Mary E Cogswell

Le Centre de Recherche en Nutrition Humaine Rhône-Alpes, Pierre-Bénite, Rhône-Alpes, France

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Publications (140)860.53 Total impact

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    ABSTRACT: Hypertension, a major risk factor for cardiovascular diseases, occurs among 29% of U.S. adults, and lowering excess sodium intake can reduce blood pressure (1-3). The 2015-2020 Dietary Guidelines for Americans recommend consuming less than 2,300 mg dietary sodium per day for persons aged ≥14 years and less for persons aged 2-13 years.* To examine the current prevalence of excess sodium intake among Americans overall, and among hypertensive adults, CDC analyzed data from 14,728 participants aged ≥2 years in the 2009-2012 National Health and Nutrition Examination Survey (NHANES). Eighty-nine percent of adults and over 90% of children exceeded recommendations for sodium intake. Among hypertensive adults, 86% exceeded 2,300 mg dietary sodium per day. To address the high prevalence of excess sodium consumption in the U.S. population, the Institute of Medicine (IOM) recommended reducing sodium in the food supply, as excess sodium added to foods during commercial processing and preparation represents the main source of sodium intake in U.S. diets (4).
    No preview · Article · Jan 2016 · MMWR. Morbidity and mortality weekly report
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    ABSTRACT: Twenty-four–hour urine collection is the recommended method for estimating sodium intake. To investigate the strengths and limitations of methods used to assess completion of 24-hour urine collection, the authors systematically reviewed the literature on the accuracy and usefulness of methods vs para-aminobenzoic acid (PABA) recovery (referent). The percentage of incomplete collections, based on PABA, was 6% to 47% (n=8 studies). The sensitivity and specificity for identifying incomplete collection using creatinine criteria (n=4 studies) was 6% to 63% and 57% to 99.7%, respectively. The most sensitive method for removing incomplete collections was a creatinine index <0.7. In pooled analysis (≥2 studies), mean urine creatinine excretion and volume were higher among participants with complete collection (P<.05); whereas, self-reported collection time did not differ by completion status. Compared with participants with incomplete collection, mean 24-hour sodium excretion was 19.6 mmol higher (n=1781 specimens, 5 studies) in patients with complete collection. Sodium excretion may be underestimated by inclusion of incomplete 24-hour urine collections. None of the current approaches reliably assess completion of 24-hour urine collection.
    No preview · Article · Jan 2016 · Journal of Clinical Hypertension
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    ABSTRACT: The sodium concentration (mg/100 g) for 23 of 125 Sentinel Foods (e.g. white bread) were identified in the 2009 CDC Packaged Food Database (PFD) and compared with data in the USDA's 2013 National Nutrient Database for Standard Reference(SR 26). Sentinel Foods are foods identified by USDA to be monitored as primary indicators to assess the changes in the sodium content of commercially processed foods from stores and restaurants. Overall, 937 products were evaluated in the CDC PFD, and between 3 (one brand of ready-to-eat cereal) and 126 products (white bread) were evaluated per selected food. The mean sodium concentrations of 17 of the 23 (74%) selected foods in the CDC PFD were 90%-110% of the mean sodium concentrations in SR 26 and differences in sodium concentration were statistically significant for 6 Sentinel Foods. The sodium concentration of most of the Sentinel Foods, as selected in the PFD, appeared to represent the sodium concentrations of the corresponding food category. The results of our study help improve the understanding of how nutrition information compares between national analytic values and the label and whether the selected Sentinel Foods represent their corresponding food category as indicators for assessment of change of the sodium content in the food supply.
