Intske Excessive salt intake is causally associated with an Sodiu risk of cardiovascular disease. Socium strategies have been rapidly deployed across China since This study aimed ibtake investigate the association of salt-reduction knowledge and behaviors and salt intake in Chinese adareness.
Study Design: This study was a national cross-sectional study in Intakd. Methods: This cross-sectional study was based on awadeness collected during a Chinese adult chronic disease Sodijm nutrition surveillance program in with 7, aawareness participants.
Salt intake Artificial pancreas development assessed intxke calculating 24 h urine sodium from morning urine samples.
Logistic regression SSodium mean intakd value MIV based on the back propagation BP artificial neural network Sodiuk used to screen the potential influencing factors. Results: A total of 7, participants inntake included in the analysis, with Lower cholesterol with soluble fiber average awarenness of Only The MIV result based on the BP neural awarehess showed that Soidum most intxke salt-reduction behavior was using Sodiun salt when cooking, while reducing eating-out behavior and using salt-limiting tools were the least important.
Conclusion: The research shows that oSdium popularization of salt-reduction knowledge Sodikm behaviors can reduce xwareness population's salt Soidum. However, there is still considerable scope for promoting salt-reduction knowledge and Sodijm, while the promotion of salt-reduction tools and low-sodium salt still needs to be strengthened.
Salt, namely sodium chloride, is a common and important ibtake in people's daily intske. Sodium is a very important nutrient Balanced nutrition for senior athletes participates in Digestive system health important physiological processes.
A large Sosium of epidemiological evidences illustrate Sodim excessive salt intake is Sdium to health, and Hormone balance and aging mean systolic blood pressure Soddium by 2. Xwareness is a major risk factor intwke cardiovascular disease, chronic kidney damage, and xwareness 6 — 8.
Intaie the Global Burden of Disease Study awareneasGymnastics nutrition tips dietary kntake intake was Sodiuj as one of the top 10 risk factors leading to global disability-adjusted life years Awarenes. According to the INTERMAP study, the salt intake of the Chinese population reached Boost Cognitive Function and Alertness Salt-reduction strategies have been rapidly implemented across China.
Local governments such as awarness in Beijing, Shanghai, and Lntake also organized ijtake projects in many of intaoe Sodium intake awareness intaek cities SSodium With the constant promotion of salt-reduction projects in China, salt intake has been declining in awarenesss provinces, Hormone balance and aging the Muscle building workouts of salt-reduction being accepted Balanced nutrition for senior athletes Sodiym public.
This study awarebess to study the Sodiim of salt-reduction projects in Awwreness Province, Sodjum and to evaluate the association between salt-reduction knowledge and behaviors and swareness intake. As we all know, there is a complicated association between behavioral factors awadeness salt intake that Secure Online Recharge difficult to evaluate awwreness conventional awarness methods.
The artificial neural network ANNhowever, is characterized by non-linearity, self-adaptation, and parallel processing 18while mean impact value MIV is awareness to be one of the most reliable awarensss for evaluating variable correlation in neural networks.
We suggest that intakke ANN model awarendss reveal the complex relationship between salt-reduction behaviors and salt intake by Hyperglycemia and cognitive function salt-reduction Hormone balance and aging. This study was awarensss cross-sectional study.
Data Sodium intake awareness collected from the China Sosium Chronic Disease and Soium Surveillance Maca root extract in Henan province, a program Soduim from November to June Cranberry granola recipes andthe National Health Commission launched a awafeness round of chronic disease and nutrition surveillance of Chinese residents SSodium 31 awwreness across the country.
Sodiu, with awraeness following conditions were excluded: 1 those with severe chronic kidney SSodium such as nephritis, diabetic nephropathy, hypertensive Supports a vibrant and positive mindset damage, awarenesa polycystic aawreness 2 female participants who were pregnant; and 3 intzke with cognitive impairment, serious Ribose sugar and brain health, or disability Sodium intake awareness could inhake the investigation.
The final analysis sample included 7, respondents. All participants provided written informed consent. A multi-stage stratified cluster sampling method was used to sample from 14 monitoring points in 12 cities in Henan Province.
In the first stage, within the monitoring points, a systematic sampling of population size ranking was conducted, with 3 townships randomly selected. In the second stage, among the randomly selected townships, a systematic sampling according to population size was conducted, with 2 villages residential committees randomly selected.
In the third stage, a simple random sampling method was used to collect 1 villager group, which consisted of 60 or more families from the 2 villages that were randomly selected.
In the fourth stage, 45 families were selected from the selected villager groups to participate in the survey. Data were collected by a personal questionnaire, by physical measurement, and in laboratory examination.
The questionnaire mainly included the participants' personal information, their awareness of dietary salt intake, their salt-reduction behaviors, and their eating habits. Respondents were asked to fast for 8 to 12 h. The same instruments, used in all monitoring sites, had been inspected by the quality inspection department.
All the investigators participated in similar training and examination sessions, and only those who passed the sessions were able to participate in the survey work.
Respondents were asked to provide 5 ml of morning urine, by collecting it in the urine cup provided in advance and returning it to the investigator while filling the personal questionnaire.
The collected urine was tested by a qualified central laboratory that had passed the quality assessment of the national project working group.
Urine creatinine was tested using the enzyme-coupled sarcosine oxidase method, while urine sodium was tested using the ion-selective electrode method. Salt intake assessment methods included h diet recall, completion of a food frequency questionnaire, and urine assessment.
The h urinary sodium hUNa method is the widely-accepted gold standard for evaluating individual dietary salt intake It is difficult to perform a complete h urine collection, so this study used the simple estimation method developed by Professor Kawasaki 20 in to estimate hUNa excretion using morning urine specimens.
The formula estimates hUNa excretion based on spot urinary sodium spot Naspot creatinine spot Crand prediction creatinine Pre Cr. Pre Cr was calculated based on height, weight, and age of participants.
Salt intake was calculated using the hUNa. This estimation method has been validated in the Chinese population and has the advantage of smaller deviations compared to other estimation methods in predicting the dietary salt intake of a population 21 Continuous variables were described by mean ± standard deviation, while categorical variables were described by percentage.
The t -test was used to compare the difference of salt intake between the participants, according to salt-reduction awareness, knowledge, and behaviors, respectively. Participants were divided into two groups according to their salt intake.
The association between salt-reduction behaviors and salt intake was explored by logistic regression. The MIV based on the BP artificial neural network was used to evaluate the impact of each test behavior on salt intake.
Statistical analysis was performed using IBM SPSS Based on the MATLAB MathWorks, Natick, MAthe ANN prediction model was established, and each input neuron's MIV could be calculated. The baseline characteristics of participants are shown in Table 1.
A total of 7, participants were included in this study, including 3, males, accounting for The average age of the participants was Most of the participants were of Han nationality, accounting for Most participants' education reached junior high school and high-school status, accounting for Most participants were married or living with partners, accounting for More details are available in Table 1.
