Salt-Related Knowledge, Attitudes, and Behaviors on Efate Island, Vanuatu

Is the Theory of Planned Behavior a good model for predicting salt consumption behavior in pregnant women? A structural equation modeling approach

BACKGROUND

Non-communicable illnesses are the leading reason for wide-reaching death. Reducing the burden of these illnesses is one of the significant objectives of the World Health Organization's action plan. In this respect, reducing salt consumption is one of the most cost-effective public health interventions. The present study aimed to adjust the Theory of Planned Behavior (TPB) in expecting salt consumption behavior in pregnant women visiting the health centers in Birjand.

MATERIALS AND METHODS

In this cross-sectional study, 273 pregnant women who visited the health centers in Birjand were selected through Quota sampling method. The data were collected using a self-administered questionnaire based on the TPB constructs. The data analysis was done in SPSS 19 and AMOS 24.

RESULTS

The mean age of participants was 27.33 ± 5.77 years, and their mean gestational age was 12.67 ± 4.11 weeks. The mean score of attitude construct was 86.54 ± 8.50, subjective norm construct 36.59 ± 4.47, perceived behavioral control construct 41.63 ± 7.01, intention construct 16.01 ± 2.65 and behavior construct 19.86 ± 2.57. There was a statistically significant relationship between attitude construct (p < 0.001), perceived behavioral control (p < 0.001), and intention (p < 0.001) with salt consumption behavior (p < 0.05). The goodness of fit indices showed a proper fit of data (χ2/df = 1.94, PNFI = 0.6, TLI = 0.9, CFI = 0.9 and RMSE = 0.06).

CONCLUSION

The results of this study showed that the TPB is an appropriate model for reviewing the behavior of salt consumption. Hence, this model offers a suitable basis for designing an educational intervention to regulate the quantity of salt consumed by pregnant women and; thus, its usage in health promotion programs is suggested.

Salt-Related Knowledge, Attitudes and Behavior in an Intervention to Reduce Added Salt When Cooking in a Sample of Adults in Portugal

(1) Background: Excessive salt intake is associated with an increased risk of hypertension and cardiovascular disease, so reducing it is critical. The main objective of this study was to verify whether one intervention to reduce added salt during cooking changed knowledge, attitudes and behavior (KAB) towards salt, and to analyze changes in the main sources of salt. (2) Methods: The intervention study was an 8-week randomized controlled trial with 97 workers from a public university. KAB in relation to salt were obtained through the WHO STEPwise questionnaire, and the main sources of salt were obtained by 24-h food recall and 24 h urinary sodium excretion over two days. (3) Results: After the intervention, participants in the intervention group reported a decrease in the addition of salt when cooking (p = 0.037), an increase in the percentage of subjects who avoided the consumption of processed foods (from 54.2% to 83.3%, p = 0.001), who looked for salt on food labels (from 18.8% to 39.6%, p = 0.013), and who bought low-salt food alternatives (from 43.8% to 60.4%, p = 0.039). However, there were no significant differences between the intervention group and the control group at baseline and post-intervention assessments. In the intervention group, after the intervention, the added salt decreased by 5%; food sources of salt such as the snacks and pizza group decreased by 7%, and the meat, fish and eggs group increased by 4%, but without statistical significance. (4) Conclusions: With innovative equipment for dosing salt when cooking, it is possible to change some dimensions of consumer behavior in relation to salt.

Barriers, Enablers, and Perceptions on Dietary Salt Reduction in the Out-of-Home Sectors: A Scoping Review

In this review, we have investigated the perceptions, barriers, and enabling factors that were responsible for a dietary salt reduction in the out-of-home sectors. For this purpose, we examined different knowledge databases such as Google Scholar, Ebscohost, MEDLINE (PubMed), Ovid, and Cochrane Library for research articles from September to December 2020. The inclusion criteria for the research articles were that they had to be published in English and had to be a qualitative or quantitative study that was conducted after 2010. These studies also had to report the various enablers, barriers, and perceptions regarding salt reduction in the out-of-home sectors. After implementing the inclusion criteria, we successfully screened a total of 440 studies, out of which 65 articles fulfilled all the criteria. The perceived barriers that hindered salt reduction among the out-of-home sectors included lack of menu and food variabilities, loss of sales due to salt reduction, lack of technical skills for implementing the salt reduction processes for cooking or reformulation, and an absence of environmental and systemic support for reducing the salt concentration. Furthermore, the enablers for salt reduction included the intervention programs, easy accessibility to salt substitutes, salt intake measurement, educational availability, and a gradual reduction in the salt levels. With regards to the behavior or perceptions, the effect of organizational and individual characteristics on their salt intake were reported. The majority of the people were not aware of their salt intake or the effect of salt on their health. These people also believed that low salt food was recognized as tasteless. In conclusion, the enablers, barriers, and perceptions regarding salt reduction in the out-of-home sectors were multifaceted. Therefore, for the implementation of the strategies, policies, and initiatives for addressing the barriers, the policymakers need to encourage a multisectoral collaboration for reducing the salt intake in the population.

Harmful Compounds and Willingness to Buy for Reduced-Additives Salami. An Outlook on Italian Consumers

The consumption pattern of salami has been subjected to relatively widespread attention by academician, but few studies concerning the health implications of salami consumption have been published. Since additives and product origins represent important attributes for salami, the objective of this paper is twofold: (i) to explore the role of two additives, salt and nitrates, in addition to the Italian origin, in relation to consumer attitudes and preferences towards salami, (ii) to segment consumer behaviour by assessing their willingness-to-buy salami, in order to verify whether different purchasing patterns can be identified within the different social groups. The analysis was conducted on two different levels. The first was developed through a conjoint analysis, while the second implemented a frequency analysis based on a bivariate analysis. Results show the price as one of the most important variables in identifying the quality level of salami, in addition, certain socio-economic segments of consumers show a significant propensity to pay an additional price for salami with a low salt content and is nitrate-free.

Mean Dietary Salt Intake in Vanuatu: A Population Survey of 755 Participants on Efate Island

Non-communicable diseases are responsible for 63% of global deaths, with a higher burden in low- and middle-income countries. Hypertension is the leading cause of cardiovascular-disease-related deaths worldwide, and approximately 1.7 million deaths are directly attributable to excess salt intake annually. There has been little research conducted on the level of salt consumption amongst the population of Vanuatu. Based on data from other Pacific Island countries and knowledge of changing regional diets, it was predicted that salt intake would exceed the World Health Organization’s (WHO) recommended maximum of 5 g per day. The current study aimed to provide Vanuatu with a preliminary baseline assessment of population salt intake on Efate Island. A cross-sectional survey collected demographic, clinical, and urine data from participants aged 18 to 69 years in rural and urban communities on Efate Island in October 2016 and February 2017. Mean salt intake was determined to be 7.2 (SD 2.3) g/day from spot urine samples, and 5.9 (SD 3.6) g/day from 24-h urine samples, both of which exceed the WHO recommended maximum. Based on the spot urine samples, males had significantly higher salt intake than females (7.8 g compared to 6.5 g; p < 0.001) and almost 85% of the population consumed more than the WHO recommended maximum daily amount. A coordinated government strategy is recommended to reduce salt consumption, including fiscal policies, engagement with the food industry, and education and awareness-raising to promote behavior change.