Saturday, March 9, 2019

Sodium and Potassium Dietary Reference Intake Values Updated in New Report

The Adequate Intake (AI), Dietary Reference Intakes (DRIs) range for Sodium and Potassium has been revised by the National Academies of Sciences, Engineering, and Medicine.

The report reaffirms the sodium AI for individuals ages 14-50, decreases the sodium AIs for children age 1-13, increases the sodium AIs for adults ages 51 and older, and decreases the potassium AIs for individuals age 1 and older.

The report also uses guidance from a 2017 National Academies report to introduce the first DRI specific to chronic disease risk reduction.

Sodium and potassium are interrelated, essential nutrients that play vital functional roles in the body, including being important for nerve signal transmission, muscle contraction, and fluid balance.
The excess intake of both the nutrients have been linked to risk of chronic disease, particularly cardiovascular disease, the report says. Therefore, the committee established a Chronic Disease Risk Reduction Intake (CDRR) for sodium using evidence of the beneficial effect of reducing sodium intake on cardiovascular disease risk, hypertension risk, systolic blood pressure, and diastolic blood pressure. Reductions in intakes that exceed the sodium CDRR are expected to reduce chronic disease risk within the apparently healthy population.
The updated sodium AIs are;
  • Infants 0-6 months 110 mg daily
  • Infants 7-12 months 370 mg daily
  • Children ages 1-3 800 mg daily
  • Ages 4-8 1,000 mg daily
  • Ages 9-13 1,200 mg daily
  • Ages 14 and older 1,500 mg daily 
    For individuals ages 14 and older, the CDRR recommendation is to reduce sodium intakes if above 2,300 mg per day. The committee also established a sodium CDRR for children ages 1-13. The effect of sodium intake on blood pressure that was used to inform the sodium tolerable upper intake level (UL) established in the 2005 DRI report is part of the evidence base that informed the CDRR.

    Most U.S. and Canadian populations consume sodium above both the AI and CDRR values. There is no concern of sodium inadequacy in the population, the report says. Reducing sodium intake has a greater effect on adults with hypertension than on adults with normal blood pressure, but the benefits of reducing sodium intake toward the sodium CDRR or below apply to both groups. 
      The updated potassium AIs are
  • Infants 0-6 months 400 mg daily
  • Infants 7-12 months 860 mg daily
  • Children ages 1-3 2,000 mg daily
  • Ages 4-8 2,300 mg daily
  • Other age groups range from 2,300 to 3,400 mg per day
    The potassium AIs in this report are lower than those established in 2005. This difference is due, in part, to the expansion of the DRI model in which consideration of chronic disease risk reduction was separate from consideration of adequacy.

    This report reaffirms that there is insufficient evidence to establish a potassium UL for apparently healthy individuals. The absence of a potassium UL does not mean that there is no risk from excessive supplemental potassium intake, either overall or for segments of the population. Caution against high intake through supplemental potassium is warranted for certain population groups, particularly those with or at high risk for compromised kidney function.

    The original article was published in The National Academies News, that can be accessed here.


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