    Full-text · Article · Dec 2015
  • Quanhe Yang · Yuna Zhong · Robert Merritt · Mary E Cogswell
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    ABSTRACT: Objective: To examine trends in pre-high blood pressure (BP [HBP]) and HBP among US adolescents by body weight category during 1988-2012. Study design: We estimated pre-HBP and HBP prevalence among 14 844 participants aged 12-19 years using National Health and Nutrition Examination Surveys from 1988-1994, 1999-2002, 2003-2006, and 2007-2012. Pre-HBP and HBP were defined based on age-sex-height-specific BP percentiles. We examined the temporal trends in pre-HBP and HBP across category of body weight (normal weight vs overweight/obese), adjusted for potential explanatory factors, and estimated the number of adolescents with pre-HBP and HBP. Results: Between 1988 and 2012, the prevalence of HBP decreased and pre-HBP did not change. Among normal weight adolescents, multivariable adjusted pre-HBP prevalence was 11.0% during 1988-2012, and 10.9% during 2007-2012 (P = .923 for trend); adjusted HBP prevalence increased from 1988-1994 (0.9%) to 1999-2002 (2.3%), then declined significantly to 1.4% during 2007-2012 (P = .049). Among overweight/obese adolescents, adjusted pre-HBP prevalence was 17.5% during 1988-2012, and 20.9% during 2007-2012 (P = .323); adjusted HBP prevalence declined significantly from 7.2% during 1988-1994 to 3.2% during 2007-2012 (P = .018). Because of population growth, estimated number of adolescents with pre-HBP or HBP increased, from 4.18 million during 1988-1994 to 5.59 million during 2007-2012. Conclusions: Between 1988 and 2012, pre-HBP prevalence was consistently higher among overweight/obese adolescent than those of normal weight, and the pattern remain unchanged. HBP prevalence declined significantly, especially among overweight/obese adolescent that are not completely explained by sociodemographic or lifestyle characteristics.
    No preview · Article · Nov 2015 · The Journal of pediatrics
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    ABSTRACT: Purpose: The purpose of this study was to provide baseline estimates of sodium levels in 125 popular, sodium-contributing, commercially processed and restaurant foods in the U.S., to assess future changes as manufacturers reformulate foods. Methods: In 2010-2013, we obtained ~ 5200 sample units from up to 12 locations and analyzed 1654 composites for sodium and related nutrients (potassium, total dietary fiber, total and saturated fat, and total sugar), as part of the U.S. Department of Agriculture-led sodium-monitoring program. We determined sodium content as mg/100 g, mg/serving, and mg/kcal and compared them against U.S. Food and Drug Administration's (FDA) sodium limits for "low" and "healthy" claims and to the optimal sodium level of < 1.1 mg/kcal, extrapolating from the Healthy Eating Index-2010. Results: Results from this study represent the baseline nutrient values to use in assessing future changes as foods are reformulated for sodium reduction. Sodium levels in over half (69 of 125) of the foods, including all main dishes and most Sentinel Foods from fast-food outlets or restaurants (29 of 33 foods), exceeded the FDA sodium limit for using the claim "healthy". Only 13 of 125 foods had sodium values below 1.1 mg/kcal. We observed a wide range of sodium content among similar food types and brands. Conclusions: Current sodium levels in commercially processed and restaurant foods in the U.S. are high and variable. Targeted benchmarks and increased awareness of high sodium content and variability in foods would support reduction of sodium intakes in the U.S.
    Full-text · Article · Nov 2015
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    ABSTRACT: Purpose . To describe the prevalence and determinants of sodium-related knowledge, attitudes, and behaviors among U.S. adults Design . A cross-sectional survey was used. Setting . The study was set in the United States in 2012. Subjects . Participants were 6122 U.S. adults. Measures . Sodium-related knowledge, attitudes, and behaviors were measured. Analysis . Chi-squared tests were used to determine differences in sodium-related knowledge, attitude, and behaviors by respondent characteristics; multiple logistic regression was used to examine associations between selected respondent characteristics and health professional advice, reported action, or knowledge, attitudes, and behaviors (adjusted for all other respondent characteristics). Results . About three-fourths of respondents answered eating too much sodium is "somewhat" or "very" harmful to their health. Twenty-six percent reported receiving health professional advice, and 45% reported taking action to reduce their sodium intake. The prevalence of reported action was highest among adults receiving advice, those with hypertension, blacks, and those aged ≥65 years. Sixty-two percent who reported action agreed that most of their sodium comes from processed or restaurant foods. Of those reporting action, the most common tactics to reduce sodium intake were checking nutrition labels, using other spices than salt, and choosing low-sodium foods; requesting lower-sodium options when eating out was the least common tactic. Conclusion . Results suggest almost half of adults overall and the vast majority of those receiving health professional advice are taking some action to watch or reduce sodium intake. Although a substantial proportion report using recommended tactics to lower intake, many are not using the most effective tactics. In order to reach the general population, health communication messages could be simpler and focus on the most effective tactics to reduce sodium intake. Furthermore, health professionals can help reduce sodium intake by discussing the benefits of sodium reduction and tactics to do so, regardless of a hypertension diagnosis.
