Average Sodium Intake Among US Adults Is Higher Than Recommended Intake Limits1-8
Data from the NHANES (2015-2016) show that Americans 19 and older consume approximately 3468 mg of sodium per day on average,2 which is more than double the ideal dietary target for most adults recommended by the American Heart Association.1,3
In addition to daily intake from food and drinks, sodium in both prescription and over-the-counter medications can contribute to daily sodium intake.9,10
Although no FDA guidelines exist, the European Medicines Agency states that high sodium-containing drugs (ie, ≥391 mg/day of sodium) can add considerably to daily sodium intake.9
AHA, American Heart Association; ESC, European Society of Cardiology; HHS, US Department of Health and Human Services; NASEM, National Academies of Sciences, Engineering, and Medicine; NHANES, National Health and Nutrition Examination Survey; USDA, United States Department of Agriculture; WHO, World Health Organization.
*For adults. †No recommended age range provided. ‡For people aged ≥14 years. §Based on 2015-2016 NHANES data.
*For adults. †No recommended age range provided. ‡For people aged ≥14 years. §Based on 2015-2016 NHANES data.
References: 1. Benjamin EJ et al. Circulation. 2019;139(10):e56-e528. 2. Clarke LS et al. MMWR Morb Mortal Wkly Rep. 2021;70(42):1478-1482. 3. American Heart Association. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sodium/how-much-sodium-should-i-eat-per-day Accessed April 4, 2024. 4. World Health Organization. Guideline: Sodium Intake for Adults and Children. World Health Organization; 2012. Accessed January 5, 2024. https://www.who.int/publications/i/item/9789241504836 5. Visseren FLJ et al. Eur Heart J. 2021;42(34):3227-3337. 6. US Department of Health and Human Services and US Department of Agriculture. Dietary Guidelines for Americans, 2020-2025. 9th ed. December 2020. https://www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf. Accessed April 4, 2024. 7. Stallings VA et al, eds. Dietary Reference Intakes for Sodium and Potassium. Washington, DC: National Academies Press; 2019. https://nap.nationalacademies.org/catalog/25353/dietary-reference-intakes-for-sodium-and-potassium Accessed April 4, 2024. 8. Jackson SL et al. MMWR Morb Mortal Wkly Rep. 2016;64(52):1393-1397. 9. Perrin G et al. PLoS One. 2017;12(7):e0180634. 10. Quader ZS et al. MMWR Morb Mortal Wkly Rep. 2017;66(12):324-328.
Sodium Intake Recommendations
Although “table salt” and “sodium” are often used interchangeably, they do not mean the same thing.1
Each gram of table salt is composed of about 40% sodium and 60% chloride by weight
Therefore, the intake recommendations for salt appear higher than those for sodium, since the equivalent of 1 g of sodium is found in 2.5 g of table salt
Here are recommendations for maximum daily salt and sodium intake from major health organizations.
*For people aged ≥14 years. †For adults. ‡No recommended age range provided. §Ideal target for most adults.
References: 1. European Commission. Updated October 26, 2023. https://knowledge4policy.ec.europa.eu/health-promotion-knowledge-gateway/dietary-saltsodium_en. Accessed January 4, 2024. 2. US Department of Health and Human Services and US Department of Agriculture. Dietary Guidelines for Americans, 2020-2025. 9th ed. Published December 2020. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf Accessed April 4, 2024. 3. National Academies of Sciences, Engineering, and Medicine. Dietary Reference Intakes for Sodium and Potassium. Washington, DC: The National Academies Press; 2019. https://nap.nationalacademies.org/catalog/25353/dietary-reference-intakes-for-sodium-and-potassium. Accessed April 4, 2024. 4. World Health Organization. Guideline: Sodium Intake for Adults and Children. World Health Organization; 2012. https://www.who.int/publications/i/item/9789241504836. Accessed April 4, 2024. 5. Visseren FLJ et al. Eur Heart J. 2021;42(34):3227-3337. 6. Benjamin EJ et al. Circulation. 2019;139(10):e56-e528.
Experts Share Their Approaches to Discussing Sodium Intake and CV Risk With Patients
Watch Dr Christopher Winter, a sleep specialist, moderate a discussion among a cardiologist, nutritionist, and primary care/family practitioner as they share their perspectives on the connection between sodium intake and cardiovascular (CV) risks among people with narcolepsy, including how to have such conversations with patients.
Participants were compensated for their time by Jazz Pharmaceuticals, Inc.