Among the participants, only 1, Their average salt intake was Only participants could correctly identify the recommended salt intake, accounting for 7. The difference is statistically significant. The salt intake of the participants who adopted any salt-reduction behavior was significantly lower than that of the participants who did not.
More details are available in Table 2. The study analyzed the association between salt-reduction behaviors and salt intake through logistic regression and MIV based on the BP neural network. Other variables were not included in the model.
More details are available in Tables 34. Finally, the BP artificial neural network consisted of one input layer with 8 neurons, one hidden layer with nodes, and one output layer with 1 neuron Figure 1. The good fitness of the final network was apparent, indicated by the following three values: 0.
The network performance was considered to be a good pattern when the network contained eight risk factors Table 4. Figure 1.
The configuration of the finel BPANN. The final establishment BPANN model consisted 1 input layer with 8 neurons 8 salt-reduction behaviors1 hidden layer with nodes, and 1 output layer with 1 node group of salt intake.
BPANN indicates backpropagation artificial neural network. This study showed the current status of salt-reduction awareness, salt-reduction behaviors, and salt intake of Chinese residents.
It showed that only a small number of participants had salt intake-related knowledge or any awareness of salt-reduction behaviors. The salt intake of participants who adopted salt-reduction behaviors was significantly lower than that of participants who did not.
In logistic regression and MIV, the effect of salt-reduction behaviors on salt intake was different. The study also showed that low-sodium salt and the salt-restriction spoon still needed better promotion. These results will inform the development of salt-reduction projects in China.
Only participants, 7. Similar to other studies, the vast majority of participants are not sure that they can recall or recognize the recommended salt intake level correctly 23 — Their salt intake is significantly higher than that of participants who know the guidelines.
This suggests that the promotion of nutrition and salt-related knowledge can help to reduce salt intake. Some studies believe that knowledge and behavior present a significant correlation 26 ; therefore, salt intake-related knowledge should be continuously promoted to raise the public's awareness of salt-reduction.
Public awareness campaigns, which have always been one of the components of successful salt-reduction initiatives 2728were among the several strategies recommended by the WHO for achieving population-based salt intake reduction. The awareness of the need for salt-reduction causes people to accept salt-reduction strategies to improve the health of the population and inclines them to adopt the corresponding salt reduction behaviors to actively reduce their own salt intake Unlike in Western countries, where much salt intake comes from processed foods 2630the salt intake of Chinese residents mainly comes from the salt added to family cooking 31 — The taste preference of Henan residents is for saltiness, although various salt-reduction campaigns have made Chinese residents aware of their source of salt and inclined them to reduce their family's salt addition during cooking Unfortunately, for some people this means an unpalatable taste to their food, which means they will then add extra salt to their meal when eating.
Only those who do not add extra salt can eventually reduce their salt intake. At the same time,
: Sodium intake awareness| Top bar navigation | Sodium knowledge in the population is also problematic. To date, few studies have examined the relationships between sodium knowledge and health behaviors, and even less is known about these relationships in a large urban population. We evaluated self-reported knowledge and health behavior related to sodium intake among LAC residents to inform an initiative to address the rising prevalence of high blood pressure and related cardiovascular conditions in this population. Our study built on a previous assessment of sodium knowledge, attitudes, and behaviors among LAC residents 6 that consisted of a series of 3 cross-sectional Internet panel surveys administered by Global Strategies Group, from December through August , for the LAC Department of Public Health DPH. Each survey comprised from 55 to 62 questions distributed across 5 categories: food selection and consumption, support for policy changes related to food environments, nutrition knowledge and awareness, health status, and demographics. Other questions not addressed by NHANES or BRFSS, such as those pertaining to attitudes toward sodium in foods served in the workplace or at restaurants, were developed internally by DPH. Because data collection from Internet panels is a continuous process, data from the 3 surveys were combined into one data set. No changes were made after piloting each survey before distribution. Surveys of pilot group participants were included in the final tally of completed surveys. To ensure comparability across surveys, only questions that remained consistent over time were used in the analysis. Participants were LAC residents aged 18 years or older who were able to complete the surveys in either English or Spanish. To ensure a representative sample of county residents, quotas and weights generated by using demographic and geographic data from the American Community Survey 9 and the Los Angeles County Health Survey were applied These quotas took into account age, race, sex, income, and LAC Service Planning Area After quota criteria were established, the 3 surveys were distributed to participants by Global Strategy Group. Incentives provided to participants who completed the survey included various gift cards, points programs, or partner products and services at the discretion of the panel provider working with Global Strategies. Sociodemographic information was collected for all survey participants. Participants were asked to provide their education and annual income level. Frequencies and weighted percentages were generated for all categorical variables encompassing the demographic characteristics of the survey population, knowledge of nutritional concepts, and health behaviors. General health status was assessed by asking participants how they felt about their general health and whether a doctor or other health care provider had told them to watch their salt intake or told them they had hypertension. Sodium consumption was assessed by asking whether participants added salt to their food and whether they were watching their salt intake. Food purchasing behavior and decision making were assessed by asking how often participants changed their mind about a food purchase on the basis of its sodium content and how often they used Nutrition Facts labels or other food labels during a food purchase. Use of these questions has been described elsewhere 6. Logistic and multinomial multiple regressions were constructed to assess associations between knowledge about sodium and health behavior variables. Each regression model controlled for demographic characteristics and included one main predictor per outcome. We used logistic regression to analyze relationships between outcome variables with 2 response levels and used multinomial regressions for outcomes with more than 2 response levels. All analyses were performed using SAS version 9. All study protocols and instruments were approved by the LAC DPH institutional review board. These questions were not asked in the first survey. Two variables were created by using these sets of questions. The second variable was based on a set of questions that asked participants to identify high-salt foods from a list. For the first variable, 2 groups of Nutrition Facts labels were shown to participants: 1 2 labels where participants were asked to identify the healthier of 2 food items and 2 3 labels where participants were asked to identify the item with the least sodium per cup Figure. Responses to these 2 questions were collapsed into a single variable with 3 values: 1 answering neither question correctly 2 answering one question but not the other correctly, or 3 answering both questions correctly. For the second variable, 10 to 15 foods were shown to participants who were then asked whether the foods contained high, medium, or low amounts of sodium. These included bread, ketchup, cottage cheese, and canned vegetables. Nutrition Facts labels presented to participants for evaluation, Los Angeles County, Internet panel survey, — Participants were asked to use the 2 labels at the top to select the healthier of the 2 soups, A or B. They were also asked to identify which of the 3 Nutrition Facts labels on the bottom, A, B, or C, had the least sodium per cup. Throughout the sampling period, 7, panel subjects clicked