European Journal of Nutrition

, Volume 58, Issue 3, pp 947–953 | Cite as

24-h urinary sodium to potassium ratio and its association with obesity in children and adolescents

  • Nahid Rafie
  • Sahar Golpour Hamedani
  • Noushin Mohammadifard
  • Awat Feizi
  • Sayyed Morteza SafaviEmail author
Original Contribution



There are epidemiologic studies indicating a positive correlation between high sodium and low potassium intake and body mass index. Therefore, this study was conducted in a cross-sectional sample of Iranian children and adolescents to evaluate the link between 24-h urinary Na:K ratio and risk of obesity.


In this cross-sectional study, 374 participants aged 11–18 years were included. One 24-h urine sample was collected by each participant to estimate Na:K ratio. Anthropometric measurements were carried out and overweight/obesity was defined as a BMI ≥ 85th percentile and abdominal obesity as a waist:height ratio (WHtR) of more than 0.5.


As expected, 24-h urinary Na:K ratio showed significant associations with risk of overweight/obesity. Risk of adiposity assessed by WC and PBF was significantly associated with Na:K ratio after adjusting for SSBs consumption and calorie intake. Urinary Na:K ratio showed significant association with risk of adiposity assessed by WC only in girls in the highest tertile group with OR of 2.71 (95% CI 1.14–6.43), only after the addition of calorie intake. Adiposity assessed by PBF was only associated with Na:K ratio among boys with OR of 4.47 (95% CI 1.44–9.87) and 3.87 (95% CI 1.20–8.48), after adjusting for SSBs consumption and calorie intake, respectively.


Our findings suggest that reducing Na and increasing K intake could be used as a useful approach to lower the risk of obesity and associated burden of disease in Iran. However, more studies are warranted.


Sodium Potassium 24-h urine Overweight Obesity Children Adolescents Iran 



This study was supported by Isfahan University of Medical Sciences and Isfahan Cardiovascular Research Institute. The authors would like to thank all the schools and students/parents who agreed to participate in this study.



Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interests.

Supplementary material

394_2018_1645_MOESM1_ESM.docx (22 kb)
Supplementary material 1 (DOCX 22 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Nahid Rafie
    • 1
    • 2
  • Sahar Golpour Hamedani
    • 1
    • 2
  • Noushin Mohammadifard
    • 3
  • Awat Feizi
    • 4
    • 5
  • Sayyed Morteza Safavi
    • 1
    • 2
    Email author
  1. 1.Food Security Research CenterIsfahan University of Medical SciencesIsfahanIran
  2. 2.Department of Clinical Nutrition, School of Nutrition and Food SciencesIsfahan University of Medical SciencesIsfahanIran
  3. 3.Isfahan Cardiovascular Research Center, Cardiovascular Research InstituteIsfahan University of Medical SciencesIsfahanIran
  4. 4.Department of Biostatistics and Epidemiology, School of HealthIsfahan University of Medical SciencesIsfahanIran
  5. 5.Cardiac Rehabilitation Research Center, Cardiovascular Research InstituteIsfahan University of Medical SciencesIsfahanIran

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