Important Safety Information
Warnings and Precautions (cont'd)
Abuse and Misuse
XYWAV is a Schedule III controlled substance. The active moiety of XYWAV is oxybate, also known as gamma-hydroxybutyrate (GHB), a Schedule I controlled substance. Abuse of illicit GHB, either alone or in combination with other CNS depressants, is associated with CNS adverse reactions, including seizure, respiratory depression, decreases in the level of consciousness, coma, and death. The rapid onset of sedation, coupled with the amnestic features of GHB, particularly when combined with alcohol, has proven tobe dangerous for the voluntary and involuntary user (eg, assault victim). Physicians should carefully evaluate patients for a history of drug abuse and follow such patients closely.
XYWAV and XYREM REMS
- Because of the risks of central nervous system depression and abuse and misuse, XYWAV is available only through a restricted distribution program called the XYWAV and XYREM REMS.
Notable requirements of the XYWAV and XYREM REMS include the following:
- Healthcare Providers who prescribe XYWAV are specially certified
- XYWAV will be dispensed only by the central pharmacy that is specially certified
- XYWAV will be dispensed and shipped only to patients who are enrolled in the XYWAV and XYREM REMS with documentation of safe use
Further information is available at www.XYWAVXYREMREMS.com or 1-866-997-3688.
Respiratory Depression and Sleep‑Disordered Breathing
XYWAV may impair respiratory drive, especially in patients with compromised respiratory function. In overdoses of oxybate and with illicit use of GHB, life-threatening respiratory depression has been reported. Increased apnea and reduced oxygenation may occur with XYWAV administration in adult and pediatric patients. A significant increase in the number of central apneas and clinically significant oxygen desaturation may occur in patients with obstructive sleep apnea treated with XYWAV. Prescribers should be aware that sleep-related breathing disorders tend to be more prevalent in obese patients, in men, in postmenopausal women not on hormone replacement therapy, and among patients with narcolepsy.
Depression and Suicidality
In Study 1, the randomized-withdrawal clinical trial in adult patients with narcolepsy (n=201), depression and depressed mood were reported in 3% and 4%, respectively, of patients treated with XYWAV. Two patients (1%) discontinued XYWAV because of depression. In most cases, no change in XYWAV treatment was required.
Two suicides and two attempted suicides occurred in adult clinical trials with oxybate (same active moiety as XYWAV). One patient experienced suicidal ideation and two patients reported depression in a pediatric clinical trial with oxybate. These events occurred in patients with and without previous histories of depressive disorders. The emergence of depression in patients treated with XYWAV requires careful and immediate evaluation. Monitor patients for the emergence of increased depressive symptoms and/or suicidality while taking XYWAV.
Respiratory Depression and Sleep‑Disordered Breathing
XYWAV may impair respiratory drive, especially in patients with compromised respiratory function. In overdoses of oxybate and with illicit use of GHB, life-threatening respiratory depression has been reported. Increased apnea and reduced oxygenation may occur with XYWAV administration in adult and pediatric patients. A significant increase in the number of central apneas and clinically significant oxygen desaturation may occur in patients with obstructive sleep apnea treated with XYWAV. Prescribers should be aware that sleep-related breathing disorders tend to be more prevalent in obese patients, in men, in postmenopausal women not on hormone replacement therapy, and among patients with narcolepsy.
Depression and Suicidality
In Study 1, the randomized-withdrawal clinical trial in adult patients with narcolepsy (n=201), depression and depressed mood were reported in 3% and 4%, respectively, of patients treated with XYWAV. Two patients (1%) discontinued XYWAV because of depression. In most cases, no change in XYWAV treatment was required.
Two suicides and two attempted suicides occurred in adult clinical trials with oxybate (same active moiety as XYWAV). One patient experienced suicidal ideation and two patients reported depression in a pediatric clinical trial with oxybate. These events occurred in patients with and without previous histories of depressive disorders. The emergence of depression in patients treated with XYWAV requires careful and immediate evaluation. Monitor patients for the emergence of increased depressive symptoms and/or suicidality while taking XYWAV.
Important Safety Information
WARNING: CENTRAL NERVOUS SYSTEM DEPRESSION and ABUSE AND MISUSE.
- Central Nervous System Depression
XYWAV is a CNS depressant. Clinically significant respiratory depression and obtundation may occur in patients treated with XYWAV at recommended doses. Many patients who received XYWAV during clinical trials in narcolepsy were receiving CNS stimulants.