ObjectivesTo examine sodium and potassium urinary excretion by socioeconomic status (SES), discretionary salt use habits and dietary sources of sodium and potassium in a sample of Australian schoolchildren.DesignCross-sectional study.SettingPrimary schools located in Victoria, Australia.Participants666 of 780 children aged 4–12 years who participated in the Salt and Other Nutrients in Children study returned a complete 24-hour urine collection.Primary and secondary outcome measures24-hour urine collection for the measurement of sodium and potassium excretion and 24-hour dietary recall for the assessment of food sources. Parent and child reported use of discretionary salt. SES defined by parental highest level of education.ResultsParticipants were 9.3 years (95% CI 9.0 to 9.6) of age and 55% were boys. Mean urinary sodium and potassium excretion was 103 (95% CI 99 to 108) mmol/day (salt equivalent 6.1 g/day) and 47 (95% CI 45 to 49) mmol/day, respectively. Mean molar Na:K ratio was 2.4 (95% CI 2.3 to 2.5). 72% of children exceeded the age-specific upper level for sodium intake. After adjustment for age, sex and day of urine collection, children from a low socioeconomic background excreted 10.0 (95% CI 17.8 to 2.1) mmol/day more sodium than those of high socioeconomic background (p=0.04). The major sources of sodium were bread (14.8%), mixed cereal-based dishes (9.9%) and processed meat (8.5%). The major sources of potassium were dairy milk (11.5%), potatoes (7.1%) and fruit/vegetable juice (5.4%). Core foods provided 55.3% of dietary sodium and 75.5% of potassium while discretionary foods provided 44.7% and 24.5%, respectively.ConclusionsFor most children, sodium intake exceeds dietary recommendations and there is some indication that children of lower socioeconomic background have the highest intakes. Children are consuming about two times more sodium than potassium. To improve sodium and potassium intakes in schoolchildren, product reformulation of lower salt core foods combined with strategies that seek to reduce the consumption of discretionary foods are required.

BackgroundCaffeine is a common additive in formulated beverages, including sugar-sweetened beverages. Currently there are no data on the consumption of caffeinated formulated beverages in Australian children and adolescents. This study aimed to determine total intake and consumption patterns of CFBs in a nationally representative sample of Australian children aged 2–16 years and to determine contribution of CFBs to total caffeine intake. Consumption by day type, mealtime and location was also examined.MethodsDietary data from one 24-hour recall collected in the 2007 Australian National Children’s Nutrition and Physical Activity Survey were analysed. CFBs were defined as beverages to which caffeine has been added as an additive, including cola-type beverages and energy drinks. Socioeconomic status was based on the highest level of education attained by the participant’s primary caregiver. Time of day of consumption was classified based on traditional mealtimes and type of day of consumption as either a school or non-school day. Location of consumption was defined by the participant during the survey.ResultsOn the day of the survey 15% (n = 642) of participants consumed CFBs. Older children and those of low socioeconomic background were more likely to consume CFBs (both P < 0.001). Amongst the 642 consumers mean (95% CI) intakes were 151 (115–187)g/day, 287 (252–321)g/day, 442 (400–484)g/day, and 555 (507–602)g/day for 2–3, 4–8, 9–13 and 14–16 year olds respectively. Consumers of CFBs had higher intakes of caffeine (mean (95% CI) 61 (55–67)mg vs. 11 (10–12)mg) and energy (mean (95% CI) 9,612 (9,247-9978)kJ vs. 8,186 (8,040-8,335)kJ) than non-consumers (both P < 0.001). CFBs contributed 69% of total daily caffeine intake. CFB intake was higher on non-school days compared with school days (P < 0.005) and consumption occurred predominantly at the place of residence (56%), within the “dinner” time bracket (17:00–20:30, 44%).ConclusionsThe consumption of CFBs by all age groups within Australian children is of concern. Modifications to the permissibility of caffeine as a food additive may be an appropriate strategy to reduce the intake of caffeine in this age group. Additional areas for intervention include targeting parental influences over mealtime beverage choices.