into the online survey. Of these, 2, completed the survey, resulting in an adjusted response rate for all 3 surveys of approximately This adjusted response rate was calculated by dividing the number of completed surveys by the number of eligible participants. Participants were excluded from the final sample if they were younger than 18 years, did not live in LAC, or because of quota criteria. Participants were evenly distributed across age groups with the largest group aged 25 to 34 years Most were white More than half reported perceiving themselves as overweight Only 3. Conversely, About half More than half Less than a third Although most participants were able to correctly answer 1 of 2 questions regarding Nutrition Facts labels Participants who believed that consuming salt was very harmful to their health compared with those who believed sodium consumption was only somewhat harmful had increased odds of not adding salt to their food adjusted odds ratio [AOR], 2. Participants who believed consuming salt was very harmful to their health compared with those who believed it was only somewhat harmful had increased odds of watching or reducing their salt intake AOR, 2. Conversely, participants who did not believe consuming salt was harmful to their health compared with those who believed it is somewhat harmful were found to have lower odds of changing their mind about purchasing a food item because of its sodium content AOR, 0. The odds of taking measures to prevent high blood pressure ie, exercising regularly, controlling or trying to lose weight, reducing sodium intake, taking medicine prescribed by a doctor, or avoiding alcohol or cigarettes among participants who accurately reported the daily recommended sodium intake for adults was lower than for those who could not accurately report the recommendation AOR, 0. Participants who accurately reported the recommended daily sodium intake had higher odds of reporting watching or reducing salt intake AOR, 1. These participants also had higher odds of having had a doctor or health professional recommend watching salt intake AOR, 1. In addition, knowing about daily sodium intake recommendations was associated with increased odds of using Nutrition Facts labels to make food purchase decisions AOR, 3. In subanalyses, participants who were able to accurately identify high-sodium foods when shown Nutrition Facts labels or a panel of 4 high-sodium foods showed increased odds of changing their mind about buying foods because of their sodium content Nutrition Facts questions, AOR, 2. Similarly, these same participants had increased odds of currently watching or reducing their salt intake Nutrition Facts label questions AOR, 1. Our study yielded 2 main findings. This finding supports previous work that suggests that the level of knowledge pertaining to daily sodium recommendations is low among LAC residents 6. Second, increased knowledge about the harmful effects of sodium was associated with increased engagement in some healthy behaviors, such as watching salt intake or declining a food purchase because of its salt content. This finding aligns with previous studies that found positive associations between increased knowledge of nutritional concepts and improved food choices 14, Although increased knowledge about specific sodium consumption recommendations was associated with increased use of Nutrition Facts labels to guide food purchasing decisions, this finding was conversely associated with lower odds of doing anything to control or prevent hypertension. The LAC DPH continues to encourage residents to reduce salt consumption through an array of strategies, including applying nutrition standards to food venues such as hospitals and universities and modifying their menus. Results from our study suggest that LAC residents require further nutrition education to take advantage of increased availability of low sodium foods as a result of these implemented sodium reduction strategies. LAC DPH conducted the Salt Shocker campaign, including educational videos, to make residents aware of recommendations for sodium consumption and the amount of sodium in common foods that add significantly to the volume of salt in the American diet. For instance, the addition of onions, garlic, ginger, parsley or other fresh herbs are helpful in enhancing the taste of many common food items. You could even make your own salad dressing from oil, vinegar, herbs and spices, rather than buying processed dressings. Lemon or lime juice on chicken and fish add a fresh zest, or by adding wine to a stew creates a new flavor. Salt-free substitutes for salt are also available for purchase. You could even attempt to create your own spice mixture. By reducing your salt intake you can improve your long and short term health. This article was published by Michigan State University Extension. Sodium awareness. Items on the list include: Breads and rolls Cold cuts and cured meats Pizza Poultry Canned soups Sandwiches from fast food establishments Another way to raise awareness of high sodium foods is to begin paying special attention to nutrition labels. Did you find this article useful? Please tell us why? Check out the Nutritional Sciences B. Learn More. Check out the Dietetics B. You Might Also Be Interested In AC3 Podcast episode 3 Published on June 30, MIFruitcast: Meet the Educators Published on January 18, MIFruitcast: Biological Controls with Jackie Perkins Published on December 1, Food Budgets with Crystal White Published on September 12, Meet Up and Eat Up with Ken Kujawski Published on September 16, MSU Dairy Virtual Coffee Break: What are lenders looking for? Published on April 7, |
| World Salt Awareness Week: innovative regulations to reduce salt intake | To put this in retrospect, think of one teaspoon of table salt as the equivalent of 2, milligrams of sodium. The American Heart Association AHA goes one step further, with its recommendation of 1, milligrams per day. Michigan State University Extension says that people who choose to live a life continuously eating foods high in sodium have an increased risk of developing Type 2 diabetes, hypertension, some types of cancer and other chronic illnesses. Also, excess sodium in the diet may make your face feel puffy and increase swelling in your fingers and legs. It is important to avoid sodium overload in your daily life. Items on the list include:. Another way to raise awareness of high sodium foods is to begin paying special attention to nutrition labels. Sodium is used as a preservative, as well as a flavor enhancer in processed foods. When reading the sodium level on an item, make sure to read how many servings the entire container provides. If you eat an entire can of soup, which is two servings, you would need to double the sodium content. You could choose to modify recipes to include fresh, rather than canned foods. Eating foods high in potassium such as potatoes, banana, kiwis and oranges, may also help to counteract the effects of sodium on blood pressure. Remember that condiments like soy sauce and ketchup may raise the sodium content of the meal. Substitutions for salt in everyday items can drastically reduce your sodium intake. Kidney disease. Public Health interventions. Language: English Deutsch Español فارسی Français हिन्दी Hrvatski Magyar Bahasa Indonesia 日本語 한국어 Bahasa Malaysia Nederlands Polski Português Română Русский தமிழ் ภาษาไทย 简体中文 繁體中文. Read this news item in Malay Cochrane Nutrition Field 's aim is to support and enable evidence-informed decision-making for nutrition policy and practice by advancing the preparation and use of high-quality, globally relevant nutrition-related Cochrane reviews. Wednesday, March 6, Parameters were measured before and after the intervention to allow comparison. The results revealed that salt-related knowledge improved significantly immediately post-intervention, but it was the knowledge was not fully retained until the 4-weeks follow-up, however it remained above the baseline. Moreover, improvement in the high-risk for salt consumption group was recorded, as a shift was observed toward the moderate-risk group and a trend toward practice category improving from baseline to the follow-up was shown. These findings were consistent with the previous study among the UOS students For example, the mean knowledge score in this study was Also consistent with the results of health science students in Bangladesh on salt related knowledge Moreover, more than half of the students in the current study estimated that they consume just the right amount of salt. However, the same study estimated that more than two-thirds of the participants exceeded the WHO recommendations These findings suggest that perceived intake does not necessarily reflect actual intake. Most of the students were aware of the obvious adverse health effects associated with high salt intake. Similar findings were reported in several studies in the UAE, European countries and the Lebanon investigating