/ajh/hpad094 · Cited by 32
Mossavar‐Rahmani, Y., Sotres‐Alvarez, D., Wong, W. W., Loria, C. M., Gellman, M. D., Horn, L. V., Alderman, M. H., Beasley, J. M., Lora, C. M., Siega‐Riz, A. M., et al. (2017) · Journal of Human Hypertension · doi:10.1038/jhh.2016.98 · Cited by 28
Surgical Treatment of Myelomeningocele Carried Out at ‘Time Zero’ Immediately after Birth
Pinto, F. C. G., Matushita, H., Furlan, A. L. B., Alho, E. J. L., Goldenberg, D. C., Bunduki, V., Krebs, V. L. J., & Teixeira, M. J. (2009) · Pediatric Neurosurgery · doi:10.1159/000209285 · Cited by 27
Judd, E. K., Calhoun, D. A., & Warnock, D. G. (2014) · Seminars in Nephrology · doi:10.1016/j.semnephrol.2014.08.007 · Cited by 27
Yatabe, M., Iwahori, T., Watanabe, A., Takano, K., Sanada, H., Watanabe, T., Ichihara, A., Felder, R. A., Miura, K., Ueshima, H., et al. (2017) · Nutrients · doi:10.3390/nu9090951 · Cited by 25
Terry, A. L., Cogswell, M. E., Wang, C., Chen, T., Loria, C. M., Wright, J. D., Zhang, X., Lacher, D. A., Merritt, R. K., & Bowman, B. A. (2016) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.115.121954 · Cited by 26
“Mean sodium excretion from our study also was comparable with results from a systematic review of US studies dating from between 1957 and 2003 (3526 mg overall; 3911 mg for men and 3084 mg for women), which were conducted well before our urine feasibility study (21); a calibration study that compared timed urine spots…”
ResultSodium Restriction in Heart Failure: Benefit or Harm?
Konerman, M. C., & Hummel, S. L. (2014) · Current Treatment Options in Cardiovascular Medicine · doi:10.1007/s11936-013-0286-x · Cited by 25
Assessment of Dietary Sodium and Potassium in Canadians Using 24-Hour Urinary Collection
Mente, A., Dagenais, G. R., Wielgosz, A. T., Lear, S. A., McQueen, M., Zeidler, J. G., Fu, L., DeJesus, J., Rangarajan, S., Bourlaud, A.-S., et al. (2015) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2015.06.020 · Cited by 27
Singer, P., Cohen, H. W., & Alderman, M. H. (2014) · American Journal of Hypertension · doi:10.1093/ajh/hpu141 · Cited by 24
Ruzicka, M., Hiremath, S. S., Steiner, S., Helis, E., Szczotka, A., Baker, P., & Fodor, G. J. (2014) · Journal of Hypertension · doi:10.1097/hjh.0000000000000182 · Cited by 24
“Given the proven relationship between dietary sodium intake and hypertension, the known risk of adverse outcomes of hypertension, as well as the financial, health, and social benefits to be expected individually and public health-wise from following low sodium intake, it is surprising that salt intake remains stagnant…”
BackgroundInfluentialFacts, issues and controversies in salt reduction for the prevention of cardiovascular disease
Cappucci, F., & Capewell, S. (2015) · University of Warwick · doi:10.82444/warw.33693334 · Cited by 23
Twenty‐Two‐Year Population Trends in Sodium and Potassium Consumption: The Minnesota Heart Survey
Meyer, K. A., Harnack, L., Luepker, R. V., Zhou, X., Jacobs, D. R., & Steffen, L. M. (2013) · Journal of the American Heart Association · doi:10.1161/jaha.113.000478 · Cited by 23
“A recent meta-analysis of 24-hour urinary sodium excretion estimates from studies published between 1957 and 2003 supported a small, statistically nonsignificant increase in sodium consumption over time.(10) The use of urinary sodium Table 2.”
Cornélio, M. E., Godin, G., Rodrigues, R. C. M., Agondi, R. D. F., Alexandre, N. M. C., & Gallani, M. C. B. J. (2015) · European Journal of Cardiovascular Nursing · doi:10.1177/1474515115589275 · Cited by 23
Strategies for Reducing Sodium Intake in Bakery Products, a Review
Codină, G. G., Voinea, A., & Dabija, A. (2021) · Applied Sciences · doi:10.3390/app11073093 · Cited by 22
“The amount of sodium needed to maintain homeostasis in adults is extremely low (<500 mg) compared to the average intake of most Americans (>3200 mg) [21].”
BackgroundGrace, X., Bhimla, A., Zhu, L., Beeber, M., Aczon, F., Tan, Y., Quinn, S. B., Khan, O., & Gadegbeku, C. A. (2020) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-020-00781-z · Cited by 23
Science trumps politics: urinary sodium data challenge US dietary sodium guideline
McCarron, D. A., Drüeke, T. B., & Stricker, E. M. (2010) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.110.002709 · Cited by 21
Reducing Salt Intake for Prevention of Cardiovascular Disease—Times Are Changing
Stolarz‐Skrzypek, K., & Staessen, J. A. (2015) · Advances in Chronic Kidney Disease · doi:10.1053/j.ackd.2014.12.002 · Cited by 20
Understanding of sodium content labeled on food packages by Japanese people
Okuda, N., Nishi, N., Ishikawa‐Takata, K., Yoshimura, E., Horie, S., Nakanishi, T., Sato, Y., & Takimoto, H. (2013) · Hypertension Research · doi:10.1038/hr.2013.149 · Cited by 19
Protocol for developing the evidence base for a national salt reduction programme for India
Johnson, C., Mohan, S., Praveen, D., Woodward, M., Maulik, P. K., Shivashankar, R., Amarchand, R., Webster, J. L., Dunford, E., Thout, S. R., et al. (2014) · BMJ Open · doi:10.1136/bmjopen-2014-006629 · Cited by 20
Goff, D. C., Gillespie, C., Howard, G., & Labarthe, D. R. (2012) · Annals of Epidemiology · doi:10.1016/j.annepidem.2012.04.021 · Cited by 18
Dietary Salt Restriction in Heart Failure: Where Is the Evidence?
