Dietary Salt Intake In Children And Adolescents

Published Date: 02 Nov 2017

Statistical analyses suggest that 25-50% of the salt intake of Western populations is derived from the discretionary use of cooking and table salt [27]. The natural salt content of food provides about 10% intake, the remaining percentage is being derived from salt added by manufacturers [27]. Some studies even suggest that approximately 80% of salt intake comes from salt added to processed, restaurant, fast, and takeaway foods in most developed countries [12]. Therefore, this indicates that any programme for reducing the salt consumption of a population should concentrate on a reduction in the salt used during food processing.

In order to reduce sodium intake in children, it is necessary to identify the major sources of sodium in children’s diets. Grimes et al. charted the relative contribution of each major food group to total daily sodium intake in Australian children by age group [11]. Across all age groups, the greatest contributor to sodium intake was cereals and cereal products, accounting for over 20% of intake. Other major sources, contributing to more than 10% of intake across most age groups, are cereal-based products and dishes; meat, poultry and game products; and milk products and dishes. The contribution of each major food category to sodium intake was relatively similar across all age groups. An important side note here is that only sources of sodium from major food groups were used. Added salt during cooking and table salt were excluded here. Nevertheless, there was also found that salt added during cooking and at the table has been estimated to contribute 15% of total daily intake [11].

The report of the second National Diet and Nutrition Survey (NDNS) rolling programme, combining data from 2008-2010, was published in 2011. It provides data of adults and children [28].

Table I: From [29] Top contributers to average daily sodium intakes¹, by food category, for children (percentage contribution).

¹ Estimates of sodium intake does not include salt added in cooking and food preperation

Here, the top contributers to average daily sodium intakes are given. As can be seen, the greatest contributer to sodium intake in all age groups are cereals and cereal products. This is corresponding to the results of the study of Grimes et al. Other major sources, contributing more than 10% of intake across most age groups, are meat and meat products and milk and milk products. Besides that, it has to be noticed that the NDNS programme does not collect information on salt added at the table or during cooking.

The National Diet and Nutrition Survey in young people in Great Britain was carried out in 1997 and measured salt intake using a 7-day dietary record in 856 boys and 845 girls. The average salt intake, at the age of 4 to 6 years, was 5.2 g per day for boys and 4.6 g per day for girls. With increasing age, there was an increase in salt intake, and by the age of 15 to 18 years, salt intake was 8.2 and 5.7 g per day for boys and girls, respectively [12]. The current salt intake in children and adolescents is likely to have increased further due to a greater consumption of highly salty foods since this survey was conducted.

Due to the Dutch Food Consumption Survey (‘VCP’), for boys and girls the average salt intake is 8.3 and 6.8 gram per day, respectively. 79% of the salt comes from purchased foods. The main sources of salt intake are bread, meat products and cheese. An estimated twenty percent of the salt consumption comes from discretionary salt. Despite differences in salt consumption between men, women and children, the sources of salt are similar. Dinner contributes most to salt intake (36%), followed by lunch (31%). The most important sources of salt at dinner, excluding discretionary table salt, are sauces and meat products. At lunch and breakfast, bread and cheese are the most important contributors of salt consumption. In between meals, the main sources are biscuits and cakes. Most salt from foods is consumed at home (69%)[30].

Age - Gender

Mean daily salt intake¹ (g)

Mean daily sodium intake¹ (g)

7-8 y Males

6.1

2.4

7-8 y Females

5.7

2.3

9-13 y Males

8.0

3.2

9-13 y Females

6.7

2.7

14-18 y Males

9.4

3.8

14-18 y Females

7.3

2.9

¹ Estimates of sodium intake include salt added in cooking and food preparation

Table II: From [30]. Classification of the quartiles of salt consumption.

In 2007-2008, the United States Department of Agriculture took a dietary intake survey. As implemented in What We Eat in America (WWEIA), the dietary intake interview component of the National Health and Nutrition Examination Survey (NHANES), salt adjustment was a postcollection data processing step that was based on the respondent’s reply to a question about the use of salt in household cooking or food preparation. It was applied only to foods likely to be home prepared, i.e., foods that generally have salt added during preparation and were obtained from the store.

The mean of the daily sodium intake was calculated for six groups; 2-5 years males (n=455), 2-5 years females (n=377), 6-11 years males (n=550), 6-11 years females (n=571), 12-19 years males (n=607), 12-19 years females (n=549).

Age-Gender

Mean daily salt intake¹ (g)

Mean daily sodium intake¹ (g)

2-5 y Males

5.8

2.3

2-5 y Females

5.8

2.3

6-11 y Males

7.8

3.1

6-11 y Females

7.3

2.9

12-19 y Males

10.5

4.2

12-19 y Females

7.5

3.0

¹ Estimates of sodium intake include salt added in cooking and food preparation

Table III: From [31]. Estimated Mean daily sodium intake (g), by age–gender group.

A difference can be noticed between Table II and Table III. The youngest participants in the Dutch Food Consumption Survey are 7 years old, while the youngest participants in the survey of the U.S. Department of Agriculture are 2 years old.

In addition, it can be concluded that boys in general have a higher intake of sodium than girls. This is related to the fact that boys have a higher food intake than girls. Besides that, it can be seen that the intake of dietary sodium increases with the age. This might be due to the fact that the total food intake will also increase with the age [bron]. Finally, it can be concluded that the sources of dietary sodium intake in children are mostly the same for all age groups.