Dietary Reference Intakes for Sodium and Potassium

As essential nutrients, sodium and potassium contribute to the fundamentals of physiology and pathology of human health and disease. In clinical settings, these are two important blood electrolytes, are frequently measured and influence care decisions. Yet, blood electrolyte concentrations are usually not influenced by dietary intake, as kidney and hormone systems carefully regulate blood values.Over the years, increasing evidence suggests that sodium and potassium intake patterns of children and adults influence long-term population health mostly through complex relationships among dietary intake, blood pressure and cardiovascular health. The public health importance of understanding these relationships, based upon the best available evidence and establishing recommendations to support the development of population clinical practice guidelines and medical care of patients is clear.This report reviews evidence on the relationship between sodium and potassium intakes and indicators of adequacy, toxicity, and chronic disease. It updates the Dietary Reference Intakes (DRIs) using an expanded DRI model that includes consideration of chronic disease endpoints, and outlines research gaps to address the uncertainties identified in the process of deriving the reference values and evaluating public health implications.Table of ContentsFront MatterSummaryPart I1 Introduction2 Applying the "Guiding Principles Report"3 Methodological ConsiderationsPart II4 Potassium: Dietary Reference Intakes for Adequacy5 Potassium: Dietary Reference Intakes for Toxicity6 Potassium: Dietary Reference Intakes Based on Chronic Disease7 Potassium Dietary Reference Intakes: Risk Characterization and Special Considerations for Public HealthPart III8 Sodium: Dietary Reference Intakes for Adequacy9 Sodium: Dietary Reference Intakes for Toxicity10 Sodium: Dietary Reference Intakes Based on Chronic Disease11 Sodium Dietary Reference Intakes: Risk Characterization and Special Considerations for Public HealthPart IV12 Knowledge Gaps and Future DirectionsAppendix A: Acronyms and AbbreviationsAppendix B: Open Session AgendasAppendix C: Committee's Assessment of the "Agency for Healthcare Research and Quality Systematic Review"Appendix D: Indicators Not Relevant for Establishing Dietary Reference Intake ValuesAppendix E: Supplemental Literature SearchesAppendix F: Estimates of Potassium and Sodium Intakes from Breast Milk and Complementary FoodsAppendix G: Sources of Evidence for Potassium and Sodium Intake DistributionsAppendix H: Supplemental Risk Characterization FiguresAppendix I: Committee Member Biographical SketchesAppendix J: Dietary Reference Intakes Summary Tables