Modeling dietary patterns to assess sodium recommendations for nutrient adequacy

Background: The 2010 Dietary Guidelines Advisory Committee report contained dietary patterns developed by using nutrient-dense foods. In most cases, low-sodium forms of foods were incorporated into the patterns. Objectives: We wanted to determine whether choosing lower-sodium foods could lower the sodium content to 1500 mg without compromising nutrient adequacy. We also explored the effect of choosing typical foods (more calories with higher sodium) and the feasibility of implementing sodium recommendations on a density basis (mg Na/kcal). Design: Food patterns developed during the 2010 Dietary Guidelines development process were used as the base for this analysis. Modeling was then used to analyze the effect of substituting lower-sodium foods on nutrient adequacy. Results: Sodium amounts in the base model varied directly with energy level (1.0 mg Na/kcal) and ranged from 996 to 3176 mg/d. Amounts in the lowest-sodium model also varied with energy level (similar to 0.5 mg/kcal) and ranged from 500 to 1250 mg/d. A comparison of sodium density for the base and the lowest sodium models showed that sodium in the lowest model is similar to 50% of the base. For typical food choices, sodium amounts were much higher (1.6-2.0 mg/kcal and 1715-5078 mg/d). Comparison of sodium density for the base and the typical food choice models showed that amounts were 1.6-2.0 times greater than the base. Conclusions: By choosing only low-sodium foods, it was possible to construct nutritionally adequate dietary patterns with 1500 mg Na/d. Sodium density (mg Na/kcal) is a practical approach for expressing sodium recommendations. Am J Clin Nutr 2013;97:842-7.