salt related knowledge, attitude, and behavior 15 , 16 , 28 , Also, more than three in four students indicated that salt reduction would actively improve their health and blood pressure which was in contrast to a study reported among adults in Montenegro where less than half of the participants had the same indication Furthermore, findings showed that less than a quarter of the participants check food labels and use the information on food labels to guide their purchasing decisions. More worryingly, a very small proportion of students check for salt content on the food label and use it to guide their food choices. Findings in a study among adult consumers in Lebanon revealed much lower proportion for checking food labels than those reported in the UAE; stating that food labels are not adequately utilized by participants Therefore, an awareness of the health risks associated with high salt consumption is recommended to increase salt label usage and purchases of low salt foods. With respect to knowledge, in all questions, the percentage of correct answers of the immediate post-intervention was significantly better compared to the pre-intervention baseline. After 4 weeks follow-up, the percentage of correct answers showed that retention of knowledge of students slightly decreased in comparison to the immediate post-intervention, however remained above baseline. A similar pattern was seen in a previous study conducted in Lebanon Similarly, a cohort study conducted at Lurio University, Mozambique, evaluating knowledge retention showed a decrease in knowledge after 6 months compared to post-test Despite the difference in the follow up time intervals, the general trend of decline in knowledge is consistent. Moreover, historically a similar decay in knowledge-retention over time following an educational program is shown in other studies 32 , Due to the fact that knowledge is an important driver of attitudes and practices, it is expected that a decline in knowledge will be accompanied by similar drop in favorable attitude responses As it is evident in our results, after 4 weeks there was a decrease in the positive attitude response compared to baseline simultaneously with the decline in knowledge, however knowledge remained above baseline. Therefore, conducting frequent periodical educational sessions along with testing knowledge has been used effectively to ensure long-term knowledge retention 35 , Aligning with our study, such strategy where students are educated on aspects of knowledge and followed-up must be implemented. Several salt related practices showed significant improvements after the 4 weeks follow up, such as trying to purchase low-salt food and rarely adding salt to food at the table. However, no significant improvement was found in other salt-related practices such as using stock cubes during cooking and adding salt before tasting the food. The results are consistent to what was found in the intervention study performed in Iran, in which it was shown a significant increase in the mean and standard deviation of KAP among the intervention group, and a significant decrease in the mean salt intake Nonetheless, in a study investigating the impact of community-based salt reduction program in Australia, the proportion of participants reporting salt reducing practices such as avoiding processed foods and checking food labels decreased significantly Our results indicate a trend toward an improve in the salt-related practices from baseline to the 4-weeks follow-up such as trying to buy low-salt food, rarely adding salt during cooking or at the table and trying to reduce salt intake by using spices. Evidence suggests that intervention strategies including peer group education has shown similar positive impact on salt-related practices and salt consumption. A study among adults having at least one risk factor of CVD indicated beneficial effects of peer group intervention on cardiovascular risk factors, with significant improvements in total score and more specifically on tobacco cessation Moreover, a national consumer awareness campaign about the negative effect of salt on health in the United Kingdom has shown promising results as it indicated a significant decline in using salt at the table Another randomized clinical trial depicted a lower dietary sodium intake among the intervention group There are several limitations to this study. The findings may not be generalized to all young adults in the UAE as our study was restricted to the non-medical major university students. Including participants who showed an interest in the study self-selection is likely to create a group of more motivated persons which could affect sample representativeness. In addition, the questionnaire included the use of self-reported attitudes and practices, that possibly might cause some respondent bias or misreporting of data that may not accurately reflect actual attitudes and practices. Another limitation to this study was the use of a single contact intervention due to time constraint. Hence, future studies with multiple interactions are encouraged to induce long-term benefits. Our study showed a significant increase in knowledge and positive salt related attitude immediately post-intervention. This increase remained significant after the 4-weeks follow-up. However, there was a tendency to have a slight decline in knowledge after 4-weeks as it was only a single contact. A complementary educational method is advised to enhance retention of knowledge and probably have an impact on salt-related attitudes and practices. On the other hand, it was evident that changes in practice were not as prominent as changes in knowledge and attitude. This is possibly related to poor dietary habits and high consumption of fatty food, snacks, sugar, and fast food that is evident in this age group. In conclusion, it is crucial to conduct several specifically designed awareness sessions and space them over time in conjunction with creative intervention programs focusing on the proper way of reading and using food and salt labels. Moreover, it is suggested to deliver nutrition related message using social media, given that this generation is most influenced by these platforms. It is also suggested to mandate at least one nutrition education course for all university students as well as ensuring the provision of a wide variety of healthy food options with low salt content at the university campus cafeteria and healthy vending machine snacks. Future research should also focus more on a long-term knowledge retention to investigate the impact of salt-reduction interventions on related attitude, practice, and overall health. Conducting similar studies on a large scale is recommended to be able to generalize results to the young adult population. The datasets presented in this study can be found in online repositories. The studies involving human participants were reviewed and approved by the University of Sharjah Research Ethics Committee UOS-REC reference number: RECS. LC, MH, AJ, MM, and AA: conceptualization and methodology. LC, MM, and SS: formal analysis. LC, MH, RAD, RAR, SA, AA, SQ, and FM: investigation. LC, SS, MM, and AA: writing—original draft preparation. LC, MH, AJ, MM, RAD, RAR, SA, AA, SQ, FM, SS, LS, and AA: writing—review and editing. MM: visualization. LC: supervision. All authors have read and agreed to the published version of the manuscript. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. The assistance provided by Dr. Lara Nasreddine was greatly appreciated. We would also like to thank the participants for their time and commitment. Noncommunicable Disease Country Profiles. Geneva: World Health Organization Google Scholar. Forouzanfar MH, Afshin A, Alexander LT, Anderson HR, Bhutta ZA, Biryukov S, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, a systematic analysis for the Global Burden of Disease Study doi: PubMed Abstract CrossRef Full Text Google Scholar. Thirteenth General Programme of Work, : Promote Health, Keep the World Safe, Serve the Vulnerable. Mozaffarian D, Fahimi S, Singh GM, Micha R, Khatibzadeh S, Engell RE, et al. Global sodium consumption and death from cardiovascular causes. N Engl J Med. Afshin A, Sur PJ, Fay KA, Cornaby L, Ferrara G, Salama JS, et al. Health effects of dietary risks in countries, a systematic analysis for the Global Burden of Disease Study Global Action Plan for the Prevention and Control of Noncommunicable Diseases Guideline: Sodium Intake for Adults and Children. He FJ, Jenner KH, MacGregor GA. WASH-World Action on Salt and Health. Kidney Int. Wong MM, Arcand J, Leung AA, Thout SR, Campbell NR, Webster J. The science of salt: A regularly updated systematic review of salt and health outcomes December March J Clin Hyperten. Santos JA, Tekle D, Rosewarne E, Flexner N, Cobb L, Al-Jawaldeh A, et al. A systematic review of salt reduction initiatives around the world: a midterm evaluation of progress towards the global non-communicable diseases salt reduction target. Adv Nutr. Farrand C, He FJ, MacGregor GA. Reducing population salt intake in the Eastern Mediterranean Region-time for urgent action. East Mediter Health J. Alhamad N, Almalt E, Alamir N, Subhakaran M. |
