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Home » 2020 Topics & Objectives » Nutrition and Weight Status » NWS-19 Data Details

NWS-19 Data Details

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NWS-19 Reduce consumption of sodium in the population aged 2 years and older

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
National Health and Nutrition Examination Survey
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
milligrams (age adjusted—see Comments)
Baseline (Year): 
3,658 (2009–12)
Target: 
2,300
Target-Setting Method: 
Modeling
Target-Setting Method Justification: 
A systematic approach was used to set HP2020 targets for all dietary intake objectives. First, a challenging but achievable 2020 target was considered, at a minimum, to be a shift in the baseline mean intake for the total population: 1) to the 75th percentile value of the baseline usual intake distribution for objectives aiming to increase consumption and 2) to the 25th percentile value for objectives aiming to decrease consumption. The need for any adjustments to these initial targets was then assessed by examining baseline estimates in relation to recommendations, target applicability to subpopulations, the ability to detect change over time, past trends and whether the same trend would be anticipated this decade, and additional considerations for each objective
Numerator: 

Total one day intake of sodium (in mg) among persons aged 2 years and over

Denominator: 

Number of persons aged 2 years and over

Comparable Healthy People 2010 Objective: 
Adapted from HP2010 objective
Questions Used to Obtain the National Baseline Data: 

    From the 2003-04 and 2005-06 National Health and Nutrition Examination Survey:

    [NUMERATOR:]

    Foods and beverages:

    The 2003-04 and 2005-06 NHANES included the collection of 1 day of dietary data for all respondents through in-person 24-hour recalls and collection of a 2nd-day 24-hour recall by telephone. For these analyses, sodium intake from only the first 24 hour recall will be used. Each respondent was asked to recall the kinds and amounts of foods and beverages consumed at home and away from home during the previous day (midnight to midnight). Amounts of foods and beverages reported in household measures were then converted to gram amounts, and sodium intake from foods and beverages was estimated with the use of food composition files.

    Plain Drinking Water:

    Plain drinking water intakes were collected directly as part of the dietary intake collection of foods and beverages beginning with the 2005-2006 NHANES. Thus, the dietary intake records from the 2005-2006 NHANES include the sodium provided by drinking water. The 2003-2004 NHANES collected plain drinking water intake through questions about the total amount of water drunk on the previous day (same period as the dietary intake). These amounts of water are provided in the NHANES dataset in gram units separately for tap and bottled water but the sodium from drinking water is not included in the dietary intake files.

    Additional questions used to assess total sodium intake include:

    Dietary supplement use:

    Has (Person) taken any vitamins or minerals in the past month? Please include those that are prescribed by a doctor or dentist and those that are not prescribed.

    1. Yes
    2. No
    3. Refused
    4. Don’t Know

    Has (Person) taken or used any medicines for which a doctor's or dentist's prescription is needed, in the past month? This includes any products which cannot be obtained without a doctor's or dentist's prescription. Include those medicines which you may have already mentioned.

    1. Yes
    2. No
    3. Refused
    4. Don’t Know

    [If yes:]

    May I see the containers for all of the (vitamins and minerals/prescription medicines) (Person) took in the past month?

    Enter complete name of vitamin/mineral from label, or probe respondent:

    • Container seen
    • Container not seen
    • Product furnished by respondent
    • Product name not on container
    • Enter manufacturer's or distributor's name and address (city and State)

    How often did (Person) take (product) in the past month?

    1. ______ Days (Number from 1 to 30)
    2. Refused
    3. Don’t Know

    How much (product) did (Person) take each time (Person) took it?

    1. ______ Number of capsules, tablet/pills; teaspoons; tablespoons; fluid ounces/ounces; drops/droppers; packets/packs/packages; ml.; wafers; other
    2. Refused
    3. Don’t Know

    Antacid use:

    Antacid use:

    Enter complete name of antacid from label or probe respondent:

    1. Antacid seen
    2. Antacid not seen. Product name furnished by respondent.

    How often did you take (antacid) in the past month?

    1. ______ Days (Number from 1 to 30)
    2. Refused
    3. Don’t Know

    How much (antacid) did you take each time you took it?

