The relation of potassium and sodium intakes to diet cost among US adults

The 2010 Dietary Guidelines recommended that Americans increase potassium and decrease sodium intakes to reduce the burden of hypertension. One reason why so few Americans meet the recommended potassium or sodium goals may be perceived or actual food costs. This study explored the monetary costs associated with potassium and sodium intakes using national food prices and a representative sample of US adults. Dietary intake data from the 2001-2002 National Health and Nutrition Examination Survey were merged with a national food prices database. In a population of 4,744 adults, the association between the energy-adjusted sodium and potassium intakes and the sodium-to-potassium ratio (Na:K), and energy-adjusted diet cost was evaluated. Diets that were more potassium-rich or had lower sodium-potassium ratios were associated with higher diet costs, while sodium intakes were not related to cost. The difference in diet cost among participants with highest and lowest potassium intakes was $1.49 (95% CI 1.29, 1.69). A food-level analysis showed that beans, potatoes, coffee, milk, bananas, citrus juices and carrots are frequently consumed and low-cost sources of potassium. Based on existing dietary data and current American eating habits, a potassium-dense diet was associated with higher diet costs, while sodium was not. Price interventions may be an effective approach to improve potassium intakes and reduce the Na:K ratio of the diet. The present methods helped identify some alternative low-cost foods that were effective in increasing potassium intakes. The identification and promotion of lower-cost foods to help individuals meet targeted dietary recommendations could accompany future dietary guidelines.