DiNicolantonio, J. J., Chatterjee, S., & O’Keefe, J. H. (2015) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2015.12.002 · Cited by 19
Diuretics in the Management of Cardiorenal Syndrome
Chitturi, C., & Novak, J. E. (2018) · Advances in Chronic Kidney Disease · doi:10.1053/j.ackd.2018.08.008 · Cited by 19
Potassium urinary excretion and dietary intake: a cross-sectional analysis in 8–10 year-old children
Oliveira, A. C., Padrão, P., Moreira, A. M., Pinto, M., Neto, M., Silva-Santos, T., Madureira, J., Fernandes, E. D. O., Graça, P., Breda, J., et al. (2015) · BMC Pediatrics · doi:10.1186/s12887-015-0374-z · Cited by 19
“Urinary Na and urinary K were converted to mg/day (23 mgNa = 1 mmol Na or 1 mEq Na; 39 mgK = 1 mmol K or 1 mEq K) [44].”
MethodReference intervals for 24 laboratory parameters determined in 24-hour urine collections
Curcio, R., Stettler, H., Suter, P. M., Barman‐Aksözen, J., Saleh, L., Spanaus, K. S., Bochud, M., Minder, E. I., & von Eckardstein, A. (2015) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2014-1041 · Cited by 17
“Therefore, the higher median (135 mmol/24 h) and upper reference level probably reflect the higher than recommended salt intake [28] in the Swiss population, which however is in agreement with many other studies [29, 30].”
ResultUechi, K., Sugimoto, M., Kobayashi, S., & Sasaki, S. (2017) · Journal of Nutrition · doi:10.3945/jn.116.240960 · Cited by 17
“Reports of 24-h urinary sodium excretion from previous surveys and epidemiologic studies would provide data to assess potential trends in sodium intake (19).”
BackgroundOliveira, A. C., Padrão, P., Moreira, A. M., Pinto, M., Neto, M., Silva-Santos, T., Madureira, J., Fernandes, E. D. O., Graça, P., Breda, J., et al. (2016) · BMC Pediatrics · doi:10.1186/s12887-016-0562-5 · Cited by 16
The Cochrane Review of Sodium and Health
Alderman, M. H. (2011) · American Journal of Hypertension · doi:10.1038/ajh.2011.117 · Cited by 17
Urinary Sodium and Potassium Excretion and Carotid Atherosclerosis in Chinese Men and Women
Dai, X., Wang, C., Xu, Y. X., Guan, K., Su, Y., & Chen, Y. (2016) · Nutrients · doi:10.3390/nu8100612 · Cited by 16
“Studies have suggested that exposure to sodium is relatively constant over time at a population level estimated either by 24-h urine sodium excretion [30] or by 24-h dietary recall [31].”
Naturally cured meats: Quality, safety, and chemistry
Sullivan, G. A. (2011) · Iowa State University Digital Repository (Iowa State University) · doi:10.31274/etd-180810-2479 · Cited by 16
“Due to relationship of sodium and hypertension, efforts have been taken to reduce sodium intake over the past half century but little change in intake has occurred (Bernstein & Willett, 2010).”
BackgroundThe Population Risks of Dietary Salt Excess Are Exaggerated
Mente, A., O'Donnell, M. J., & Yusuf, S. (2014) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2014.02.003 · Cited by 14
Essential Minerals: Nutritional Requirements, Dietary Sources, and Deficiencies
Tako, E. (2022) · Nutrition and health · doi:10.1007/978-3-030-82515-7_35 · Cited by 14
What Determines Human Sodium Intake: Policy or Physiology?
McCarron, D. A. (2014) · Advances in Nutrition · doi:10.3945/an.114.006502 · Cited by 15
Bautista‐Gallego, J., Arroyo‐López, F. N., Romero‐Gil, V., Rodríguez‐Gómez, F., Garcı́a, P., & Garrido-Fernández, A. (2013) · Journal of Food Protection · doi:10.4315/0362-028x.jfp-12-504 · Cited by 14
Metadata
- Authors
- Bernstein, A. M., & Willett, W. C.
- Affiliations
- Harvard University (US)
- ORCID
- Willett, Walter C
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2010-11
- Volume
- 92
- Issue
- 5
- Pages
- 1172-1180
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC2954449
- OpenAlex
- W2139499460
- Semantic Scholar
- 806768d9d6a3e9689ebeda05bd3d45dc2dcaf034
- Cited by
- 166
- References
- 78
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 4 · 2023: 5 · 2022: 5 · 2021: 9 · 2020: 3 · 2019: 7 · 2018: 7 · 2017: 12 · 2016: 12 · 2015: 21 · 2014: 18 · 2013: 23 · 2012: 16
- FWCI
- 1.97
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (DK00703)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- sodium intake, 24-hour urinary sodium excretion, temporal trends, dietary sodium, sex differences, racial differences
- MeSH terms
- Diet, Female, Humans, Male, Sodium, Sodium, Dietary, United States, Nutrition Policy
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