Trends in Dietary Sodium from Food Sources in Australian Children and Adolescents from 2007 to 2011/12

Background In western countries, most children eat more sodium than is recommended. In Australia in 2009, voluntary sodium reformulation targets were adopted for nine categories of processed foods, but the impact of this initiative on children's sodium intake has not been assessed. Objective To compare sodium consumption of Australian children aged 2 to 16 years from 2007 to 2011/12. Design Cross-sectional analysis of data from the 2007 Children's Nutrition and Physical Activity Survey (n=4,487) and the 2011/12 National Nutrition and Physical Activity Survey (n=2,548). Participants/setting A nationally representative sample of 6,705 Australian children aged 2 to 16 years who provided plausible 24-hour dietary recall data according to Goldberg cutoffs for misreporting of energy intake. Main outcome measures Mean intakes of energy, sodium, and sodium density (mg/ 1,000 kcal) were assessed via one 24-hour dietary recall; measurement error models with up to two 24-hour dietary recalls were used to estimate usual sodium intake and the proportion of children exceeding the age-specific upper level for sodium. Statistical analyses preformed Statistical analysis incorporated survey weights and accounted for the complex survey design. Two-sample t-tests and two-sample test of proportions were used to assess differences in continuous and categorical variables between survey years. Results Dietary sodium declined by 8% between 2007 and 2011/12 (-188 +/- SE 31 mg/day; P<0.001), and this was in conjunction with a 5% reduction in energy intake (98 +/- 19 kcal/day; P<0.001). When stratified by age group, significant reductions in sodium intake remained across all four age groups (ie, 2-3 years, 4-8 years, 9-13 years, and 14-16 years); similarly, with the exception of 2- to 3-year-old children, reductions in energy intake were observed across all other age groups. Overall sodium density declined by 2% (-29 mg/1,000 kcal/day; P=0.01); however, in age subgroup analysis the decline in sodium density only remained among children aged 2 to 3 years. The upper level for sodium was exceeded by 94% or more children in 2007 and 78% or more in 2011/2012. Conclusion Although results suggest a small reduction in reported sodium intake over 5 years, most children in 2011/12 had a sodium intake that exceeded the recommended upper level. Ongoing efforts to reduce sodium in the diets of Australian children are required.