Abstract: About 90% of Americans exceed recommended sodium intakes. The top 15 sodium food contributors have been previously identified, but their dietary contributions to other nutrients and food groups are unknown. The objective was to determine nutrient and food group contributions of the top food sources of sodium to the diets of the US population overall and by age/sex, ethnicity, and incom Data from a single 24-hour dietary recall from the 2017–2018 National Health and Nutrition Examination Survey (NHANES), with corresponding nutrient databases, were used. A population-ratio approach was used to estimate macro- and micronutrient contributions. Food group contributions were calculated as the proportion consumed from the top sodium sources in relation to overall population food group intakes. NHANES weights, strata, and primary sampling units were used to adjust for the complex sample survey design to ensure nationally representative results. Among the top sodium contributors (ie, pizza, breads/rolls/buns, cold cuts/meats, soups, burritos/tacos, savoury snacks, poultry, cheese, pasta, burgers, meat, cookies/brownies/cakes, bacon/frankfurters/sausages, vegetables, and chicken nuggets), pizza provided moderate amounts of iron, folate, and calcium, and cheese was a major source of calcium and vitamin D, but both contributed significantly to energy, saturated fat, and sodium intakes. Cakes, cookies, and brownies were among the top contributors to sodium intakes but provided limited nutritional value. Vegetables were a good source of fiber and potassium. Vegetables, pasta, burritos/tacos, and pizza contributed 4% to >6%), while higher-income groups consumed more folate and fiber from breads and vegetables (>3% to >9%). Asian Americans obtained more iron from breads (10.42%), soups (4.69%), and vegetables (5.57%), and older adults consumed more fiber (>11%) from these sources. Younger ages had higher protein intake from chicken nuggets compared with other age groups. Major sources of sodium also contribute key nutrients (such as iron, calcium, potassium, among others), with variation across foods and population groups. While reducing high-sodium food intake is a dietary goal, reformulating products to lower sodium by 10% to 30%, such as combination foods, bread and bakery products, soups, snack foods, and processed vegetables, has been shown to be feasible without compromising acceptability, but should also be implemented in ways to preserve the nutrient contributions of these foods. Along with dietary patterns, strategies should consider sociodemographic patterns and support lower-sodium alternatives to advance public health.
Ahmed et al. (Thu,) studied this question.