Dietary Reference Values for sodium - European Food Safety ...

1 SCIENTIFIC opinion ADOPTED: XX MM YYYY EFSA Journal 20YY;volume(issue):NNNN Dietary Reference Values for sodium EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA), Dominique Turck, Jean-Louis Bresson, Barbara Burlingame, Tara Dean, Susan Fairweather-Tait, Marina Heinonen, Karen Ildico Hirsch-Ernst, Inge Mangelsdorf, Harry J McArdle, Monika Neuh user-Berthold, Gra yna Nowicka, Kristina Pentieva, Yolanda Sanz, Alfonso Siani, Anders Sj din, Martin Stern, Daniel Tom , Henk Van Loveren, Marco Vinceti, Peter Willatts, Peter Aggett, Ambroise Martin, Hildegard Przyrembel, Agn s De Sesmaisons-Lecarr , Silvia Valtue a Mart nez and Androniki Naska Abstract Tbc 20YY European Food Safety Authority.

2 EFSA Journal published by John Wiley and Sons Ltd on behalf of the European Food Safety Authority. Keywords: Tbc Requestor: European Commission Question number: EFSA-Q-2011-01224 Correspondence: Dietary Reference Values for sodium 2 EFSA Journal 20YY;volume(issue):NNNN Panel members: Jean-Louis Bresson, Barbara Burlingame, Tara Dean, Susan Fairweather-Tait, Marina Heinonen, Karen Ildico Hirsch-Ernst, Inge Mangelsdorf, Harry J McArdle, Androniki Naska, Monika Neuh user-Berthold, Gra yna Nowicka, Kristina Pentieva, Yolanda Sanz, Alfonso Siani, Anders Sj din, Martin Stern, Daniel Tom , Dominique Turck, Henk Van Loveren, Marco Vinceti and Peter Willatts.

3 Suggested citation: EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies), Turck D, Bresson J-L, Burlingame B, Dean T, Fairweather-Tait S, Heinonen M, Hirsch-Ernst KI, Mangelsdorf I, McArdle HJ, Neuh user-Berthold M, Nowicka G, Pentieva K, Sanz Y, Siani A, Sj din A, Stern M, Tom D, Van Loveren H, Vinceti M, Willatts P, Aggett P, Martin A, Przyrembel H, De Sesmaisons-Lecarr A, Valtue a Mart nez S and Naska A, 20YY. Scientific opinion on Dietary Reference Values for sodium . EFSA Journal 20YY;volume(issue):NNNN, 72 pp. ISSN: 1831-4732 20YY European Food Safety Authority.

4 EFSA Journal published by John Wiley and Sons Ltd on behalf of European Food Safety Authority. This is an open access article under the terms of the Creative Commons Attribution-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited and no modifications or adaptations are made. The EFSA Journal is a publication of the European Food Safety Authority, an agency of the European Union. Dietary Reference Values for sodium 3 EFSA Journal 20YY;volume(issue):NNNN Summary 1 Tbc 2 Dietary Reference Values for sodium 4 EFSA Journal 20YY;volume(issue):NNNN Table of contents 3 4 Abstract.

5 1 5 Summary .. 3 6 Background as provided by the European Commission .. 6 7 Terms of Reference as provided by the European Commission .. 6 8 Data and Methodologies .. 8 9 Assessment .. 9 10 1. Introduction .. 9 11 2. Definition/category .. 9 12 Chemistry .. 9 13 Function of the nutrient .. 10 14 Biochemical functions .. 10 15 Health consequences of deficiency and excess .. 10 16 Physiology and metabolism .. 11 17 Intestinal absorption and 11 18 Transport in blood .. 12 19 Distribution to tissues .. 12 20 Elimination .. 13 21 Modification of sodium metabolism during pregnancy .. 16 22 Interaction with other nutrients.

6 17 23 Potassium .. 17 24 Chloride .. 17 25 Calcium .. 18 26 Biomarkers .. 19 27 Biomarkers of intake .. 19 28 Biomarkers of status .. 21 29 Effects of genotypes .. 21 30 3. Dietary sources and intake data .. 22 31 Dietary sources .. 22 32 sodium sources and relative contributions to Dietary sodium intake .. 22 33 Dietary intake .. 23 34 Methodological considerations .. 23 35 sodium urinary excretion in European populations and abroad .. 24 36 4. Overview of Dietary Reference Values and recommendations .. 25 37 Adults .. 25 38 Infants and children .. 28 39 Pregnancy and lactation .. 30 40 5. Criteria (endpoints) on which to base Dietary Reference Values .

7 31 41 Biomarkers as indicators of sodium requirement .. 31 42 Balance studies .. 31 43 Balance studies in adults .. 31 44 Balance studies in children .. 33 45 Conclusions on balance studies .. 33 46 Indicators of sodium requirement in pregnancy and lactation .. 33 47 Indicators of sodium requirement in children .. 34 48 sodium intake and health consequences .. 35 49 6. Data on which to base Dietary Reference Values .. 35 50 Conclusions .. 35 51 Recommendations for research .. 35 52 References .. 35 53 Appendices .. 47 54 Appendix A sodium concentration in breast milk from mothers of term infants in 55 western countries.

8 47 56 Appendix B Comparisons of measured 24H urinary Na excretions vs. 24H urinary Na 57 excretions estimated from equations based on concentrations of Na in spot urine samples .. 49 58 Dietary Reference Values for sodium 5 EFSA Journal 20YY;volume(issue):NNNN Appendix C Daily sodium urinary excretion in children, boys and girls, in European countries .. 58 59 Appendix D Daily sodium urinary excretion in adult males in European countries .. 59 60 Appendix E Daily sodium urinary excretion in adult females in European countries .. 65 61 Abbreviations .. 71 62 63 64 Dietary Reference Values for sodium 6 EFSA Journal 20YY;volume(issue):NNNN Background as provided by the European Commission 65 The scientific advice on nutrient intakes is important as the basis of Community action in the field of 66 nutrition, for example such advice has in the past been used as the basis of nutrition labelling.

9 The 67 Scientific Committee for Food (SCF) report on nutrient and energy intakes for the European 68 Community dates from 1993. There is a need to review and if necessary to update these earlier 69 recommendations to ensure that the Community action in the area of nutrition is underpinned by the 70 latest scientific advice. 71 In 1993, the SCF adopted an opinion on the nutrient and energy intakes for the European 72 The report provided Reference Intakes for energy, certain macronutrients and 73 micronutrients, but it did not include certain substances of physiological importance, for example 74 Dietary fibre.

10 75 Since then new scientific data have become available for some of the nutrients, and scientific advisory 76 bodies in many European Union Member States and in the United States have reported on 77 recommended Dietary intakes. For a number of nutrients these newly established (national) 78 recommendations differ from the Reference intakes in the SCF (1993) report. Although there is 79 considerable consensus between these newly derived (national) recommendations, differing opinions 80 remain on some of the recommendations. Therefore, there is a need to review the existing EU 81 Reference Intakes in the light of new scientific evidence, and taking into account the more recently 82 reported national recommendations.