Article Text

Download PDFPDF

The feasibility of meeting the WHO guidelines for sodium and potassium: a cross-national comparison study
  1. Adam Drewnowski1,2,
  2. Colin D Rehm1,3,
  3. Matthieu Maillot4,
  4. Alfonso Mendoza1,5,
  5. Pablo Monsivais6
  1. 1Center for Public Health Nutrition, University of Washington, Seattle, Washington, USA
  2. 2Institute for Cardiometabolism and Nutrition (ICAN), Université Pierre et Marie Curie Paris VI, Groupe Hospitalier Pitié-Salpetrière, Paris, France
  3. 3Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
  4. 4MS-Nutrition SAS, Marseille, France
  5. 5Departamento de Ciencias Sociales, Centro de Investigación e Inteligencia Económica, Universidad Popular Autónoma del Estado de Puebla, Puebla, Mexico
  6. 6The Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
  1. Correspondence to Dr Adam Drewnowski; adamdrew{at}


Objective To determine joint compliance with the WHO sodium–potassium goals in four different countries, using data from nationally representative dietary surveys.

Setting Compared to national and international recommendations and guidelines, the world's population consumes too much sodium and inadequate amounts of potassium. The WHO recommends consuming less than 2000 mg sodium (86 mmol) and at least 3510 mg potassium (90 mmol) per person per day.

Participants Dietary surveillance data were obtained from the National Health and Nutrition Examination Survey (NHANES 2007–2010) for the USA; the Encuesta Nacional de Salud y Nutrición 2012 for Mexico; the Individual and National Study on Food Consumption (INCA2) for France; and the National Diet and Nutrition Survey (NDNS) for the UK.

Primary outcome measures We estimated the proportion of adults meeting the joint WHO sodium–potassium goals in the USA, the UK, France and Mexico.

Results The upper bounds of joint compliance with the WHO sodium–potassium goals were estimated at 0.3% in the USA, 0.15% in Mexico, 0.5% in France and 0.1% in the UK.

Conclusions Given prevailing food consumption patterns and the current food supply, implementing WHO guidelines will be an enormous challenge for global public health.


This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.