Abstract Body: Background: Excess dietary sodium and sugar intake have been linked to cardiovascular and coronary disease, but their associations with peripheral artery disease (PAD) are not well defined. We examined the relationship between sodium and sugar intake and ankle-brachial index (ABI) in a nationally representative U.S. sample.

Methods: The study population was obtained from the 2003-2004 NHANES database and comprised 2,040 adults (mean age 60.26 ± 12.9 years, 52.5% male). Sodium intake (per 1,000 mg) and sugar intake (per 10 g), normalized to total caloric intake, were modeled as continuous variables and categorized as high vs. low intake. Survey-weighted linear regression assessed associations with ABI, and logistic regression estimated odds ratios (ORs) for PAD (ABI < 0.9), adjusting for age, sex, race/ethnicity, body mass index, blood pressure, and smoking status.

Results: In our unadjusted analyses, higher sodium intake was associated with lower ABI (β (95% CI): -0.013 (-0.025, -0.001); P = 0.037), though this association was attenuated and lost statistical significance after adjustment (-0.009 (-0.027, 0.008); P = 0.191). Sugar intake was not associated with ABI in either unadjusted or adjusted models. Categorically, a high sodium diet was associated with increased odds of PAD in unadjusted analyses (OR (95% CI): 1.70 (1.16, 2.49); P = 0.010), but not after adjustment (1.44 (0.78, 2.63); P = 0.155). High sugar intake was inversely associated with PAD in unadjusted models (0.55 (0.36, 0.83); P = 0.008), though this association was no longer significant after adjustment. Combined high sodium and high sugar intake was not significantly associated with PAD.

Conclusions: Our findings suggest that higher sodium intake was associated with lower ABI and greater odds of PAD in unadjusted models, but associations were attenuated after multivariable adjustment. Sugar intake showed no independent association with ABI or PAD. These findings underscore the complexity of dietary influences on peripheral vascular disease.