Background
Dietary Na⁺ or Na⁺/K⁺ ratio has been reported to be associated with bone mineral density (BMD). However, this remains unclear, and only a few studies have been reported on the Korean population. Therefore, this study aimed to determine the association between dietary Na⁺, K⁺, and Na⁺/K⁺ ratios and BMD in middle-aged Korean women.
Methods
This study used data from the Korea National Health and Nutrition Examination Survey 2008–2011. A total of 3,690 women aged >50 years were included. Study participants were classified into quartiles (lowest quartile Q1–highest quartile Q4) according to dietary Na⁺, K⁺, and Na⁺/K⁺ ratio, and we examined the association of these parameters with BMD. Total femur and lumbar spine BMD were measured using dual-energy X-ray absorptiometry. Multiple linear regression analyses were performed using IBM SPSS ver. 19.0.
Results
The mean age was 62 years, and a significant negative trend in the β-coefficient regarding dietary Na⁺ was only observed in the total femur BMD. However, the total femur and lumbar spine BMD decreased from Q1 to Q4 regarding the dietary Na⁺/K⁺ ratio (P-value for trend: 0.044 for total femur BMD and 0.002 for lumbar spine BMD).
Conclusion
A significant negative trend in the β-coefficient for both total femur and lumbar spine BMD was observed regarding the Na⁺/K⁺ ratio. Therefore, based on the results of this study, a higher dietary Na⁺/K⁺ ratio may be associated with a lower BMD.

Citations

• Bioactive Compounds and Health Functions of Plums: Current Status and Future Opportunities
  Ming-Qiang Xu, Samuel Ariyo Okaiyeto, Xiao-Xiao Niu, Qing-Hui Wang, Sriram K. Vidyarthi, Haiou Wang, Li-Zhen Deng, Parag Prakash Sutar, Hong-Wei Xiao
  Food Reviews International.2025; 41(5): 1360.     CrossRef
• Does Changing the Ratio of Dietary Sodium-to-Potassium Intake Affect Bone Mineral Density?
  Soo Young Kim
  Korean Journal of Family Medicine.2023; 44(1): 1.     CrossRef