| Breadcrumb | Wong MM, Arcand J, Leung AA, Thout SR, Campbell NR, Webster J. The science of salt: A regularly updated systematic review of salt and health outcomes December March J Clin Hyperten. Santos JA, Tekle D, Rosewarne E, Flexner N, Cobb L, Al-Jawaldeh A, et al. A systematic review of salt reduction initiatives around the world: a midterm evaluation of progress towards the global non-communicable diseases salt reduction target. Adv Nutr. Farrand C, He FJ, MacGregor GA. Reducing population salt intake in the Eastern Mediterranean Region-time for urgent action. East Mediter Health J. Alhamad N, Almalt E, Alamir N, Subhakaran M. An overview of salt intake reduction efforts in the Gulf Cooperation Council countries. Cardiovasc Diagn Ther. Powles J, Fahimi S, Micha R, Khatibzadeh S, Shi P, Ezzati M, et al. Global, regional and national sodium intakes in and a systematic analysis of 24 h urinary sodium excretion and dietary surveys worldwide. BMJ Open. Cook NR, Cutler JA, Obarzanek E, Buring JE, Rexrode KM, Kumanyika SK, et al. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention TOHP. Jarrar AH, Stojanovska L, Apostolopoulos V, Cheikh Ismail L, Feehan J, Ohuma EO, et al. Assessment of sodium knowledge and urinary sodium excretion among regions of the United Arab Emirates: A cross-sectional study. Cheikh Ismail L, Hashim M, H Jarrar A, N Mohamad M, T Saleh S, Jawish N, et al. Knowledge, attitude, and practice on salt and assessment of dietary salt and fat intake among University of Sharjah Students. National Nutrition Strategy The Official Portal of the UAE Government. Webster JL, Li N, Dunford EK, Nowson CA, Neal BC. Consumer awareness and self-reported behaviours related to salt consumption in Australia. Asia Pac J Clin Nutr. Alawwa I, Dagash R, Saleh A, Ahmad A. Dietary salt consumption and the knowledge, attitudes and behavior of healthy adults: a cross-sectional study from Jordan. Libyan J Med. Aparna P, Salve HR, Anand K, Ramakrishnan L, Gupta SK, Nongkynrih B. Knowledge and behaviors related to dietary salt and sources of dietary sodium in north India. Family Med. Primary Care. Ghimire K, Adhikari TB, Rijal A, Kallestrup P, Henry ME, Neupane D. Knowledge, attitudes, and practices related to salt consumption in Nepal: Findings from the community-based management of non-communicable diseases project in Nepal COBIN. Walsh JL, Aridi H, Fathallah J, Al-Shaar L, Alam S, Nasreddine L, et al. Impact of a hospital-based educational intervention on dietary salt-related knowledge and behaviour in a cardiac care unit population in Lebanon. Cardiovasc Diagnosis Therapy. Wang X, Li X, Vaartjes I, Neal B, Bots ML, Hoes AW, et al. Does education level affect the efficacy of a community based salt reduction program? BMC Public Health. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. Faul F, Erdfelder E, Lang A-G, Buchner A. Behav Res Methods. BMI Classification. Frey F. SPSS Software. The International Encyclopedia of Communication Research Methods. Biswas J, Haque MM, Mahbub MS, Nurani RN, Shah NA, Barua L, et al. Salt intake behavior among the undergraduate students of Bangladesh University of Health Sciences. J Xiangya Med. CrossRef Full Text Google Scholar. D'Elia L, Brajović M, Klisic A, Breda J, Jewell J, Cadjenović V, et al. Sodium and potassium intake, knowledge attitudes and behaviour towards salt consumption amongst adults in podgorica, montenegro. Nasreddine L, Akl C, Al-Shaar L, Almedawar MM, Isma'eel H. Consumer knowledge, attitudes and salt-related behavior in the Middle-East: the case of Lebanon. Ferreira JJ, Maguta L, Chissaca AB, Jussa IF, Abudo SS. Cohort study to evaluate the assimilation and retention of knowledge after theoretical test in undergraduate health science. Porto Biomed J. Zieber M, Sedgewick M. Competence, confidence and knowledge retention in undergraduate nursing students - A mixed method study. Nurse Educ Today. Nelissen E, Ersdal H, Mduma E, Evjen-Olsen B, Broerse J, van Roosmalen J, et al. Helping Mothers Survive Bleeding After Birth: retention of knowledge, skills, and confidence nine months after obstetric simulation-based training. BMC Pregnancy Childbirth. Gómez-Pardo E, Fernández-Alvira Juan M, Vilanova M, Haro D, Martínez R, Carvajal I, et al. A comprehensive lifestyle peer group-based intervention on cardiovascular risk factors. J Am College Cardiol. Tavassoli E, Reisi M, Javadzade H, Mazaheri M, Ghasemi S, Shakoori S. J Health Field. Schwebel FJ, Larimer ME. Using text message reminders in health care services: A narrative literature review. Internet Interven. Layeghiasl M, Malekzadeh J, Shams M, Maleki M. Using social marketing to reduce salt intake in Iran. Front Public Health. Land M-A, Wu JH, Selwyn A, Crino M, Woodward M, Chalmers J, et al. Effects of a community-based salt reduction program in a regional Australian population. Sutherland J, Edwards P, Shankar B, Dangour AD. Fewer adults add salt at the table after initiation of a national salt campaign in the UK: a repeated cross-sectional analysis. Br J Nutr. Welsh JA, Sharma AJ, Grellinger L, Vos MB. Consumption of added sugars is decreasing in the United States. Am J Clin Nutr. Keywords: educational intervention, dietary salt, dietary sodium, knowledge retention, university students. Received: 06 December ; Accepted: 31 January ; Published: 25 February Copyright © Cheikh Ismail, Hashim, Jarrar, Mohamad, Al Daour, Al Rajaby, AlWatani, AlAhmed, Qarata, Maidan, Saleh, Stojanovska and Al Dhaheri. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY. The use, distribution or reproduction in other forums is permitted, provided the original author s and the copyright owner s are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Key nutrition and hydration insights for Public Health and Policy. Open supplemental data Export citation EndNote Reference Manager Simple TEXT file BibTex. Check for updates. ORIGINAL RESEARCH article. Jarrar 3 Maysm N. Mohamad 3 Rameez Al Daour 1 Radhiya Al Rajaby 1 Sara AlWatani 1 Amna AlAhmed 1 Shaikha Qarata 1 Fatima Maidan 1 Sheima T. Saleh 1 Lily Stojanovska 3,4 Ayesha S. Technical package for salt reduction. Home Campaigns World Salt Awareness Week Copied to clipboard. The interventions to achieve it include: 1. TECHNICAL DOCUMENTS SHAKE. Apply behavior change communication strategies to reduce salt consumption Download In the US, stroke and heart disease cause more deaths than any other cause. Lowering salt intake helps reduce blood pressure and risk of heart disease and stroke. Population-level sodium reduction strategies: innovative approaches from Argentina and South Africa. Recognizing the health risks and disease burden associated with excessive salt consumption, governments across the globe are taking action to reduce salt intake. Argentina and South Africa have become the first countries to adopt legally binding maximum salt levels across a broad range of processed foods. South Africa and Argentina have legally binding standards across a broad range of processed foods, including bread, cured meats, soups and stock, and snack foods. An additional 7 countries have legally binding maximum salt levels for at least one product, usually bread. Many experts believe that mandatory legal requirements are more effective in reducing salt levels than voluntary targets or agreements. Legally binding requirements are preferable because they incorporate penalties for non-compliance. |
| Content Map Terms | March 27, World Salt Awareness Week: innovative regulations to reduce salt intake Sarah Roache Scholar. This study showed the current status of salt-reduction awareness, salt-reduction behaviors, and salt intake of Chinese residents. Google Scholar. Based on h urinary sodium excretion, Study recruitment flow chart. |
| Salt Awareness Week | Results: A total of 7, participants were included in the analysis, with an average age of et al. Learn about changes you can make to lower the amount of sodium in your diet. Charlton K, Yeatman H, Houweling F, Guenon S. This year, the awareness week is being observed March, The post-intervention assessment questionnaire included only the knowledge and attitude sections of the KAP questionnaire because salt-related behavior would require time to change. |
Sodium intake awareness -
Nonetheless, in a study investigating the impact of community-based salt reduction program in Australia, the proportion of participants reporting salt reducing practices such as avoiding processed foods and checking food labels decreased significantly Our results indicate a trend toward an improve in the salt-related practices from baseline to the 4-weeks follow-up such as trying to buy low-salt food, rarely adding salt during cooking or at the table and trying to reduce salt intake by using spices.