    No preview · Article · Sep 2015 · American journal of health promotion: AJHP
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    ABSTRACT: This study examined the impact of overweight/obesity on sodium, potassium, and blood pressure associations using the Shandong-Ministry of Health Action on Salt Reduction and Hypertension (SMASH) project baseline survey data. Twenty-four-hour urine samples were collected in 1948 Chinese adults aged 18 to 69 years. The observed associations of sodium, potassium, sodium-potassium ratio, and systolic blood pressure (SBP) were stronger in the overweight/obese population than among those of normal weight. Among overweight/obese respondents, each additional standard deviation (SD) higher of urinary sodium excretion (SD=85 mmol) and potassium excretion (SD=19 mmol) was associated with a 1.31 mm Hg (95% confidence interval, 0.37-2.26) and -1.43 mm Hg (95% confidence interval, -2.23 to -0.63) difference in SBP, and each higher unit in sodium-potassium ratio was associated with a 0.54 mm Hg (95% confidence interval, 0.34-0.75) increase in SBP. The association between sodium, potassium, sodium-potassium ratio, and prevalence of hypertension among overweight/obese patients was similar to that of SBP. Our study indicated that the relationships between BP and both urinary sodium and potassium might be modified by BMI status in Chinese adults. © 2015 Wiley Periodicals, Inc.
    No preview · Article · Aug 2015 · Journal of Clinical Hypertension
  • Jing Fang · Mary E Cogswell · Soyoun Park · Sandra L Jackson · Erika C Odom
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    ABSTRACT: Excess sodium intake is a major risk factor for hypertension, and subsequently, heart disease and stroke, the first and fifth leading causes of U.S. deaths, respectively. During 2011-2012, the average daily sodium intake among U.S. adults was estimated to be 3,592 mg, above the Healthy People 2020 target of 2,300 mg. To support strategies to reduce dietary sodium intake, 2013 Behavioral Risk Factor Surveillance System (BRFSS) data from states and territories that implemented the new sodium-related behavior module were assessed. Across 26 states, the District of Columbia (DC), and Puerto Rico, 39%-73% of adults reported taking action (i.e., watching or reducing sodium intake) (median = 51%), and 14%-41% reported receiving advice from a health professional to reduce sodium intake (median = 22%). Compared with adults without hypertension, a higher percentage of adults with self-reported hypertension reported taking action and receiving advice to reduce sodium intake. For states that implemented the module, these results can serve as a baseline to monitor the effects of programs designed to reduce sodium intake.
    No preview · Article · Jul 2015 · MMWR. Morbidity and mortality weekly report
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    ABSTRACT: Excessive sodium intake is a key modifiable risk factor for hypertension and cardiovascular disease. Although 95% of U.S. adults exceed intake recommendations, knowledge is limited regarding whether doctor or health professional advice motivates patients to reduce intake. Our objectives were to describe the prevalence and determinants of taking action to reduce sodium, and to test whether receiving advice was associated with action. Analyses, conducted in 2014, used data from the 2013 Behavioral Risk Factor Surveillance System, a state-based telephone survey representative of non-institutionalized adults. Respondents (n=173,778) from 26 states, the District of Columbia, and Puerto Rico used the new optional sodium module. We estimated prevalence ratios (PRs) based on average marginal predictions, accounting for the complex survey design. Fifty-three percent of adults reported taking action to reduce sodium intake. Prevalence of action was highest among adults who received advice (83%), followed by adults taking antihypertensive medications, adults with diabetes, adults with kidney disease, or adults with a history of cardiovascular disease (range, 73%-75%), and lowest among adults aged 18-24 years (29%). Overall, 23% of adults reported receiving advice to reduce sodium intake. Receiving advice was associated with taking action (prevalence ratio=1.59; 95% CI=1.56, 1.61), independent of sociodemographic and health characteristics, although some disparities were observed across race/ethnicity and BMI categories. Our results suggest that more than half of U.S. adults in 26 states and two territories are taking action to reduce sodium intake, and doctor or health professional advice is strongly associated with action. Published by Elsevier Inc.
