Where Americans Get Their Sodium and Potassium: The Top 10 Foods, 2015–2016

Most Americans eat too much sodium and too little potassium, raising their risk of cardiovascular disease — the leading cause of death in the United States. For healthy adults 19 and older, guidelines advise cutting sodium intake above 2,300 mg a day and getting at least 3,400 mg of potassium a day for men and 2,600 mg for women. Lowering sodium reduces blood pressure; enough potassium may offset some of sodium’s effect on it.

CDC and the U.S. Department of Agriculture analyzed a day’s food recall from 7,976 people aged 1 and older in the 2015–2016 National Health and Nutrition Examination Survey (NHANES) to find which foods supply these two minerals. Foods were grouped into 87 categories, counting sandwiches and burgers as eaten, fillings included. Salt added at the table was not counted.

The numbers

Top 10 sources

Five categories appear on both lists — deli meat sandwiches, burritos and tacos, savory snacks, poultry and vegetables — showing how intertwined the sources of the two minerals are. Sodium comes mostly from prepared foods with salt added; potassium from foods naturally low in sodium, such as milk, fruit and vegetables, as well as prepared foods.

Who eats differently

The top five sodium sources for nearly every group were among the overall top 10, with some exceptions:

• unflavored milk (7.5%) for children aged 1–3
• breads, rolls and buns for adults 71 and older (4.0%) and non-Hispanic Asian people (3.6%)
• rice (9.0%) for non-Hispanic Asian people
• quesadillas, tamales, fajitas and enchiladas (4.3%) for Hispanic people
• other meat sandwiches (3.6%) for adults with elevated blood pressure

For potassium, exceptions included flavored milk for children 4–8 (7.0%) and 9–13 (4.2%), pizza for teens 14–18 (5.7%), and soups for non-Hispanic Asian people (6.5%). The top 10 potassium categories supplied from 39.5% of intake among 14–18-year-olds to 56.1% among children 1–3.

What can help

Eating foods naturally low in sodium — such as fruits and vegetables without added salt — in place of high-sodium prepared foods could cut sodium and raise potassium at the same time. Federal efforts include the Food and Drug Administration’s draft voluntary sodium targets for the food supply and the Food Service Guidelines for Federal Facilities, which can be adapted for hospitals, government facilities, after-school and recreation programs, faith-based organizations and other institutions, with CDC programs funding their use. Because top foods differ by race and ethnicity, strategies need to reflect what different communities actually eat.

Limits: diets were self-reported, and the recall method may underestimate both minerals; table salt (which may add 5%–6% of sodium) and potassium supplements were not counted; hypertension was classified by a 2017 guideline issued after the data were collected; and rankings partly depend on how foods were grouped — counting sandwiches whole, but salads by ingredient, may push sandwiches up the list.

Sources

Based on Woodruff RC, Zhao L, Ahuja JKC, et al., "Top Food Category Contributors to Sodium and Potassium Intake — United States, 2015–2016," MMWR Vol. 69, No. 32, CDC; a work of the United States government in the public domain.