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The association between dietary sodium intake, adiposity and sugar-sweetened beverages in children and adults: a systematic review and meta-analysis

Published online by Cambridge University Press:  15 October 2020

Carley A. Grimes*
Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC 3216, Australia
Kristy A. Bolton
Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC 3216, Australia
Alison B. Booth
Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC 3216, Australia
Durreajam Khokhar
School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC 3125, Australia
Carrie Service
School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC 3125, Australia
Feng H. He
Wolfson Institute of Preventative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 4NS, UK
Caryl A. Nowson
Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC 3216, Australia
*Corresponding author: Dr Carley A. Grimes, email


Higher intakes of Na may contribute to weight gain. The primary aim of this systematic review and meta-analysis was to examine the relationship between dietary Na intake and measures of adiposity in children and adults. Given the previous link between Na intake and the consumption of sugar-sweetened beverages (SSB), which are a known risk factor for obesity, a secondary aim examining the relationship between Na intake and SSB consumption was assessed. A systematic literature search identified cross-sectional and longitudinal studies and randomised controlled trials (RCT) which reduced dietary Na (≥3 months). Meta-analysis was performed for outcomes with ≥3 studies. Cross-sectionally higher Na intakes were associated with overweight/obesity in adults (five studies; n 11 067; OR 1·74; 95 % CI 1·43, 2·13) and in children (three studies; n 3625, OR 3·29; 95 % CI 2·25, 4·80), and abdominal obesity (five studies; n 19 744; OR 2·04; 95 % CI 1·72, 2·42) in adults. Overall, associations remained in sensitivity analyses which adjusted for energy. Findings from longitudinal studies were inconsistent. RCT in adults indicated a trend for lower body weight on reduced-Na compared with control diets (fifteen studies; n 5274; −0·29 kg; 95 % CI −0·59, 0·01; P = 0·06); however, it is unclear if energy intakes were also altered on reduced-Na diets. Among children higher Na intakes were associated with higher intake of SSB (four studies, n 10 329, b = 22, 16 and 26 g/d); no studies were retrieved for adults. Overall, there was a lack of high-quality studies retrieved. While cross-sectional evidence indicates Na intake was positively associated with adiposity, these findings have not been clearly confirmed by longitudinal studies or RCT.

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© The Author(s), 2020. Published by Cambridge University Press on behalf of The Nutrition Society

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The association between dietary sodium intake, adiposity and sugar-sweetened beverages in children and adults: a systematic review and meta-analysis
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