    No preview · Article · Jun 2015 · American journal of preventive medicine
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    ABSTRACT: This article summarizes current data and approaches to assess sodium intake in individuals and populations. A review of the literature on sodium excretion and intake estimation supports the continued use of 24-h urine collections for assessing population and individual sodium intake. Since 2000, 29 studies used urine biomarkers to estimate population sodium intake, primarily among adults. More than half used 24-h urine; the rest used a spot/casual, overnight, or 12-h specimen. Associations between individual sodium intake and health outcomes were investigated in 13 prospective cohort studies published since 2000. Only three included an indicator of long-term individual sodium intake, i.e., multiple 24-h urine specimens collected several days apart. Although not insurmountable, logistic challenges of 24-h urine collection remain a barrier for research on the relationship of sodium intake and chronic disease. Newer approaches, including modeling based on shorter collections, offer promise for estimating population sodium intake in some groups. Expected final online publication date for the Annual Review of Nutrition Volume 35 is July 17, 2015. Please see http://www.annualreviews.org/catalog/pubdates.aspx for revised estimates.
    Full-text · Article · May 2015 · Annual Review of Nutrition
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    Jessica Lee Levings · Joyce Maalouf · Xin Tong · Mary E Cogswell
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    ABSTRACT: Comparing nutrition labels and choosing lower sodium foods are tactics to help reduce excessive sodium intake, a major risk factor for hypertension. Our objective was to assess US adult consumers' reported use and perceived understanding of sodium information on nutrition labels by sociodemographic and health status. We analyzed responses to questions from 3,729 adults aged 18 years or older participating in 2 national cross-sectional mail panel surveys in 2010. We found that 19.3% (95% confidence interval [CI], 17.2%-21.6%) of respondents agreed they were confused about how to figure out how much sodium is in the foods they eat; 57.9% (95% CI, 55.4%-60.5%) reported that they or the person who shops for their food buy items labeled low salt or low sodium; and 46.8% (95% CI, 44.3%-49.4%) reported they check nutrition labels for sodium content as a tactic to limit salt. Consumers with a high school education or less were more likely than college graduates to report they were confused about sodium content on labels (adjusted odds ratio [AOR], 1.9; 95% CI, 1.4-2.8) and less likely to check labels for sodium as a tactic to limit salt intake (AOR, 0.7; 95% CI, 0.6-0.98). Most survey respondents in our study reported buying low sodium food items. However, a higher proportion of respondents with low education than respondents with high education reported confusion with and less use of sodium content information, suggesting enhanced efforts may be needed to assist this group. Opportunity exists for health care professionals to educate patients about using and understanding nutrition labels and consuming a diet consistent with the Dietary Approaches to Stop Hypertension (DASH) eating plan.
    Full-text · Article · Apr 2015 · Preventing chronic disease
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    ABSTRACT: Excess sodium intake correlates positively with high blood pressure. Blood pressure varies by region, but whether sodium content of foods sold varies across regions is unknown. We combined nutrition and sales data from 2009 to assess the regional variation of sodium in packaged food products sold in 3 of the 9 US census divisions. Although sodium density and concentration differed little by region, fewer than half of selected food products met Food and Drug Administration sodium-per-serving conditions for labeling as "healthy." Regional differences in hypertension were not reflected in differences in the sodium content of packaged foods from grocery stores.
    Full-text · Article · Apr 2015 · Preventing chronic disease
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    ABSTRACT: High US sodium intake and national reduction efforts necessitate developing a feasible and valid monitoring method across the distribution of low-to-high sodium intake. We examined a statistical approach using timed urine voids to estimate the population distribution of usual 24-h sodium excretion. A sample of 407 adults, aged 18-39 y (54% female, 48% black), collected each void in a separate container for 24 h; 133 repeated the procedure 4-11 d later. Four timed voids (morning, afternoon, evening, overnight) were selected from each 24-h collection. We developed gender-specific equations to calibrate total sodium excreted in each of the one-void (e.g., morning) and combined two-void (e.g., morning + afternoon) urines to 24-h sodium excretion. The calibrated sodium excretions were used to estimate the population distribution of usual 24-h sodium excretion. Participants were then randomly assigned to modeling (n = 160) or validation (n = 247) groups to examine the bias in estimated population percentiles. Median bias in predicting selected percentiles (5th, 25th, 50th, 75th, 95th) of usual 24-h sodium excretion with one-void urines ranged from -367 to 284 mg (-7.7 to 12.2% of the observed usual excretions) for men and -604 to 486 mg (-14.6 to 23.7%) for women, and with two-void urines from -338 to 263 mg (-6.9 to 10.4%) and -166 to 153 mg (-4.1 to 8.1%), respectively. Four of the 6 two-void urine combinations produced no significant bias in predicting selected percentiles. Our approach to estimate the population usual 24-h sodium excretion, which uses calibrated timed-void sodium to account for day-to-day variation and covariance between measurement errors, produced percentile estimates with relatively low biases across low-to-high sodium excretions. This may provide a low-burden, low-cost alternative to 24-h collections in monitoring population sodium intake among healthy young adults and merits further investigation in other population subgroups. This study was registered at clinicaltrials.gov as NCT01631240. © 2015 American Society for Nutrition.
