What is the normal range of human dietary sodium intake based on 24-hour urinary sodium excretion worldwide?

December 27, 2025 •

4 min read

The global mean dietary sodium intake for adults is 4,310 mg per day, more than double the World Health Organization's (WHO) recommendation of under 2,000 mg daily. Accurate assessment of sodium consumption is critical for public health, and 24-hour urinary sodium excretion is considered the gold standard for measuring population-level intake.

Quick Summary

This article examines the physiologically observed normal range of sodium intake from 24-hour urinary excretion studies versus global health recommendations. It explores international variations, the accuracy of measurement methods, and the health implications of different intake levels.

Key Points

Global Intake Exceeds Recommendations: The worldwide average sodium intake, as measured by 24-hour urinary excretion, is approximately 3,666 mg/day, far above the WHO's recommendation of under 2,000 mg/day.
Measurement is Reliable: 24-hour urinary sodium excretion is considered the gold standard for reliably measuring dietary sodium intake at a population level, with 90-93% of consumed sodium being excreted through urine.
Intake Varies by Region and Diet: Observed sodium intake levels vary significantly between countries due to cultural culinary practices, with high discretionary salt use in some regions and high processed food intake dominating others.
Health Risks Associated with High Intake: Consistently high sodium intake is strongly linked to health issues like hypertension, cardiovascular disease, gastric cancer, and kidney problems.
Debate on Very Low Intake: Some research suggests a potential J-shaped relationship where risks increase at both very low (below 3,000 mg/day) and very high intake levels, though definitive evidence is still being debated.
Reducing Processed Foods is Key: In many developed nations, the majority of sodium comes from processed and restaurant foods, making label-reading and cooking at home crucial strategies for reduction.

What 24-Hour Urinary Excretion Reveals about Sodium Intake

Accurately measuring dietary sodium intake is a cornerstone of nutritional science and public health. While dietary recalls are prone to inaccuracies, the 24-hour urinary sodium excretion test provides the most reliable snapshot of a person's average sodium consumption. The premise is that approximately 90% to 93% of the sodium consumed is excreted in the urine, with the rest lost through feces and sweat. {Link: pmc.ncbi.nlm.nih.gov https://pmc.ncbi.nlm.nih.gov/articles/PMC8030843/}.

The Physiologically Determined Normal Range

Research indicates a consistent, physiologically determined range of sodium intake across various populations and decades, as measured by 24-hour urinary excretion. A meta-analysis involving over 50,000 participants globally found a mean 24-hour urinary sodium excretion of approximately 159.4 mmol/day, ranging from 114 to 210 mmol/day. This translates to a mean intake of around 3,666 mg/day, with a range of 2,622 to 4,830 mg/day. This consistency suggests a biologically regulated range for sodium intake.

Global and Regional Variations in Sodium Consumption

Despite the existence of a physiologically consistent range, actual dietary sodium consumption varies significantly worldwide due to cultural and economic factors. National studies using 24-hour urine collection show considerable differences. For instance, data from the Americas indicated a mean excretion of about 3,618 mg/day. In contrast, a study in China's Shandong province showed a higher mean of approximately 4,634 mg/day, largely due to cooking and condiments. Income levels also play a role, with lower-income countries using more discretionary salt (added during cooking or at the table), while higher-income countries consume more sodium from processed and restaurant foods.

Comparing Recommended vs. Observed Sodium Intake

Public health organizations like the WHO recommend less than 2,000 mg/day of sodium to reduce cardiovascular risk. This is substantially lower than the observed global average intake of 3,000-5,000 mg/day from 24-hour urinary excretion. {Link: pmc.ncbi.nlm.nih.gov https://pmc.ncbi.nlm.nih.gov/articles/PMC8030843/}.


