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Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate
have assessed the relationship of potassium intake with blood pressure or its rise during childhood and adolescence. In one prospective observational study of 233 Dutch children aged 5 to 17 years, the rise in blood pressure over 7 years was significantly and inversely associated with dietary potassium intake and the dietary sodium:potassium ratio, as estimated from multiple overnight urine collections (Geleijnse et al., 1990). Two small trials tested the effects of potassium supplementation in children (Miller et al., 1987; Sinaiko et al., 1993). In both trials, potassium had no significant effect on blood pressure; however, statistical power may have been inadequate.
Because the conditions resulting from potassium deficiency (i.e., elevated blood pressure, bone demineralization, and kidney stones) are chronic and likely result from inadequate intake over an extended period of time, including childhood, it is appropriate to extrapolate recommended intakes of potassium in adults to children. However, the optimal approach to extrapolation is uncertain (e.g., adjustment based on weight, energy intake, or another method). Adjustment based on energy intake was deemed most appropriate because of concern that adjustment based on weight might lead to a relatively low and potentially inadequate intake of potassium. Furthermore, given the high energy intake of children relative to their weight and the potential for a high sodium intake as a result of their high energy intake, a greater intake of dietary potassium would be appropriate as a means to mitigate the adverse effects of sodium.
The AI is thus derived by extrapolating from the adult AI on the basis of the average of median energy intake levels. Based on data from CSFII, the median energy intake for 1- to 3- and 4- to 8-year-old children is 1,372 and 1,759 kcal/day, respectively (IOM, 2002). Median energy intakes for preadolescent (9 to 13 years of age) and adolescent (14 to 18) boys and girls range from 1,877 to 2,226 and 1,872 to 2,758 kcal/day, respectively.