    Full-text · Article · Apr 2015 · Journal of Nutrition
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    ABSTRACT: Sodium intake is high in US children. Data are limited on the dietary sources of sodium, especially from birth to age 24 mo. We identified top sources of dietary sodium in US children from birth to age 24 mo. Data from the NHANES 2003-2010 were used to examine food sources of sodium (population proportions and mean intakes) in 778 participants aged 0-5.9 mo, 914 participants aged 6-11.9 mo, and 1219 participants aged 12-23.9 mo by sociodemographic characteristics. Overall, mean dietary sodium intake was low in 0-5.9-mo-old children, and the top contributors were formula (71.7%), human milk (22.9%), and commercial baby foods (2.2%). In infants aged 6-11.9 mo, the top 5 contributors were formula (26.7%), commercial baby foods (8.8%), soups (6.1%), pasta mixed dishes (4.0%), and human milk (3.9%). In children aged 12-23.9 mo, the top contributors were milk (12.2%), soups (5.4%), cheese (5.2%), pasta mixed dishes (5.1%), and frankfurters and sausages (4.6%). Despite significant variation in top food categories across racial/ethnic groups, commercial baby foods were a top food contributor in children aged 6-11.9 mo, and frankfurters and sausages were a top food contributor in children aged 12-23.9 mo. The top 5 food categories that contributed to sodium intake also differed by sex. Most of the sodium consumed (83-90%) came from store foods (e.g., from the supermarket). In children aged 12-23.9 mo, 9% of sodium consumed came from restaurant foods, and 4% of sodium came from childcare center foods. The vast majority of sodium consumed comes from foods other than infant formula or human milk after the age of 6 mo. Although the majority of sodium intake was from store foods, after age 12 mo, restaurant foods contribute significantly to intake. Reducing the sodium content in these settings would reduce sodium intake in the youngest consumers. © 2015 American Society for Nutrition.
    Full-text · Article · Mar 2015 · American Journal of Clinical Nutrition
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    ABSTRACT: Although evidence shows that reduced sodium intake lowers blood pressure, some studies suggest that sodium reduction may adversely affect insulin resistance and glucose tolerance. The objectives were to assess the effects of sodium reduction on glucose tolerance, evaluate strengths and weaknesses of the relevant scientific literature, and provide direction for future research. We searched The Cochrane Library, MEDLINE, EMBASE, CINAHL, and Web of Science through August 2014. Both randomized and nonrandomized intervention trials were included in our meta-analyses. The effects of sodium reduction on glucose tolerance were evaluated in 37 articles, but because of a lack of comparable data, 8 trials were excluded from the meta-analyses. Participants were 10-79 y old, either primarily healthy or with hypertension. In meta-analyses of 20 randomized, crossover trials (n = 504 participants) and 9 nonrandomized crossover trials (n = 337), circulating glucose concentrations of fasting participants were not affected by reduction in sodium intake. In contrast, in meta-analyses of 19 of the 20 randomized, crossover trials (n = 494), fasting insulin concentrations were 9.53 pmol/L higher (95% CI: 5.04, 14.02 pmol/L higher) with sodium reduction. In 9 nonrandomized trials (n = 337), fasting insulin did not differ with reduced sodium intake. Results differed little when the analyses were restricted to studies with a low risk of bias and duration of ≥7 d. This meta-analysis revealed no evidence that, in trials with a short intervention and large reductions in sodium, circulating glucose concentrations differed between groups. Recommendations for future studies include extending intervention durations, ensuring comparability of groups at baseline through randomization, and assessing sodium intakes relevant to population sodium reduction. In addition, analyses on other metabolic variables were limited because of the number of trials reporting these outcomes and lack of consistency across measures, suggesting a need for comparable measures of glucose tolerance across studies. © 2015 American Society for Nutrition.
