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Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2005)
Food and Nutrition Board (FNB)

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. "9 A Research Agenda." Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. Washington, DC: The National Academies Press, 2005.

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Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate

on public health strategies that effectively reduce sodium intake and others that increase potassium intake in the general population.

Highest priority is given to research that has the potential to prevent or retard human disease processes and to prevent deficiencies with functional consequences. The following broad areas for research were deemed the highest priority (specific research recommendations are found at the conclusions of Chapters 4 through 7):

  • Research on effective public health strategies to achieve and sustain a reduced sodium and increased potassium intake in the general population, including

    • behavioral change studies in individuals, and

    • community-based intervention studies.

  • Research on alternative technologies that reduce the sodium content of foods, with a special emphasis on maintaining flavor, texture, consumer acceptability, safety, and low cost.

  • Studies that test the effects of reduced sodium and increased potassium intake, alone and combined, on clinical outcomes (e.g., stroke, bone mineral density, and kidney stones). To the extent possible, clinical trials should be conducted. A formal assessment of the feasibility of a sodium reduction trial with clinical cardiovascular outcomes should be undertaken. In the absence of trials, methodologically rigorous observational studies that concomitantly collect electrolyte intake, other dietary information, and genetic information should be conducted.

  • Studies to assess the potential for increased potassium intake to mitigate the adverse consequences of excess sodium intake and, vice versa, the potential for a reduced sodium intake to mitigate the adverse consequences of inadequate potassium intake. Potential outcomes include blood pressure, salt sensitivity, bone demineralization, and bone mineral density.

  • Studies on the adverse effects of chronic, low-grade metabolic acidosis that results from an inadequate intake of potassium and its bicarbonate precursors. Potential outcomes include bone mineral density and kidney stones.

  • Water, sodium, and potassium balance studies that enroll broad populations and that vary climate and physical activity levels. Populations of particular interest are children, as well as older persons with chronic, but stable, illnesses.

  • Research to improve the assessment of sodium and potassium intake and total body stores.

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469
Front Matter (R1-R20)
Summary (1-20)
1 Introduction to Dietary Reference Intakes (21-36)
2 Overview and Methods (37-49)
3 A Model for the Development of Tolerable Upper Intake Levels (50-72)
4 Water (73-185)
5 Potassium (186-268)
6 Sodium and Chloride (269-423)
7 Sulfate (424-448)
8 Applications of Dietary Reference Intakes for Electrolytes and Water (449-464)
9 A Research Agenda (465-470)
Appendix A: Glossary and Acronyms (471-476)
Appendix B: Origin and Framework of the Development of Dietary Reference Intakes (477-484)
Appendix C: Predictions of Daily Water and Sodium Requirements (485-493)
Appendix D: U.S. Dietary Intake Data from the Third National Health and Nutrition Examination Survey, 1988–1994 (494-517)
Appendix E: U.S. Dietary Intake Data for Water and Weaning Foods from the Continuing Survey of Food Intakes by Individuals, 1994–1996, 1998 (518-526)
Appendix F: Canadian Dietary Intake Data for Adults from Ten Provinces, 1990–1997 (527-533)
Appendix G: U.S. Water Intake and Serum Osmolality Data from the Third National Health and Nutrition Examination Survey, 1988–1994 (534-536)
Appendix H: U.S. Total Water Intake Data by Frequency of Leisure Time Activity from the Third National Health and Nutrition Examination Survey, 1988–1994 (537-545)
Appendix I: Dose-Response Effects of Sodium Intake on Blood Pressure (546-557)
Appendix J: Serum Electrolyte Concentrations NHANES III, 1988-94 (558-563)
Appendix K: Options for Dealing with Uncertainties (564-568)
Appendix L: Acknowledgments (569-571)
Appendix M: Biographical Sketches of Panel Members (572-576)
Index (577-618)