Mandatory fortification of bread with iodized salt was introduced in Australia in 2009, and studies using spot urine collections conducted post fortification indicate that Australian schoolchildren are now replete. However an accurate estimate of daily iodine intake utilizing 24-h urinary iodine excretion (UIE μg/day) has not been reported and compared to the estimated average requirement (EAR). This study aimed to assess daily total iodine intake and status of a sample of primary schoolchildren using 24-h urine samples. Victorian primary school children provided 24-h urine samples between 2011 and 2013, from which urinary iodine concentration (UIC, μg/L) and total iodine excretion (UIE, μg/day) as an estimate of intake was determined. Valid 24-h urine samples were provided by 650 children, mean (SD) age 9.3 (1.8) years (n = 359 boys). The mean UIE of 4–8 and 9–13 year olds was 94 (48) and 111 (57) μg/24-h, respectively, with 29% and 26% having a UIE below the age-specific EAR. The median (IQR) UIC was 124 (83,172) μg/L, with 36% of participants having a UIC < 100 μg/L. This convenience sample of Victorian schoolchildren were found to be iodine replete, based on UIC and estimated iodine intakes derived from 24-h urine collections, confirming the findings of the Australian Health Survey.

Purpose Urinary iodine concentration (UIC (μg/ml) from spot urine samples collected from school-aged children is used to determine the iodine status of populations. Some studies further extrapolate UIC to represent daily iodine intake, based on the assumption that children pass approximately 1 L urine over 24-h, but this has never been assessed in population studies. Therefore, the present review aimed to collate and produce an estimate of the average 24-h urine volume of children and adolescents (> 1 year and < 19 years) from published studies. Methods EBSCOHOST and EMBASE databases were searched to identify studies which reported the mean 24-h urinary volume of healthy children (> 1 year and < 19 years). The overall mean (95% CI) estimate of 24-h urine volume was determined using a random effects model, broken down by age group. Results Of the 44 studies identified, a meta-analysis of 27 studies, with at least one criterion for assessing the completeness of urine collections, indicated that the mean urine volume of 2-19 year olds was 773 (654, 893) (95% CI) mL/24-h. When broken down by age group, mean (95% CI) 24-h urine volume was 531 mL/day (454, 607) for 2-5 year olds, 771 mL/day (734, 808) for 6-12 year olds, and 1067 mL/day (855, 1279) for 13-19 year olds. Conclusions These results demonstrate that the average urine volume of children aged 2-12 years is less than 1 L, therefore, misclassification of iodine intakes may occur when urine volumes fall below or above 1 L. Future studies utilizing spot urine samples to assess iodine status should consider this when extrapolating UIC to represent iodine intakes of a population.

Objective: In 2015, the Victorian Salt Reduction Partnership launched a 4-year multifaceted salt reduction intervention designed to reduce salt intake by 1 g/d in children and adults living in Victoria, Australia. Child-relevant intervention strategies included a consumer awareness campaign targeting parents and food industry engagement seeking to reduce salt levels in processed foods. This study aimed to assess trends in salt intake, dietary sources of salt and discretionary salt use in primary school children pre and post-delivery of the intervention. Design: Repeated cross-sectional surveys were completed at baseline (2010-13) and follow-up (2018-19). Salt intake was measured via 24-hr urinary sodium excretion, discretionary salt use behaviours by self-report and sources of salt by 24-hour dietary recall. Data were analysed with multivariable adjusted regression models. Setting: Victoria, Australia. Participants: Children aged 4-12 years Results: Complete 24-hour urine samples were collected from 666 children at baseline and 161 at follow-up. Mean salt intake remained unchanged from baseline (6.0; standard error 0.1 g/d) to follow-up (6.1; 0.4 g/d) (p=0.36), there were no clear differences in the food sources of salt and at both timepoints approximately 70% of children exceeded sodium intake recommendations. At follow-up, 14% more parents (p=0.001) reported adding salt during cooking but child use of table salt and inclusion of a saltshaker on the table remained unchanged. Conclusion: These findings show no beneficial effect of the Victorian Salt Reduction Partnership intervention on children’s salt intake. More intensive, sustained and co-ordinated efforts between state and federal stakeholders are required.