    No preview · Article · Mar 2015 · Journal of Nutrition
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    ABSTRACT: Iodized salt has been an important source of dietary iodine, a trace element important for regulating human growth, development, and metabolic functions. This analysis identified iodized table salt sales as a percentage of retail salt sales using Nielsen ScanTrack. We identified 1117 salt products, including 701 salt blends and 416 other salt products, 57 of which were iodized. When weighted by sales volume in ounces or per item, 53% contained iodized salt. These findings may provide a baseline for future monitoring of sales of iodized salt.
    Full-text · Article · Mar 2015 · Nutrients
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    ABSTRACT: Most sodium in the US diet comes from commercially processed and restaurant foods. Sodium reduction in these foods is key to several recent public health efforts. The objective was to provide an overview of a program led by the USDA, in partnership with other government agencies, to monitor sodium contents in commercially processed and restaurant foods in the United States. We also present comparisons of nutrients generated under the program to older data. We track ∼125 commercially processed and restaurant food items ("sentinel foods") annually using information from food manufacturers and periodically by nationwide sampling and laboratory analyses. In addition, we monitor >1100 other commercially processed and restaurant food items, termed "priority-2 foods" (P2Fs) biennially by using information from food manufacturers. These foods serve as indicators for assessing changes in the sodium content of commercially processed and restaurant foods in the United States. We sampled all sentinel foods nationwide and reviewed all P2Fs in 2010-2013 to determine baseline sodium concentrations. We updated sodium values for 73 sentinel foods and 551 P2Fs in the USDA's National Nutrient Database for Standard Reference (releases 23-26). Sodium values changed by at least 10% for 43 of the sentinel foods, which, for 31 foods, including commonly consumed foods such as bread, tomato catsup, and potato chips, the newer sodium values were lower. Changes in the concentrations of related nutrients (total and saturated fat, total sugar, potassium, or dietary fiber) that were recommended by the 2010 Dietary Guidelines for Americans for reduced or increased consumption accompanied sodium reduction. The results of sodium reduction efforts, based on resampling of the sentinel foods or re-review of P2Fs, will become available beginning in 2015. This monitoring program tracks sodium reduction efforts, improves food composition databases, and strengthens national nutrition monitoring. © 2015 American Society for Nutrition.
    Full-text · Article · Mar 2015 · American Journal of Clinical Nutrition
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    ABSTRACT: To evaluate the sodium and sugar content of US commercial infant and toddler foods. We used a 2012 nutrient database of 1074 US infant and toddler foods and drinks developed from a commercial database, manufacturer Web sites, and major grocery stores. Products were categorized on the basis of their main ingredients and the US Food and Drug Administration's reference amounts customarily consumed per eating occasion (RACC). Sodium and sugar contents and presence of added sugars were determined. All but 2 of the 657 infant vegetables, dinners, fruits, dry cereals, and ready-to-serve mixed grains and fruits were low sodium (≤140 mg/RACC). The majority of these foods did not contain added sugars; however, 41 of 79 infant mixed grains and fruits contained ≥1 added sugar, and 35 also contained >35% calories from sugar. Seventy-two percent of 72 toddler dinners were high in sodium content (>210 mg/RACC). Toddler dinners contained an average of 2295 mg of sodium per 1000 kcal (sodium 212 mg/100 g). Savory infant/toddler snacks (n = 34) contained an average of sodium 1382 mg/1000 kcal (sodium 486 mg/100 g); 1 was high sodium. Thirty-two percent of toddler dinners and the majority of toddler cereal bars/breakfast pastries, fruit, and infant/toddler snacks, desserts, and juices contained ≥1 added sugar. Commercial toddler foods and infant or toddler snacks, desserts, and juice drinks are of potential concern due to sodium or sugar content. Pediatricians should advise parents to look carefully at labels when selecting commercial toddler foods and to limit salty snacks, sweet desserts, and juice drinks. published in the public domain by the American Academy of Pediatrics.
