Knowledge and behaviors regarding salt intake in Mozambique

Jessen, Neusa; Santos, Artur; Damasceno, Albertino; Silva-Matos, Carla; Severo, Milton; Padrão, Patrícia; Lunet, Nuno

doi:10.1038/s41430-018-0125-y

Cited by 19 publications

(20 citation statements)

References 34 publications

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“…For example, knowledge that salt could be detrimental for health was associated with only one salt-related practice, i.e., low discretionary use of salt. A study conducted in 2014–2015 in Mozambique also found participants high in knowledge but low in attitudes and practices, in which is similar to our study [ 25 ]. This suggests that campaigns aimed at raising awareness about the detrimental impact of salt intake on health might better translate in actual salt reduction if structural measures are also implemented, e.g., programs to reduce salt in the food served in work or school canteens and measures to limit salt intake in selected manufactured foods (e.g., bread).…”

Section: Discussionsupporting

confidence: 91%

Food Consumption, Knowledge, Attitudes, and Practices Related to Salt in Urban Areas in Five Sub-Saharan African Countries

et al. 2018

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High salt intake is a major risk factor of hypertension and cardiovascular disease. Improving knowledge, attitudes, and practices (KAP) related to salt intake in the general population is a key component of salt reduction strategies. The objective of this study was to describe and compare the KAP of adults related to salt in urban areas of five countries in sub-Saharan Africa. The survey included 588 participants aged 25 to 65 years who were selected using convenience samples in the urban areas of Benin, Guinea, Kenya, Mozambique, and Seychelles. Socio-demographic and food consumption were assessed using a structured closed-ended questionnaire administered by survey officers. Height, weight, and blood pressure were measured. Food consumption varied largely between countries. Processed foods high in salt, such as processed meat, cheese, pizzas, and savory snacks were consumed rather infrequently in all the countries, but salt-rich foods, such as soups or bread and salty condiments, were consumed frequently in all countries. The majority of the participants knew that high salt intake can cause health problems (85%) and thought that it is important to limit salt intake (91%). However, slightly over half (56%) of the respondents regularly tried to limit their salt intake while only 8% of the respondents thought that they consumed too much salt. Salt and salty condiments were added most of the time during cooking (92% and 64%, respectively) but rarely at the table (11%). These findings support the need for education campaigns to reduce salt added during cooking and for strategies to reduce salt content in selected manufactured foods in the region.

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Section: Discussionsupporting

confidence: 91%

Food Consumption, Knowledge, Attitudes, and Practices Related to Salt in Urban Areas in Five Sub-Saharan African Countries

et al. 2018

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“…This difference may be due, at least in part, to sex differences in energy intake 63 . In agreement with our results, 41,59 women have higher knowledge and healthier behaviors regarding salt intake compared with men 64‐66 . This observation may reflect more frequent engagement in health promoting practices among women, due to a greater use of health services, 67 and subsequent behavior changes to adhere to lower sodium diets compared with men.…”

Section: Discussionsupporting

confidence: 88%

“…Most participants had fairly high knowledge of the adverse health effects of excessive salt intake, regarded salt reduction as of low importance, and did not practice salt reduction behaviors. In addition, women have higher knowledge regarding salt intake than men 41,59 …”

Section: Resultsmentioning

confidence: 99%

“…However, this knowledge did not seem to translate into attitudes and practices related to salt intake reduction. For example, participants were frequently unable to correctly identify the maximum recommended daily salt intake, nor were they aware of the link between salt and sodium, and generally did not perceive their salt intake to be high 25,27,32,41,55,56,59 . The latter may contribute to the low proportion of participants who reported adopting practices known to reduce salt consumption observed in the included studies.…”

Section: Discussionmentioning

confidence: 97%

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Monitoring and implementation of salt reduction initiatives in Africa: A systematic review

