Abstract 16878: Nationally-representative 24-h Urine Specimens Indicate Most U.S. Adults Consume Excess Dietary Sodium and Not Enough Potassium, National Health and Nutrition Examination Survey (NHANES), 2014

Introduction: Accurate monitoring of population intake is essential for evaluating the impact of sodium reduction strategies, such as sodium targets for manufactured and restaurant foods. Previous nationally representative estimates of U.S. sodium intake were based on dietary recalls rather than 24-h urine collections, the gold standard measure for sodium intake given about 90% is excreted in urine. In contrast, 60%-90% of potassium consumed is excreted in urine. Hypothesis: We hypothesized most U.S. adults aged 20-69 years consume excess sodium and inadequate potassium. Methods: We used 24-h urinary excretion based on complete, timed, collections from a nationally-representative sample of NHANES participants aged 20-69 y in 2014 (n=827, 75% of selected respondents). We estimated usual 24-h sodium and potassium excretion and their ratio. Within-individual, day-to-day variation in 24-h excretion was adjusted using measurement error models with a repeat 24-h urine collection, 4-11 days from the first, among 436 participants. Results: Overall, mean 24-h urinary sodium excretion was 3,662 mg (95% confidence interval [CI], 3,502, 3,822 mg); 89% (95% CI, 84, 93%) of U.S. adults aged 20-69 y excreted ≥2,300 mg (Tolerable Upper Intake). Sodium excretion differed by sex (men, 4,207 mg, 95% CI, 3,984, 4430, mg; women, 3,142 mg, 95% CI, 2,985, 3,299 mg), but not age, race-ethnicity, income, education, body mass index, physical activity, or hypertension. Among pre-hypertensive and hypertensive adults who may benefit from lowering intake further, 99% excreted >1500 mg. Mean 24-h urinary potassium excretion was 2,202 mg (95% CI, 2,098, 2,306 mg) much less than 4700 mg (Adequate Intake). Potassium excretion differed by sex (men, 2,422 mg; women, 1,973 mg) and race-ethnicity (non-Hispanic black, 1,781 mg; non-Hispanic white, 2,328 mg; non-Hispanic white; 2,133 mg non-Hispanic Asian; 2,055 mg Hispanic), but not other examined characteristics. Conclusions: These first nationally-representative estimates of 24-h urinary excretion indicate that most U.S. adults consume excess sodium, potentially benefiting from population sodium reduction. Average 24-h urinary potassium excretion is low, suggesting that intake is low, and varies by race-ethnicity.