September 11, 2014
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CDC: Children’s sodium intake higher than recommended

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Sodium intake among school-aged children in the United States is higher than CDC recommendations, according to a recent MMWR report.

More than 90% of children in the United States consume too much sodium, based on the Institute of Medicine’s Dietary Guidelines for Americans. The Healthy People 2020 objective aims to reduce sodium intake by 40% and, as a result, reduce risk for hypertension.

Mary E. Cogswell, DrPH, of the CDC’s National Center for Chronic Disease Prevention and Health Promotion, and colleagues assessed data from What We Eat in America, a component of the 2009-2010 National Health and Nutrition Examination Survey, to determine whether the Healthy People 2020 objective of reducing sodium intake to 2,300 mg daily was achieved among children. Study participants (n=2,266), aged 6 to 18 years, were asked to recall what they consumed during 24 hours.

Mary E. Cogswell, DrPH

Mary E. Cogswell

Mean daily sodium intake was 3,279 mg and mean sodium density was 1,638 mg sodium per 1,000 kcal. Sodium intake and density were highest among high school-aged children. Children who qualified for reduced-price school meals had the lowest sodium intake. Sodium consumption was highest among males and did not vary by race/ethnicity or weight.

Forty-three percent of sodium consumed by study participants came from the following food categories: pizza, yeast bread and rolls, cold cuts/cured meats, savory snacks (eg, chips, pretzels and popcorn), sandwiches, cheese, chicken patties, nuggets and tenders, pasta dishes, Mexican-mixed dishes and soups.

Store-bought food accounted for 65.1% of consumed sodium, whereas fast food/pizza restaurants accounted for 13%, school cafeterias accounted for 9.1% and restaurants accounted for 4.9%. Children aged 14 to 18 years had a higher proportion of total sodium intake from fast food or pizza restaurants (15.5%) vs. children aged 6 to 10 years (10.9%) and children aged 11 to 13 years (10.8%). Among children aged 6 to 10 years, 11.7% of sodium consumption was from school cafeteria foods vs. 8.9% among children aged 11 to 13 years and 7.4% among children aged 14 to 18 years.

Fast food and pizza restaurants had the highest mean sodium density of 1,843 mg per 1,000 kcal.

Approximately 39% of sodium intake occurred during dinner, 29.5% at lunch, 16.4% at snacks and 14.9% at breakfast. High school-aged children had a lower proportion of total sodium intake at breakfast compared with younger children.

Store-bought food contributed to 11.3% to 26% of sodium intake on a typical day. School cafeteria food contributed to 7.2% of sodium intake at lunch while fast food and pizza restaurants contributed to 6.6% of sodium intake at dinner.

Thomas R. Frieden

Tom Frieden

“Too many children are consuming way too much sodium, and the result will be risks of high blood pressure and heart disease in the future. Most sodium is from processed and restaurant food, not the salt shaker. Reducing sodium intake will help our children avoid tragic and expensive health problems,” CDC Director Tom Frieden, MD, MPH, said in a press release.

“The Institute of Medicine recommends setting targets for commercially processed restaurant foods to further reduce sodium intake. Complementing this strategy, national nutrition standards for school breakfasts and lunches and almost all foods sold in US schools set phased targets for sodium content starting with the 2014 to 2015 school year, and evidence suggests that reducing sodium content of these foods is achievable. These phased targets are estimated to result in a 25% to 50% sodium reduction in school meals by 2022,” the researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.