Feature	WHO Recommended Intake	Global Average Intake (24-hr urine)	Physiological Normal Range (Research)
Daily Sodium Limit	< 2,000 mg/day	~3,500 - 4,500 mg/day	Mean ~3,666 mg/day (2,622-4,830 mg/day)
Basis for Value	Public health guideline aimed at reducing hypertension and cardiovascular risk	Observed mean intake across diverse populations, reflecting typical eating habits	Consistent, biologically regulated range observed over decades in numerous studies
Health Context	Preventive guideline for reducing population-wide non-communicable diseases	Reflects real-world consumption patterns, often exceeding health recommendations	Suggests a 'sweet spot' for intake, with risks potentially increasing at both extremes

Methodological Considerations and the Full Picture

While the 24-hour urine test is the benchmark, a single collection may not reflect long-term habits due to daily and seasonal variations. Multiple collections are better for individual assessment. Incomplete collections can also affect results. Factors like health, activity, and hydration influence excretion rates. {Link: pmc.ncbi.nlm.nih.gov https://pmc.ncbi.nlm.nih.gov/articles/PMC8030843/}.

The Impact of Lifestyle and Diet

Sodium intake is linked to other dietary factors. Studies show higher sodium intake is associated with higher BMI and waist circumference, suggesting a link to obesity. A diet high in potassium can help counteract the blood pressure effects of high sodium, emphasizing the sodium-to-potassium balance.

Actionable Steps for Managing Sodium Intake

Reducing sodium intake involves limiting discretionary salt and processed foods. Key strategies include:

Read Nutrition Labels: Check sodium content (%DV) on packaged foods, aiming for 5% DV or less per serving.
Prioritize Home Cooking: Control sodium by cooking with fresh ingredients.
Use Herbs and Spices: Flavor food without excessive salt.
Choose Fresh Products: Opt for fresh or frozen (without added salt/sauce) meats and vegetables.
Rinse Canned Foods: Rinse canned items to remove some sodium.
Be Mindful of Condiments: Limit salty condiments like soy sauce.

The Ongoing Debate and Future Directions

The debate about optimal sodium intake is complex. While global intake exceeds recommendations, some studies question the benefits of very low sodium diets. Many experts agree most populations consume too much and would benefit from reduction. Future research is needed for definitive evidence on different intake levels and cardiovascular outcomes. The discrepancy between health targets and observed consumption remains a focus. More information can be found at the {Link: World Health Organization https://www.who.int/news-room/fact-sheets/detail/sodium-reduction}.

Conclusion

While 24-hour urinary excretion studies reveal a consistent physiological range of sodium intake (around 2,600 to 4,800 mg/day), the global average intake is considerably higher than the WHO's recommendation of under 2,000 mg/day. The data confirm widespread sodium overconsumption linked to increased risk of conditions like hypertension. Reducing intake, especially from processed foods, aligns with major health guidelines, though the debate on the optimal low-end target continues. For most, reducing intake below the global average is beneficial for health, underscoring the link between excess sodium and health risks. {Link: pmc.ncbi.nlm.nih.gov https://pmc.ncbi.nlm.nih.gov/articles/PMC8030843/}.

Frequently Asked Questions

The World Health Organization (WHO) recommends that adults consume less than 2,000 mg of sodium per day, which is equivalent to less than 5 grams of salt (or about one teaspoon).

The 24-hour urinary sodium excretion test is considered the most accurate method for assessing sodium intake. It measures the total amount of sodium excreted in urine over a 24-hour period, which typically reflects about 90-93% of a person's dietary intake.

No, the exact percentage can vary slightly between individuals and is affected by factors such as health status, hydration, physical activity, and body mass. However, for a population, the average excretion rate is consistently around 90-93% of intake.

The global average is higher because many populations, particularly in developed countries, rely heavily on processed foods and restaurant meals that are high in sodium. Traditional cooking methods in some cultures also involve significant amounts of salt.

Sources vary by region, but common contributors include packaged and processed foods (breads, cereals, meats, dairy), restaurant meals, and discretionary salt added during cooking or at the table. In some Asian countries, sources like soy sauce and other salty condiments are significant.

Some cohort studies have suggested a J-shaped or U-shaped relationship between sodium intake and cardiovascular risk, implying that very low intake (e.g., under 3,000 mg/day) could be associated with increased risk compared to a moderate range (3,000-5,000 mg/day). This remains a topic of scientific debate and does not negate the risks of excessively high intake.

To reduce sodium, focus on limiting processed and restaurant foods, cooking at home more often, reading nutrition labels, and using herbs, spices, and citrus to flavor meals instead of salt.

A single 24-hour collection provides a good estimate for that specific day or for a population average, but due to daily and seasonal variations in diet, multiple non-consecutive collections are needed to accurately assess an individual's usual long-term sodium intake.