Tekle

Santos

Trieu

et al. 2020

J of Clinical Hypertension

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This systematic review aims to document salt consumption patterns and the implementation status and potential impact of salt reduction initiatives in Africa, from studies published between January 2009 and November 2019. Studies were sourced using MEDLINE, Embase, Cochrane Library electronic databases, and gray literature. Of the 887 records retrieved, 38 studies conducted in 18 African countries were included. Twelve studies measured population salt intake, 11 examined salt level in foods, 11 assessed consumer knowledge, attitudes, and behaviors, 1 study evaluated a behavior change intervention, and 3 studies modeled potential health gains and cost savings of salt reduction interventions. The population salt intake studies determined by 24‐hour urine collections showed that the mean (SD) salt intake in African adults ranged from 6.8 (2.2) g to 11.3 (5.4) g/d. Salt levels in foods were generally high, and consumer knowledge was fairly high but did not seem to translate into salt lowering behaviors. Modeling studies showed that interventions for reducing dietary sodium would generate large health gains and cost savings for the health system. Despite this evidence, adoption of population salt reduction strategies in Africa has been slow, and dietary consumption of sodium remains high. Only South Africa adopted legislation in 2016 to reduce population salt intake, but success of this intervention has not yet been fully evaluated. Thus, rigorous evaluation of the salt reduction legislation in South Africa and initiation of salt reduction programs in other African countries will be vital to achieving the targeted 30% reduction in salt intake by 2025.

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“…The large variability in bread Na content observed between bakeries and the higher price of brown compared to white bread show that further improvements are possible. In Mozambique, most of the population does not adopt behaviours to reduce salt intake (32) . Among Maputo inhabitants, discretionary salt is the most frequent source of dietary Na intake (60 %) (12) .…”

Section: Discussionmentioning

confidence: 99%

Sodium content of bread from bakeries in Maputo, Mozambique: trends between 2012 and 2018

Jessen

Padrão

Pinho

et al. 2020

Public Health Nutr.

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Objective:To assess the Na content and price of bread available in bakeries in the city of Maputo in 2018 and describe trends since 2012.Design:Cross-sectional evaluation of bread sold in twenty bakeries in the city of Maputo. Three loaves of white and three loaves of brown bread were collected from each bakery when available, and Na contents were quantified by flame photometry. To assess trends, samples of white bread collected in 2012 and analysed using the same methodology were compared with samples of white bread collected in 2018 from the same bakeries.Setting:City of Maputo, capital of Mozambique.Results:In 2018, the mean (range) Na content in mg/100 g of white and brown breads were 419·1 (325·4–538·8) and 389·8 (248·0–609·0), respectively. Non-compliance with Na targets in bread according to the South African regulation (<380 mg/100 g) was observed in 70 % of white and 43 % of brown bread samples. A total of twelve bakeries had samples evaluated in both 2012 and 2018; among these, the mean Na content in white bread decreased by just over 10 % – the mean difference (95 % CI) was 46·6 mg/100 g (1·7, 91·5); and there was a significant increase of 3·7–5·4 meticais in the mean price per 100 g of white bread.Conclusions:The Na content of bread available in bakeries in the city of Maputo decreased in recent years despite the absence of a specific regulation in Mozambique.

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Knowledge and behaviors regarding salt intake in Mozambique

Abstract: Most Mozambicans were aware that high salt intake can cause health problems, but the self-reported salt intake and behaviors for its control show an ample margin for improvement. This study provides evidence to guide population level salt-reducing policies.

Cited by 19 publications

References 34 publications

Food Consumption, Knowledge, Attitudes, and Practices Related to Salt in Urban Areas in Five Sub-Saharan African Countries

Food Consumption, Knowledge, Attitudes, and Practices Related to Salt in Urban Areas in Five Sub-Saharan African Countries

Monitoring and implementation of salt reduction initiatives in Africa: A systematic review

Sodium content of bread from bakeries in Maputo, Mozambique: trends between 2012 and 2018

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