EFSA finally establishes safe sodium and chloride values after ten years

12-Sep-2019 - Last updated on 11-Sep-2019 at 16:05 GMT

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The European Food Safety Agency (EFSA) finally publish dietary reference values (DRVs) for sodium and chloride marking the culmination of a decade’s work by the Agency’s nutrition scientists.

Writing in its official journal, EFSA’s Panel on Nutrition, Novel Foods and Food Allergens assign a value of 2.0 grams (g) sodium per day as a safe and adequate intake for the general EU adult population.

The DRV for chloride is set at 3.1 g per day (g/day) for adults including pregnant and lactating women as the Panel cites parallels with the reference values for sodium as “safe and adequate for the general EU population”.

“It’s really satisfying to see the final two DRVs published,” says Androniki ‘Ada’ Naska, EFSA NDA Panel member.

“Sodium and chloride are good examples of the challenges of setting DRVs when there is a complex physiological interplay between several nutrients.

“Knowing how much of these nutrients is necessary, adequate or tolerable are multifaceted scientific questions.”

The publication of these values (DRVs) brings to a close ten years of work that began with a request by the European Commission to update values last set in the 1990s for macronutrients such as proteins and carbohydrates, and all vitamins and minerals.

As well as the interaction between a number of nutrients, Naska cites a main challenge in defining values for sodium and chloride as weighing up the scientific literature.

“On sodium we reviewed the literature systematically, critically appraised eligible studies and then carried out a “meta-analysis,” she explains.

“Modelling helped us to identify dose-responses which we needed to set reference values. We further quantified the uncertainties in our conclusions to enhance transparency. It was an exhaustive process.”

Kids’ energy & growth requirements

With 2.0 g sodium/day for the general EU adult population, this value is also considered safe for pregnant and lactating women.

The scientific opinion also explains that safe sodium intakes for children are adjusted for their energy requirements and growth considerations.

The Panel conclude that 1.1 g/day of sodium for children aged 1–3 years is adequate as is 1.3 g/day for children aged 4–6 years, 1.7 g/day for children aged 7–10 years and 2.0 g/day for children aged 11–17 years, respectively.

For infants aged 7–11 months, an Adequate Intake (AI) of 0.2 g/day is proposed based on the estimated sodium intake in exclusively breast-fed infants aged 0–6 months.

Determination of chloride values take a similar methodology, with the Panel considering that reference values can be set at values equimolar to the reference values for sodium for all population groups.

They conclude that 1.7 g/day for children aged 1–3 years, 2.0 g/day for children aged 4–6 years, 2.6 g/day for children aged 7–10 years, 3.1 g/day for children aged 11–17 years are adequate. For infants aged 7–11 months, an adequate intake of 0.3 g/day is set.

Western diet considerations

“Consistent with the reference values for sodium, these levels of chloride intake are considered to be safe and adequate for the general EU population, under the consideration that the main dietary source of chloride intake is sodium chloride,” the opinion concludes.

“In Western diets sodium and chloride are mainly found in salt but are naturally present in most food,” comments Agnès de Sesmaisons-Lecarré, fellow EFSA NDA Panel member.

“The body needs them to function but, when consumed in excess, they can cause elevated blood pressure, a risk factor for cardiovascular disease.

“European intakes in adults are typically higher so EU decision-makers can use this value where appropriate to set population targets for reducing sodium intake.”

In publishing these two scientific opinions EFSA also update its DRV Finder in the process. This is an interactive tool that gives access to EFSA’s DRV nutrient values intended for nutrition and health professionals.

“Users can search by nutrient or by target population,” says EFSA’s Céline Dumas. “Professionals can easily check useful definitions, access the corresponding scientific opinions of EFSA or its predecessor [the Scientific Committee on Food], or export their selection for further use.”