Sodium and Potassium Excretion of Schoolchildren and Relationship with Their Family Excretion in China

This cross-sectional study aimed to assess 24-h urinary sodium and potassium excretion in children and the relationships with their family excretion. Using the baseline data of a randomized trial conducted in three cities of China in 2018, a total of 590 children (mean age 8.6 +/- 0.4 years) and 1180 adults (mean age 45.8 +/- 12.9 years) from 592 families had one or two complete 24-h urine collections. The average sodium, potassium excretion and sodium-to-potassium molar ratio of children were 2180.9 +/- 787.1 mg/d (equivalent to 5.5 +/- 2.0 g/d of salt), 955.6 +/- 310.1 mg/d and 4.2 +/- 1.7 respectively, with 77.1% of the participants exceeding the sodium recommendation and 100% below the proposed potassium intake. In mixed models adjusting for confounders, every 1 mg/d increase in sodium excretion of adult family members was associated with a 0.11 mg/d (95% CI: 0.06 to 0.16, p < 0.0001) increase in sodium excretion of children. The family-child regression coefficient corresponds to 0.20 mg/d (95% CI: 0.15 to 0.26, p < 0.0001) per 1 mg/d in potassium and to 0.36 (95% CI: 0.26 to 0.45, p < 0.0001) in sodium-to-potassium molar ratio. Children in China are consuming too much sodium and significantly inadequate potassium. The sodium, potassium excretion and sodium-to-potassium ratio of children are associated with their family excretions in small to moderate extent. Efforts are warranted to support salt reduction and potassium enhancement in children through comprehensive strategies engaging with families, schools and food environments.

Automated summary

Children in China are consuming excess sodium and inadequate potassium. The excretion levels of sodium, potassium, and sodium-to-potassium ratio in children are moderately associated with their family members' excretions. Efforts should be made to reduce salt intake and increase potassium intake in children through comprehensive strategies involving families, schools, and food environments.