    1. ______ Number of capsules, tablet/pills; teaspoons; tablespoons; fluid ounces/ounces; drops/droppers; packets/packs/packages; ml.; wafers; other
    2. Refused
    3. Don’t Know
Data Collection Frequency: 
Periodic
Methodology Notes: 

    Estimates include consideration of several sources of sodium intake: foods, dietary supplements, antacids, tap water, and salt use at the table.

    Estimation of Sodium Intake from Salt Use at the Table:

    Regarding salt use at the table, sea salt, flavored salts such as garlic, onion, and celery salt, and seasoning salts were counted as ordinary salts. Lite salt was labeled as such and has a reduced sodium content of at least 50%. Salt substitutes do not contain sodium. To obtain a daily amount for each person, the amount of sodium depending on salt type was multiplied by the frequency value. (Sodium in type of salt x frequency amount of sodium from table salt added per day. See table below).

    Type of salt:

    For "ordinary salt," sodium intake from salt use at the table was estimated based on a 1991 study that estimated mean sodium intake for adults to be about 580 mg. Specifically, 580 mg of sodium (which is about 1500 mg or ¼ teaspoon of salt) for the "very often" code was assigned for persons aged 2 years and older. For "lite" salt which contains at least half the amount of sodium as "ordinary salt," 290 mg of sodium was assigned. A zero sodium value was assigned for "salt substitute," "other" or "don't use."

    Frequency of salt use:

    For "rarely," the sodium value was multiplied by 0.25; for "occasionally," the sodium value was multiplied by 0.50; for "very often," the sodium value was multiplied by 1. The frequency question was not asked if response to type of salt was "don't use" or "don’t know." For "don't use" responses, a zero value was assigned; for "don't know" responses, ordinary salt was assumed and 290 mg of sodium was assigned based on an assumed frequency of "occasionally."

    The following table summarizes the amount of sodium added:

    Assignment of Sodium Values

    Type Rarely Occasionally Very often DK* Missing**
    Ordinary 145 290 580 290 --
    Lite 73 145 290 145 --
    Salt Substitute 0 0 0 0 --
    Other 145 290 580 290 --
    Don't use 0 0 0 0 0
    Don't know 0 0 0 0 290

    * DK= Don't Know
    ** Missing= Not Asked

    Breast-feeding children aged 2 years and older are excluded from the analysis.

    Age Adjustment Notes: 

    This Indicator uses Age-Adjustment Groups:

    • Total: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
    • Sex: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
    • Race/Ethnicity: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
    • Educational Attainment: 25-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
    • Family Income (percent poverty threshold): 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
    • Country of Birth: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
    • Disability Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
    • Health Insurance Status: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-64
    • Marital Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
    • Veteran Status: 17-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
    • Obesity Status - Adults: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
Changes Between HP2010 and HP2020: 
Healthy People 2010 objective 19-10 assessed the proportion of the population who met a specific daily intake recommendation for sodium (i.e., less than 2400 mg based on the 2000 Dietary Guidelines for Americans, DGA), while Healthy People 2020 objective NWS-19 tracks the population's mean sodium daily intake so that the objective will not need to be modified with changes in the guidelines.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
In 2013, the baseline (2003-2006) and 2007-2010 data for this objective were revised due to a change in methodology. The baseline was revised from 3,641 to 3,640 mg, which did not impact the calculated target. The data by age group and childhood obesity status are no longer age adjusted. The age adjustment groups were revised from those matching the age specific groups to the one listed above under Age Adjustment for consistency with other objectives using NHANES data. In addition, the data by obesity status were revised due to an error in reading the initial baseline data into DATA2020 database. The data for children and adults had accidentally been switched. In 2014, the baseline was revised from 3,640 mg (2003-2006) to 3,655 mg (2009-2010) due to a change in methodology in 2009-2010. The NHANES data are no longer adjusted for salt added in cooking/food preparation. The target still remains the same.

References

Additional resources about the objective

  1. Mattes RD, Donnelly D. Relative Contributions of Dietary Sodium Sources. J Amer College Nutr. 10 (4):383-393.1991.
  2. U.S. Code of Federal Regulations. 21 CFR § 101.56 (c)(1)(i).
View Data Details for all objectives in Nutrition and Weight Status