Evidence suggests that intervention strategies including peer group education has shown similar positive impact on salt-related practices and salt consumption. A study among adults having at least one risk factor of CVD indicated beneficial effects of peer group intervention on cardiovascular risk factors, with significant improvements in total score and more specifically on tobacco cessation Moreover, a national consumer awareness campaign about the negative effect of salt on health in the United Kingdom has shown promising results as it indicated a significant decline in using salt at the table Another randomized clinical trial depicted a lower dietary sodium intake among the intervention group There are several limitations to this study.
The findings may not be generalized to all young adults in the UAE as our study was restricted to the non-medical major university students. Including participants who showed an interest in the study self-selection is likely to create a group of more motivated persons which could affect sample representativeness.
In addition, the questionnaire included the use of self-reported attitudes and practices, that possibly might cause some respondent bias or misreporting of data that may not accurately reflect actual attitudes and practices.
Another limitation to this study was the use of a single contact intervention due to time constraint. Hence, future studies with multiple interactions are encouraged to induce long-term benefits.
Our study showed a significant increase in knowledge and positive salt related attitude immediately post-intervention. This increase remained significant after the 4-weeks follow-up. However, there was a tendency to have a slight decline in knowledge after 4-weeks as it was only a single contact.
A complementary educational method is advised to enhance retention of knowledge and probably have an impact on salt-related attitudes and practices.
On the other hand, it was evident that changes in practice were not as prominent as changes in knowledge and attitude. This is possibly related to poor dietary habits and high consumption of fatty food, snacks, sugar, and fast food that is evident in this age group.
In conclusion, it is crucial to conduct several specifically designed awareness sessions and space them over time in conjunction with creative intervention programs focusing on the proper way of reading and using food and salt labels.
Moreover, it is suggested to deliver nutrition related message using social media, given that this generation is most influenced by these platforms. It is also suggested to mandate at least one nutrition education course for all university students as well as ensuring the provision of a wide variety of healthy food options with low salt content at the university campus cafeteria and healthy vending machine snacks.
Future research should also focus more on a long-term knowledge retention to investigate the impact of salt-reduction interventions on related attitude, practice, and overall health. Conducting similar studies on a large scale is recommended to be able to generalize results to the young adult population.
The datasets presented in this study can be found in online repositories. The studies involving human participants were reviewed and approved by the University of Sharjah Research Ethics Committee UOS-REC reference number: RECS.
LC, MH, AJ, MM, and AA: conceptualization and methodology. LC, MM, and SS: formal analysis. LC, MH, RAD, RAR, SA, AA, SQ, and FM: investigation. LC, SS, MM, and AA: writing—original draft preparation. LC, MH, AJ, MM, RAD, RAR, SA, AA, SQ, FM, SS, LS, and AA: writing—review and editing.
MM: visualization. LC: supervision. All authors have read and agreed to the published version of the manuscript. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
The assistance provided by Dr. Lara Nasreddine was greatly appreciated. We would also like to thank the participants for their time and commitment.
Noncommunicable Disease Country Profiles. Geneva: World Health Organization Google Scholar. Forouzanfar MH, Afshin A, Alexander LT, Anderson HR, Bhutta ZA, Biryukov S, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, a systematic analysis for the Global Burden of Disease Study doi: PubMed Abstract CrossRef Full Text Google Scholar.
Thirteenth General Programme of Work, : Promote Health, Keep the World Safe, Serve the Vulnerable. Mozaffarian D, Fahimi S, Singh GM, Micha R, Khatibzadeh S, Engell RE, et al. Global sodium consumption and death from cardiovascular causes.
N Engl J Med. Afshin A, Sur PJ, Fay KA, Cornaby L, Ferrara G, Salama JS, et al. Health effects of dietary risks in countries, a systematic analysis for the Global Burden of Disease Study Global Action Plan for the Prevention and Control of Noncommunicable Diseases Guideline: Sodium Intake for Adults and Children.
He FJ, Jenner KH, MacGregor GA. WASH-World Action on Salt and Health. Kidney Int. Wong MM, Arcand J, Leung AA, Thout SR, Campbell NR, Webster J.
The science of salt: A regularly updated systematic review of salt and health outcomes December March J Clin Hyperten. Santos JA, Tekle D, Rosewarne E, Flexner N, Cobb L, Al-Jawaldeh A, et al. A systematic review of salt reduction initiatives around the world: a midterm evaluation of progress towards the global non-communicable diseases salt reduction target.
Adv Nutr. Farrand C, He FJ, MacGregor GA. Reducing population salt intake in the Eastern Mediterranean Region-time for urgent action. East Mediter Health J.
Alhamad N, Almalt E, Alamir N, Subhakaran M. An overview of salt intake reduction efforts in the Gulf Cooperation Council countries. Cardiovasc Diagn Ther. Powles J, Fahimi S, Micha R, Khatibzadeh S, Shi P, Ezzati M, et al.
