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Abstract

Twenty-Four-Hour Urinary Sodium and Potassium Excretion in Children and Young People: A Systematic Review and Meta-Analysis †

1
Department of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical & Health Sciences, The University of Auckland, Auckland 1023, New Zealand
2
National Institute for Health Innovation, The University of Auckland, Auckland 1023, New Zealand
3
Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia
4
Pacific Health Section, School of Population Health, Faculty of Medical & Health Sciences, The University of Auckland, Auckland 1023, New Zealand
5
National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD 20184, USA
*
Author to whom correspondence should be addressed.
Presented at the Nutrition Society of New Zealand Annual Conference, Online, 2–3 December 2021.
Med. Sci. Forum 2022, 9(1), 38; https://doi.org/10.3390/msf2022009038
Published: 23 May 2022

Abstract

:
In children and other young people, diets high in sodium and low in potassium lead to increases in blood pressure and a higher risk of cardiovascular disease later in life. Our primary objective was to assess daily sodium and potassium intakes in children and young people aged 2–18 years from upper-middle and high-income countries, using gold-standard 24 h urinary sodium and potassium excretion studies. Secondary objectives were to assess: (1) the sodium-to-potassium molar ratio; (2) differences by gender, age, and geographical region; and (3) the sodium concentration in children’s diets. The following databases were searched to identify relevant studies published between 1998 and 2021: Cochrane Database of Systematic Reviews, Embase, Food Science and Technology Abstracts, Google Scholar, MEDLINE and Scopus. Data were pooled using random-effects meta-analysis, and meta-regression was used to quantify heterogeneity. A total of 2592 studies were identified, with 22 meeting the inclusion criteria (n = 5323, 48% girls; mean age 9.7 years). Mean 24 h urinary sodium excretion in boys was 2730 mg/d (95% CI, 2460–3001), potassium excretion was 1564 mg/d (95% CI, 1400–1728), and the sodium-to-potassium molar ratio was 3.2 (95% CI, 2.8–3.6). Corresponding values for girls were 2336 mg/d (95% CI, 2139–2534), 1428 mg/d (95% CI, 1300–1556), and 3.0 (95% CI, 2.6–3.4), respectively. There was a positive association between sodium and potassium excretion and the sodium-to-potassium ratio and age. Geographically, European and Oceanian participants excreted more potassium and had a lower mean sodium-to-potassium ratio than their Asian counterparts. Mean sodium intake in children as young as 5–6 years old exceeded the World Health Organization (WHO) upper limit of 2000 mg/d, while potassium intake was subpar. Public health monitoring, policies, and programmes to reduce dietary sodium and increase potassium intake are essential to protect the future cardiovascular health of children and young people.

Author Contributions

Conceptualization and methodology, K.F., H.E., C.N.M., B.S. and V.N.; Formal analysis and investigation, K.F., B.S., K.D.H. and J.G.; Data curation, K.F., Writing—original draft preparation, K.F.; writing—review and editing, K.F., H.E., C.N.M., B.S., V.N., K.D.H. and J.G.; All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

As the study is a systematic review ethical approval was not needed.

Informed Consent Statement

Not applicable.

Conflicts of Interest

The authors declare no conflict of interest.
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Share and Cite

MDPI and ACS Style

Fuavao, K.; Ni Mhurchu, C.; Swinburn, B.; Nosa, V.; Hall, K.D.; Guo, J.; Eyles, H. Twenty-Four-Hour Urinary Sodium and Potassium Excretion in Children and Young People: A Systematic Review and Meta-Analysis. Med. Sci. Forum 2022, 9, 38. https://doi.org/10.3390/msf2022009038

AMA Style

Fuavao K, Ni Mhurchu C, Swinburn B, Nosa V, Hall KD, Guo J, Eyles H. Twenty-Four-Hour Urinary Sodium and Potassium Excretion in Children and Young People: A Systematic Review and Meta-Analysis. Medical Sciences Forum. 2022; 9(1):38. https://doi.org/10.3390/msf2022009038

Chicago/Turabian Style

Fuavao, Kava, Cliona Ni Mhurchu, Boyd Swinburn, Vili Nosa, Kevin D. Hall, Juen Guo, and Helen Eyles. 2022. "Twenty-Four-Hour Urinary Sodium and Potassium Excretion in Children and Young People: A Systematic Review and Meta-Analysis" Medical Sciences Forum 9, no. 1: 38. https://doi.org/10.3390/msf2022009038

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