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

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

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Acknowledgements

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.

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Authors and Affiliations

  1. Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

    Nahid Rafie, Sahar Golpour Hamedani & Sayyed Morteza Safavi

  2. Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

    Nahid Rafie, Sahar Golpour Hamedani & Sayyed Morteza Safavi

  3. Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

    Noushin Mohammadifard

  4. Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

    Awat Feizi

  5. Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

    Awat Feizi

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  1. Nahid Rafie
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Correspondence to Sayyed Morteza Safavi.

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Rafie, N., Hamedani, S.G., Mohammadifard, N. et al. 24-h urinary sodium to potassium ratio and its association with obesity in children and adolescents. Eur J Nutr 58, 947–953 (2019). https://doi.org/10.1007/s00394-018-1645-x

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  • DOI: https://doi.org/10.1007/s00394-018-1645-x

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