Leading Food Sources of Sodium in a Diverse Sample of Adults from Three US Metropolitan Areas
Authors: Hootman Katie C , Steffen LM , Cogswell ME , Shikany JM , Gardner CD , Harnack LJ 
Published: November 2023

BackgroundDietary sodium intake is a key determinant of hypertension risk, particularly among African Americans. Effective strategies to reduce sodium intake are needed to meet national nutrition guidelines and current evidence of the foods contributing most to sodium intake is needed to inform such strategies.ObjectiveTo identify the major food/beverage categories contributing to sodium intake in a large, diverse sample of adults living in three US metropolitan areas in order to provide specific, current evidence relevant for food‐based nutrition recommendations aimed to promote healthful diets.MethodsIn a sample of 450 adults residing in Alabama (Birmingham area, N = 150), California (Palo Alto area, N = 150), and Minnesota (Minneapolis‐St Paul area, N = 150), dietary intake was obtained from four interviewer‐administered 24‐hour recalls using the Nutrition Data System for Research software. Dietary sodium intake was quantified to rank the proportional contribution of sodium from 104 food/beverage categories overall and across demographic and geographic sub‐groups. The proportional contribution of sodium from each category was determined in each recall by dividing the amount of sodium from each category by the total amount of sodium consumed per recall day; category proportions were averaged across recalls within participant, and the resulting 104 mean proportions were aggregated and ranked to identify the top 25 categories contributing to sodium intake in this cross‐sectional analysis.ResultsThe sample included 50% women; 34% non‐Hispanic white, and 22% each African American, Asian, and Hispanic adults; 27% were aged 18–29 years, 23% aged 30–44 years, 29% aged 45–59 years, and 21% aged 60–74 years. Overall, total sodium intake averaged approximately 3500 mg/day and the top 25 food categories accounted for 65% of total intake. As shown in the table, the top contributors to sodium intake included soups, salt added to food at the table, pizza, poultry, several sandwiches (breakfast sandwiches, burgers, and other types), burritos and tacos, pasta dishes, and savory snacks. The top 25 food categories contributing to sodium intake and their ranks were similar across age and sex groups. Most of the top 25 categories were also similar across race/ethnicity groups, although African Americans and Asians reported 7 and 6 categories in their respective top 25 lists that were absent from the top 25 list for the entire sample. Category ranks by location showed soups were the top contributor in California (7.8%) and Minnesota (6.9%), but soups ranked 8th in Alabama (3.1%); in similar contrast, salt added after food preparation was the top contributor to sodium intake in Alabama (11.2%), but ranked 6th (3.5%) and 22nd (1.3%) in Minnesota and California, respectively.ConclusionStrategies to reduce individual and population sodium intake should target a range of food categories. The findings herein may inform sodium reduction strategies aimed at the sodium content of foods, tailored messages addressing salt added at the table, as well as food‐based strategies incorporating culturally and regionally popular foods that contribute meaningfully to sodium intake.Support or Funding InformationResearch reported in this publication was supported by the Centers for Disease Control and Prevention and the National Heart, Lung, and Blood Institute of the National Institutes of Health under Award Number T32HL007779 (KCH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the federal agencies.

Top 25 food and beverage categories contributing to total sodium consumption in a large, diverse sample of adults from three US metropolitan areas (N = 450); categories ranked according to mean proportion

Food Categories
Rank
Mean %

Soups
1
5.94

Added salt and spices
2
5.35

Other sandwiches
3
4.76

Pizza
4
4.67

Poultry
5
4.48

Egg/breakfast/poultry sandwiches
6
3.36

Burritos and tacos
7
3.34

Pasta dishes, excludes macaroni and cheese
8
2.94

Savory snacks (chips, popcorn, pretzels)
9
2.71

Burgers
10
2.58

Bread, rolls, buns, bagels
11
2.50

Lettuce and lettuce salads
12
2.29

Seafood
13
2.11

Eggs
14
2.06

Fried rice and lo/chow mein
15
1.95

Cheese
16
1.79

Tomato‐based condiments
17
1.52

Meat mixed dishes
18
1.45

Other Mexican mixed dishes
19
1.45

Stir‐fry and soy‐based sauce mixtures
20
1.39

Unflavored milk
21
1.34

Ready‐to‐eat cereals
22
1.32

French fries and other fried white potatoes
23
1.27

Vegetable mixed dishes
24
1.18

Rice
25
1.12

Mean proportion sum, categories 1–25 (%)

64.87