Global, regional and national sodium intakes in and a systematic analysis of 24 h urinary sodium excretion and dietary surveys worldwide. BMJ Open. Cook NR, Cutler JA, Obarzanek E, Buring JE, Rexrode KM, Kumanyika SK, et al. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention TOHP.
Jarrar AH, Stojanovska L, Apostolopoulos V, Cheikh Ismail L, Feehan J, Ohuma EO, et al. Assessment of sodium knowledge and urinary sodium excretion among regions of the United Arab Emirates: A cross-sectional study.
Cheikh Ismail L, Hashim M, H Jarrar A, N Mohamad M, T Saleh S, Jawish N, et al. Knowledge, attitude, and practice on salt and assessment of dietary salt and fat intake among University of Sharjah Students.
National Nutrition Strategy The Official Portal of the UAE Government. Webster JL, Li N, Dunford EK, Nowson CA, Neal BC.
Consumer awareness and self-reported behaviours related to salt consumption in Australia. Asia Pac J Clin Nutr. Alawwa I, Dagash R, Saleh A, Ahmad A. Dietary salt consumption and the knowledge, attitudes and behavior of healthy adults: a cross-sectional study from Jordan.
Libyan J Med. Aparna P, Salve HR, Anand K, Ramakrishnan L, Gupta SK, Nongkynrih B. Knowledge and behaviors related to dietary salt and sources of dietary sodium in north India.
Family Med. Primary Care. Ghimire K, Adhikari TB, Rijal A, Kallestrup P, Henry ME, Neupane D. Knowledge, attitudes, and practices related to salt consumption in Nepal: Findings from the community-based management of non-communicable diseases project in Nepal COBIN.
Walsh JL, Aridi H, Fathallah J, Al-Shaar L, Alam S, Nasreddine L, et al. Impact of a hospital-based educational intervention on dietary salt-related knowledge and behaviour in a cardiac care unit population in Lebanon.
Cardiovasc Diagnosis Therapy. Wang X, Li X, Vaartjes I, Neal B, Bots ML, Hoes AW, et al. Does education level affect the efficacy of a community based salt reduction program?
BMC Public Health. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. Faul F, Erdfelder E, Lang A-G, Buchner A. Behav Res Methods.
BMI Classification. Frey F. SPSS Software. The International Encyclopedia of Communication Research Methods. Biswas J, Haque MM, Mahbub MS, Nurani RN, Shah NA, Barua L, et al. Salt intake behavior among the undergraduate students of Bangladesh University of Health Sciences.
J Xiangya Med. CrossRef Full Text Google Scholar. D'Elia L, Brajović M, Klisic A, Breda J, Jewell J, Cadjenović V, et al.
Sodium and potassium intake, knowledge attitudes and behaviour towards salt consumption amongst adults in podgorica, montenegro. Nasreddine L, Akl C, Al-Shaar L, Almedawar MM, Isma'eel H.
Consumer knowledge, attitudes and salt-related behavior in the Middle-East: the case of Lebanon. Ferreira JJ, Maguta L, Chissaca AB, Jussa IF, Abudo SS. Cohort study to evaluate the assimilation and retention of knowledge after theoretical test in undergraduate health science.
Porto Biomed J. Zieber M, Sedgewick M. Competence, confidence and knowledge retention in undergraduate nursing students - A mixed method study. Nurse Educ Today. Nelissen E, Ersdal H, Mduma E, Evjen-Olsen B, Broerse J, van Roosmalen J, et al.
Helping Mothers Survive Bleeding After Birth: retention of knowledge, skills, and confidence nine months after obstetric simulation-based training. BMC Pregnancy Childbirth. Gómez-Pardo E, Fernández-Alvira Juan M, Vilanova M, Haro D, Martínez R, Carvajal I, et al.
A comprehensive lifestyle peer group-based intervention on cardiovascular risk factors. J Am College Cardiol. Tavassoli E, Reisi M, Javadzade H, Mazaheri M, Ghasemi S, Shakoori S. J Health Field. Schwebel FJ, Larimer ME.
Using text message reminders in health care services: A narrative literature review. Internet Interven. Layeghiasl M, Malekzadeh J, Shams M, Maleki M. Using social marketing to reduce salt intake in Iran. Front Public Health. Land M-A, Wu JH, Selwyn A, Crino M, Woodward M, Chalmers J, et al.
Effects of a community-based salt reduction program in a regional Australian population. Sutherland J, Edwards P, Shankar B, Dangour AD. Fewer adults add salt at the table after initiation of a national salt campaign in the UK: a repeated cross-sectional analysis.
Br J Nutr. Welsh JA, Sharma AJ, Grellinger L, Vos MB. Consumption of added sugars is decreasing in the United States.
Am J Clin Nutr. Keywords: educational intervention, dietary salt, dietary sodium, knowledge retention, university students. Received: 06 December ; Accepted: 31 January ; Published: 25 February Copyright © Cheikh Ismail, Hashim, Jarrar, Mohamad, Al Daour, Al Rajaby, AlWatani, AlAhmed, Qarata, Maidan, Saleh, Stojanovska and Al Dhaheri.
This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY. The use, distribution or reproduction in other forums is permitted, provided the original author s and the copyright owner s are credited and that the original publication in this journal is cited, in accordance with accepted academic practice.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. The Chinese diet is high in sodium. In , the estimated average salt intake of Chinese citizens was 9.
Globally, a causal link between sodium intake and high blood pressure levels is well-established. Excess dietary sodium is a major contributor to hypertension. Evidence suggests that modest reductions in dietary sodium could substantially reduce cardiovascular events and medical costs, and should be a public health priority.
Shandong Province is one of the most populous provinces in China. Sodium intake by most Shandong residents considerably exceeds the recommended limit. In , the average daily salt intake was A cross-sectional study conducted in rural Shandong province found that Among those with hypertension, only In order to help develop effective interventions for the SMASH Project, in , a base-line survey was conducted to assess the sodium intake KAP, salt consumption, and the prevalence of hypertension among the Shandong residents.
This study analyzes this baseline survey to investigates the current knowledge, attitudes, and practices related to sodium and hypertension among the general adult Shandong population aged 18—69 and to inform effective sodium reduction initiatives. During June to July, , a cross-sectional survey was conducted in Shandong province.
Multi-stage 4-stage cluster sampling was used to select a provincially representative sample of the adult population aged 18— Using a proportional probability sampling PPS method, three townships in rural areas or two streets in urban areas were selected from each selected county or district.
A total of 15, subjects were sampled. A face to face, close-ended questionnaire was administered by trained public health professionals, all of whom had previous experience in conducting interviews in similar health surveys. Questions collected information on: demographics gender, age, ethnicity, education, profession, health insurance information , health status hypertension, diabetes , lifestyle smoking, alcohol use, physical activity, and diet , and knowledge, attitudes and practices related to sodium and hypertension relationship between sodium and hypertension, consequences of hypertension, perception of salt consumption, self-reported consumption, intention to reduce salt consumption, and practices towards reducing sodium consumption.
