Elevated urinary Na/K ratio among Lebanese elementary school children is attributable to low K intake

Eur J Nutr. 2017 Apr;56(3):1149-1156. doi: 10.1007/s00394-016-1164-6. Epub 2016 Feb 3.

Abstract

Purpose: To estimate total sodium (Na) and potassium (K) intake using non-fasting morning urine specimens among Lebanese elementary (6-10 year old) schoolchildren.

Method: A national cross-sectional study was conducted. A multistage cluster sampling procedure was used to select a representative sample of 1403 healthy children from the eight districts of Lebanon. Age, anthropometric measurements, and urine samples were collected and analyzed for Na, K, and creatinine (Cr).

Results: The ratios of Na and K to Cr were 23.93 ± 15.54 mM/mM (4.86 ± 3.16 mg/mg) and 11.48 ± 5.82 mM/mM (3.97 ± 2.01 mg/mg), respectively, and showed differences (P value <0.001) between age groups. No differences were found between boys and girls in all the measured Na and K parameters. The estimated mean Na intake was 96.57 ± 61.67 mM/day (2.220 ± 1.418 g/day or 5.69 ± 3.64 g NaCl/day) and exceeded the upper limit of intake in half the children. Estimated K intake was 46.6 ± 23.02 mM/day (1.822 ± 0.900 g/day), and almost all children failed to meet the recommended daily K intake. The high Na/K ratio (2.361 ± 1.67 mM/mM or 1.39 ± 0.98 mg/mg) resulted from a combination of high Na and low K intake but was mostly affected by K intake.

Conclusions: About 50 % of children exceeded the recommended daily upper intake for Na, while the majority was below K adequate intake. This unfavorable Na/K ratio is indicative of potentially negative health effects at later stages in life. Interventions aimed at reducing salt intake and increasing consumption of fruits and vegetables are warranted.

Keywords: Lebanese children; Potassium intake; Sodium intake; Urinary potassium-to-creatinine ratio; Urinary sodium-to-creatinine ratio.

MeSH terms

  • Body Height
  • Body Mass Index
  • Body Weight
  • Child
  • Creatinine / urine
  • Cross-Sectional Studies
  • Female
  • Humans
  • Lebanon
  • Male
  • Potassium / urine*
  • Potassium, Dietary / administration & dosage*
  • Recommended Dietary Allowances
  • Sodium / urine*
  • Sodium, Dietary / administration & dosage
  • Specimen Handling

Substances

  • Potassium, Dietary
  • Sodium, Dietary
  • Sodium
  • Creatinine
  • Potassium