    Full-text · Article · Feb 2015 · Pediatrics
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    ABSTRACT: Limited data are available on the accuracy of 24-h dietary recalls used to monitor US sodium and potassium intakes. We examined the difference in usual sodium and potassium intakes estimated from 24-h dietary recalls and urine collections. We used data from a cross-sectional study in 402 participants aged 18-39 y (∼50% African American) in the Washington, DC, metropolitan area in 2011. We estimated means and percentiles of usual intakes of daily dietary sodium (dNa) and potassium (dK) and 24-h urine excretion of sodium (uNa) and potassium (uK). We examined Spearman's correlations and differences between estimates from dietary and urine measures. Multiple linear regressions were used to evaluate the factors associated with the difference between dietary and urine measures. Mean differences between diet and urine estimates were higher in men [dNa - uNa (95% CI) = 936.8 (787.1, 1086.5) mg/d and dK - uK = 571.3 (448.3, 694.3) mg/d] than in women [dNa - uNa (95% CI) = 108.3 (11.1, 205.4) mg/d and dK - uK = 163.4 (85.3, 241.5 mg/d)]. Percentile distributions of diet and urine estimates for sodium and potassium differed for men. Spearman's correlations between measures were 0.16 for men and 0.25 for women for sodium and 0.39 for men and 0.29 for women for potassium. Urinary creatinine, total caloric intake, and percentages of nutrient intake from mixed dishes were independently and consistently associated with the differences between diet and urine estimates of sodium and potassium intake. For men, body mass index was also associated. Race was associated with differences in estimates of potassium intake. Low correlations and differences between dietary and urinary sodium or potassium may be due to measurement error in one or both estimates. Future analyses using these methods to assess sodium and potassium intake in relation to health outcomes may consider stratifying by factors associated with the differences in estimates from these methods. This trial was registered at clinicaltrials.gov as NCT01631240. © 2015 American Society for Nutrition.
    Full-text · Article · Feb 2015 · American Journal of Clinical Nutrition
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    ABSTRACT: Most Americans consume more sodium than is recommended, the vast majority of which comes from commercially packaged and restaurant foods. In 2010 the Institute of Medicine recommended that manufacturers reduce the amount of sodium in their products. The aim was to assess the sodium content in commercially packaged food products sold in US grocery stores in 2009. With the use of sales and nutrition data from commercial sources, we created a database with nearly 8000 packaged food products sold in major US grocery stores in 2009. We estimated the sales-weighted mean and distribution of sodium content (mg/serving, mg/100 g, and mg/kcal) of foods within food groups that contribute the most dietary sodium to the US diet. We estimated the proportion of products within each category that exceed 1) the Food and Drug Administration's (FDA's) limits for sodium in foods that use a "healthy" label claim and 2) 1150 mg/serving or 50% of the maximum daily intake recommended in the 2010 Dietary Guidelines for Americans. Products in the meat mixed dishes category had the highest mean and median sodium contents per serving (966 and 970 mg, respectively). Products in the salad dressing and vegetable oils category had the highest mean and median concentrations per 100 g (1072 and 1067 mg, respectively). Sodium density was highest in the soup category (18.4 mg/kcal). More than half of the products sold in 11 of the 20 food categories analyzed exceeded the FDA limits for products with a "healthy" label claim. In 4 categories, >10% of the products sold exceeded 1150 mg/serving. The sodium content in packaged foods sold in major US grocery stores varied widely, and a large proportion of top-selling products exceeded limits, indicating the potential for reduction. Ongoing monitoring is necessary to evaluate the progress in sodium reduction. © 2015 American Society for Nutrition.
    Full-text · Article · Feb 2015 · American Journal of Clinical Nutrition

Publication Stats

6k Citations
860.53 Total Impact Points

Institutions

  • 2015
    • Le Centre de Recherche en Nutrition Humaine Rhône-Alpes
      Pierre-Bénite, Rhône-Alpes, France
    • CDC Climat
      Lutetia Parisorum, Île-de-France, France
  • 1995-2015
    • Centers for Disease Control and Prevention
      • • Division for Heart Disease and Stroke Prevention
      • • National Center for Chronic Disease Prevention and Health Promotion
      • • National Center on Birth Defects and Developmental Disabilities
      • • Division of Nutrition, Physical Activity, and Obesity
      • • Division of Reproductive Health
      Атланта, Michigan, United States
  • 2005
    • Harvard University
      Cambridge, Massachusetts, United States
  • 2004
    • Magee-Womens Hospital
      Pittsburgh, Pennsylvania, United States
  • 2002
    • Medical University of South Carolina
      • Department of Pediatrics
      Charleston, South Carolina, United States
  • 2001-2002
    • University of North Carolina at Chapel Hill
      • • Department of Nutrition
      • • Department of Maternal and Child Health
      Chapel Hill, NC, United States