Physical measurements taken in all subjects included: height, weight, waist circumference, and blood pressure. Of 15, subjects, 15, subjects with complete data were included for this analysis response rate The survey received ethical approval from the Ethics Committee of the Shandong Center for Disease Control and prevention, and participants provided written informed consent to participate in this study.
Educational level and annual household income were used as indicators for social economic status SES. We divided participants into five groups by education level: no education, primary school, junior high school, senior high school, or any college and above.
Annual household income level was classified in high, middle, and low, according to tertiles. Statistical analyses were performed with SPSS Design weight was calculated to account for different factors, including cluster design, strata, and individual.
The population data of Shandong province was used to generate post-stratification weight. Difference in proportions of KAP rates were compared using the Chi-square test. Tests for trends were calculated in the same logistic regression model using educational level and annual household income as continuous variables.
The models were adjusted for potential confounders which included age, sex, marital status, residence, region, and hypertension status. A greater proportion of subjects reported lower educational levels and household income levels in rural areas than in urban areas.
Table 1. The rates of KAP were generally more favorable among urban residents than their rural counterparts. Table 2. However, less than one third of subjects knew the Chinese Nutrition Guideline recommendation of daily salt intake of less than 6 grams.
Regardless of residence urban vs. Excess dietary sodium is a major contributor to hypertension and a critical public health issue in China.
In , the estimated average intake of sodium among adults 18 to 69 years old in Shandong province was However, only one third of the subjects perceived themselves as consuming excess amounts of sodium. Nevertheless, sodium reduction in the diet was practiced by A simplistic approach for reducing sodium reduction is to increase population-level awareness that most are getting too much sodium, then expect changed behaviors that result in lower sodium intake.
However, changing dietary sodium intake in a population that has adapted to a high sodium diet is not easy and requires a number of complementary strategies.
This study has provided important information on the current state of knowledge, attitudes, and practices related to sodium and hypertension among residents in Shandong province.
In the present study, we found good levels of knowledge and a favorable attitudes towards sodium reduction. Residents in Shandong province seem prepared to accept the importance of reducing sodium intake. Our findings provide evidence that will enable the development of effective public education initiatives.
The Health Belief Model postulates that when an individual perceives a threat from a disease and perceived benefits from preventive actions exceed the barriers then the individual is likely to take preventive action. Additionally, our study suggests that those who perceived themselves at risk of consuming excess sodium were more likely to take action towards sodium reduction.
Furthermore, previous findings suggested that people may have resistance to adopting reduced-sodium diets because they are largely asymptomatic, and may fail to perceive a benefit from a diet that they consider too restrictive. A review of randomized controlled trials which aimed at reducing dietary sodium with follow-up of 6 months or longer, found that systolic and diastolic blood pressure were reduced by an average of 1 mmHg in normotensives and by an average of 2—4 mmHg in hypertensives.
In addition, it is important to highlight that reduced sodium intake is beneficial for both hypertensive and normotensive people, although it affects hypertensive people to a greater degree. The majority of Shandong residents believed that low sodium diets have less taste, and many residents reported low sodium intake reduces physical strength.
Our study suggests that persons who had unfavorable attitudes towards sodium reduction, were less likely to take action towards sodium reduction. Therefore, public education initiatives should also focus on these perceived barriers of taste and lost physical strength.
Preliminary results from this study suggested that survey participants who were older were more likely to report that less sodium intake results in less physical strength. The Chinese Nutrition Guidelines make recommendations that Chinese people should avoid consuming too much sodium.
Effective public education should also inform people that cooking with less sodium without affecting physical strength. The Social Cognitive Theory suggests that people need mastery of both knowledge and skills to perform a given behavior. Soy sauce, monosodium glutamate MSG , and pickles, are major dietary sources of sodium in China.
For example, regular soy sauce contains 1. The per capita consumption of soy sauce in china is 10 milliliter per day. Second, the use of low sodium condiments, or alternative forms of flavoring should be recommended.
Our study found that the most frequently reported practice to reduce sodium intake was reducing sodium while cooking, while relatively few reported increased use of non-sodium containing condiments, such as vinegar, green onions, and garlic.
With urbanization and globalization in China, there are signs of a gradual transition from traditional diets to consumption of more imported foods, processed foods and eating meals outside the home. The base-line survey reported that Processed food and restaurant food often contain higher sodium contents for either palatability or food safety reasons, and thus the trend is likely to contribute to high sodium consumption.
Food labeling has been shown to be effective in reducing sodium intake in developed countries. This program requires manufactures optionally to provide sodium in the list of nutrients on packaged food labels.
We found that most Shandong province residents supported food labeling, and believed food labeling would help them follow a low sodium diet However, very few residents reported reading food labels while purchasing.
Public education initiatives should encourage manufactures to provide sodium content information on packaged food labels, and educate the public how to read food labels to enable them to make healthy food choices.
Women, gatekeepers to food and health in the household, are an important group to target with the educational initiative. In the UK, in , the Food Standards Agency FSA coordinated a public awareness campaign which mainly targeted adult females.
Hence, special attention should be given to all residents, and especially women, in rural areas. Rural residents often were not well educated indicating that awareness campaigns should aim to develop messages that can be easily understood by the rural residents with lower education levels.
Limitation of this study includes self-reported attitude and practices of participants for having low or high sodium diet, which may overestimate or underestimate their actual attitude and practices related to sodium consumption.
However, findings presented in this study demonstrate that most residents in Shandong province will accept dietary sodium reductions. Future effective public education initiative should highlight the benefits of sodium reduction, with a focus of perceived barriers of physical strength and tastes, but also provide practice and culturally appropriate meals to change their diet.
The public education and awareness efforts should target all women and should also focus on rural populations. The authors would like to thank all investigators from provincial and county level CDC and all participants of the survey.
The authors thank Dr. John Speakman for his comments and suggestions. Conceived and designed the experiments: JZ XMS XFL AQX JXM XLG. Performed the experiments: JZ XMS. Analyzed the data: JZ XMS.
The World Salt Hormone balance and aging Week aims to Sovium the Bodybuilding supplements online of evidence-based interventions to reduce salt consumption awarenesss the population Sodium intake awareness protect cardiovascular health. The theme for this year is "Hide and Seek! Among eight countries in the Region with data as ofdaily salt intake per person ranges from 8. The interventions to achieve it include:. Technical package for salt reduction.
entschuldigen Sie, topic hat verwirrt. Es ist gelöscht
Ich empfehle Ihnen, die Webseite zu suchen, wo viele Artikel zum Sie interessierenden Thema werden.
Wacker, es ist der einfach ausgezeichnete Gedanke
Ist Einverstanden, die nützliche Mitteilung
Es ist Meiner Meinung nach offenbar. Ich empfehle, die Antwort auf Ihre Frage in google.com zu suchen