Salt Intakes, Knowledge, and Behavior in Samoa: Monitoring Salt‐Consumption Patterns Through the World Health Organization's Surveillance of Noncommunicable Disease Risk Factors (<scp>STEPS</scp>)

High salt/sodium intake is associated with an increased risk of hypertension, which is a major risk factor for cardiovascular diseases. This paper aims to examine the association between salt consumption and salt‐related knowledge, attitudes, and practices (KAP) in Nepal. The cross‐sectional data used in this study were collected as part of the community‐based management of non‐communicable diseases project (COBIN) to understand the amount and KAP related to salt consumption in Nepal. Multivariate hierarchical logistic regression was performed to assess the association of salt‐related KAP and determinants of high salt consumption in Nepal. The mean per capita salt intake was 8.0 (±3.7) g/day, with 81.6% of the population reporting higher intake than the WHO recommendation of <5 g/day. People of upper castes [adjusted odds ratio (aOR) = 0.7; 95% confidence interval (CI): 0.5‐0.9], people in large families (aOR = 0.6; 95% CI: 0.5‐0.7), respondents who were advised to lower salt intake (aOR = 0.6; 95% CI: 0.4‐0.9) and who checked salt/sodium labels in food (aOR = 0.6; 95% CI: 0.4‐0.9) were less likely to consume higher amounts of salt. Similarly, people who added extra salt to their food at the table (aOR = 1.4; 95 CI: 1.1‐1.9) and who reported consuming high amounts of salt (aOR = 1.5; 95% CI: 1.1‐2.3) were more likely to have high salt intake. High salt intake was documented in this population. This study suggests the need for culturally tailored community‐based behavior modification through health education and dietary counseling to effectively reduce salt consumption and thereby support a reduction in hypertension and cardiovascular diseases in Nepal.

Section: Discussionsupporting

confidence: 78%

Knowledge, attitudes, and practices related to salt consumption in Nepal: Findings from the community‐based management of non‐communicable diseases project in Nepal (COBIN)

Ghimire

Adhikari

Rijal

et al. 2019

“…The WHO is supporting countries to measure population salt intake as part of its STEPwise approach to surveillance of noncommunicable risk factors. This approach has been piloted in Samoa . The WHO recommends that where possible and appropriate, countries should collect 24‐hour urine samples but recognizes that this is not always possible, in which case, countries should obtain spot samples from a representative sample of the population.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of a Communication for Behavioral Impact (COMBI) Intervention to Reduce Salt Intake in a Vietnamese Province Based on Estimations From Spot Urine Samples

Santos

Trieu

et al. 2016

Self Cite

This study evaluated the effectiveness of the Communication for Behavioral Impact (COMBI)–Eat Less Salt intervention conducted in Viet Tri, Vietnam. The behavior change intervention was implemented in four wards and four communes for one year, which included mass media communication, school interventions, community programs, and focus on high‐risk groups. Mean sodium excretion was estimated from spot urine samples using different equations. A subsample provided 24‐hour urine to validate estimates from spot urine. Information about salt‐related knowledge and behaviors was also collected. There were 513 participants at both baseline and follow‐up. Mean sodium excretion estimated from spot urines fell significantly from 8.48 g/d at baseline to 8.05 g/d at follow‐up (P=.001). All spot equations demonstrated a significant reduction in sodium levels; however, the change was smaller than the measured 24‐hour urine. Participants showed improved knowledge and behaviors following the intervention. The COMBI intervention was effective in lowering average population salt intake and improving knowledge and behaviors.

“…13 However, most of these studies were conducted in high-income countries and there is little evidence about the usefulness of spot urine in low-or middle-income countries. 45,47,48 In the recently published SHAKE Package for Salt Reduction, WHO recommends that if resources and capacity permit, countries should collect 24-hour urine samples, but in cases where this is not possible, countries may obtain spot urine samples to measure population salt consumption. 3 The usefulness of spot urine in estimating mean change in population salt intake over time has also been recently explored.…”

Section: Discussionmentioning

confidence: 99%

The Science of Salt: A regularly updated systematic review of the implementation of salt reduction interventions (March–August 2016)

Santos

Trieu

Thout

et al. 2017

Self Cite

This review aims to identify, summarize, and appraise studies reporting on the implementation of salt reduction interventions that were published between March and August 2016. Overall, 40 studies were included: four studies evaluated the impact of salt reduction interventions, while 36 studies were identified as relevant to the design, assessment, and implementation of salt reduction strategies. Detailed appraisal and commentary were undertaken on the four studies that measured the impact of the interventions. Among them, different evaluation approaches were adopted; however, all demonstrated positive health outcomes relating to dietary salt reduction. Three of the four studies measured sodium in breads and provided consistent evidence that sodium reduction in breads is feasible and different intervention options are available.None of the studies were conducted in low-or lower middle-income countries, which stresses the need for more resources and research support for the implementation of salt reduction interventions in these countries. | INTRODUCTIONHigh salt intake is one of the main contributors to premature death from cardiovascular diseases globally. of countries (China, Finland, France, England, and Ireland) had already achieved significant reductions in population salt intake. | METHODOLOGYA detailed description of the search strategy used to identify and screen studies in this review has been previously reported. In the current review, studies evaluating the impact of salt reduction interventions were appraised for risk of bias by two independent reviewers using a modified Cochrane risk of bias tool for nonrandomized trials of intervention studies. 4,7 Detailed appraisal and commentary were also performed on these studies. Other types of studies that provided information pertinent to the design, implementation, and assessment of salt reduction interventions were summarized in a table.These include (1) studies on monitoring and surveillance of salt intake;(2) salt content in foods; (3) consumers' knowledge, attitudes, and behaviors toward salt; (4) economic evaluation or modeling studies of salt reduction strategies; and (5) other studies related to implementation of salt reduction initiatives. | RESULTSThe MEDLINE search identified 3675 citations, of which 85 were considered potentially eligible for full review on the basis of their findings relevant to salt reduction interventions. Ultimately, a total of 40 studies met the inclusion criteria: four studies evaluated the impact of salt reduction interventions, 21 were surveillance or monitoring studies, five were modeling studies relating to salt reduction, and 10 other studies related to the implementation of salt reduction interventions (Figure 1). conducted at a community level, 8,11 one assessed the impact of salt substitution in breads employed at a community level, 10 and one evaluated the changes in sodium levels in foods achieved through voluntary sodium reduction targets implemented at a national level. 9The method for evaluating the impact ...