Health Professional Advice and Adult Action to Reduce Sodium Intake

Purpose. To describe the prevalence and determinants of sodium-related knowledge, attitudes, and behaviors among U.S. adults Design. A cross-sectional survey was used. Setting. The study was set in the United States in 2012. Subjects. Participants were 6122 U.S. adults. Measures. Sodium-related knowledge, attitudes, and behaviors were measured. Analysis. Chi-squared tests were used to determine differences in sodium-related knowledge, attitude, and behaviors by respondent characteristics; multiple logistic regression was used to examine associations between selected respondent characteristics and health professional advice, reported action, or knowledge, attitudes, and behaviors (adjusted for all other respondent characteristics). Results. About three-fourths of respondents answered eating too much sodium is “somewhat” or “very” harmful to their health. Twenty-six percent reported receiving health professional advice, and 45% reported taking action to reduce their sodium intake. The prevalence of reported action was highest among adults receiving advice, those with hypertension, blacks, and those aged ≥65 years. Sixty-two percent who reported action agreed that most of their sodium comes from processed or restaurant foods. Of those reporting action, the most common tactics to reduce sodium intake were checking nutrition labels, using other spices than salt, and choosing low-sodium foods; requesting lower-sodium options when eating out was the least common tactic. Conclusion. Results suggest almost half of adults overall and the vast majority of those receiving health professional advice are taking some action to watch or reduce sodium intake. Although a substantial proportion report using recommended tactics to lower intake, many are not using the most effective tactics. In order to reach the general population, health communication messages could be simpler and focus on the most effective tactics to reduce sodium intake. Furthermore, health professionals can help reduce sodium intake by discussing the benefits of sodium reduction and tactics to do so, regardless of a hypertension diagnosis.

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Change in US Adult Consumer Knowledge, Attitudes, and Behaviors Related to Sodium Intake and Reduction: SummerStyles 2012 and 2015

American Journal of Health Promotion ◽

10.1177/0890117116679163 ◽

2016 ◽

Vol 32 (6) ◽

pp. 1357-1364 ◽

Cited By ~ 2

Author(s):

Katherine A. John ◽

Mary E. Cogswell ◽

Lixia Zhao ◽

Xin Tong ◽

Erika C. Odom ◽

...

Keyword(s):

Health Professional ◽

Sodium Intake ◽

Consumer Knowledge ◽

Cross Sectional ◽

Panel Surveys ◽

Professional Advice ◽

Attitudes And Behaviors ◽

The Us ◽

And Behaviors ◽

Sectional Analysis

Purpose: To describe changes in consumer knowledge, attitudes, and behaviors related to sodium reduction from 2012 to 2015. Design: A cross-sectional analysis using 2 online, national research panel surveys. Setting: United States. Participants: A total of 7796 adults (18+ years). Measures: Sodium-related knowledge, attitudes, and behaviors. Analysis: Data were weighted to match the US population survey proportions using 9 factors. Wald χ2 tests were used to examine differences by survey year and hypertensive status. Results: Despite the lack of temporal changes observed in respondent characteristics (mean age: 46 years, 67% were non-Hispanic white, and 26% reported hypertension), some changes were found in the prevalence of sodium-related knowledge, attitudes, and behaviors. The percentage of respondents who recognized processed foods as the major source of sodium increased from 54% in 2012 to 57% in 2015 ( P = .04), as did the percentage of respondents who buy or choose low/reduced sodium foods, from 33% in 2012 to 37% in 2015 ( P = .016). In contrast, the percentage of self-reported receipt of health professional advice among persons with hypertension decreased from 59% in 2012 to 45% in 2015 ( P < .0001). Other sodium-related knowledge, attitudes, and behaviors did not change significantly during 2012 to 2015. Conclusion: In recent years, some positive changes were observed in sodium-related knowledge and behaviors; however, the decrease in reported health professional advice to reduce sodium among respondents with hypertension is a concern.

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Receiving Advice from a Health Professional and Action Taken to Reduce Dietary Sodium Intake among Adults

Public Health Nutrition ◽

10.1017/s1368980021002019 ◽

2021 ◽

pp. 1-17

Author(s):

Rebecca C. Woodruff ◽

Katherine J. Overwyk ◽

Mary E. Cogswell ◽

Jing Fang ◽

Sandra L. Jackson

Keyword(s):

New York ◽

Health Professional ◽

Sodium Intake ◽

New York State ◽

Dietary Sodium ◽

Behavioral Risk ◽

Sodium Reduction ◽

Reduce Sodium Intake ◽

Reported Data ◽

Taking Action

Abstract Objective: Population reductions in sodium intake could prevent hypertension, and current guidelines recommend that clinicians advise patients to reduce intake. This study aimed to estimate the prevalence of taking action and receiving advice from a health professional to reduce sodium intake in 10 US jurisdictions, including the first-ever data in New York state and Guam. Design: weighted prevalence and 95% confidence intervals (CI) overall and by location, demographic group, health status, and receipt of provider advice using self-reported data from the 2017 Behavioral Risk Factor Surveillance System optional sodium module Setting: seven states, the District of Columbia, Puerto Rico, and Guam Participants: adults aged ≥18 years Results: Overall, 53.6% (CI: 52.7, 54.5) of adults reported taking action to reduce sodium intake, including 54.8% (CI: 52.8, 56.7) in New York and 61.2% (CI: 57.6, 64.7) in Guam. Prevalence varied by demographic and health characteristics and was higher among adults who reported having hypertension (72.5%; CI: 71.2, 73.7) vs. those who did not report having hypertension (43.9%; CI: 42.7, 45.0). Among those who reported receiving sodium reduction advice from a health professional, 82.6% (CI: 81.3, 83.9) reported action vs. 44.4% (CI: 43.4, 45.5) among those who did not receive advice. However, only 24.0% (CI: 23.3, 24.7) of adults reported receiving advice from a health professional to reduce sodium intake. Conclusions: The majority of adults report taking action to reduce sodium intake. Results highlight an opportunity to increase sodium reduction advice from health professionals during clinical visits to better align with existing guidelines.

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Does pragmatically structured outpatient dietary counselling reduce sodium intake in hypertensive patients? Study protocol for a randomized controlled trial

Trials ◽

10.1186/s13063-015-0794-y ◽

2015 ◽

Vol 16 (1) ◽

Cited By ~ 5

Author(s):

Marcel Ruzicka ◽

Tim Ramsay ◽

Ann Bugeja ◽

Cedric Edwards ◽

George Fodor ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Study Protocol ◽

Sodium Intake ◽

Controlled Trial ◽

Hypertensive Patients ◽

Randomized Controlled ◽

Dietary Counselling ◽

Reduce Sodium Intake

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Health professional advice, use of medications and smoking cessation: A population-based prospective cohort study

Preventive Medicine ◽

10.1016/j.ypmed.2016.07.027 ◽

2016 ◽

Vol 91 ◽

pp. 117-122 ◽

Cited By ~ 9

Author(s):

Bo Zhang ◽

Michael O. Chaiton ◽

Lori M. Diemert ◽

Susan J. Bondy ◽

K. Stephen Brown ◽

...

Keyword(s):

Smoking Cessation ◽

Cohort Study ◽

Health Professional ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Population Based ◽

Professional Advice

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Population strategies to reduce sodium intake: The right way and the wrong way

Nutrition ◽

10.1016/j.nut.2010.10.009 ◽

2011 ◽

Vol 27 (4) ◽

pp. 387 ◽

Cited By ~ 6

Author(s):

Norman J. Temple

Keyword(s):

Sodium Intake ◽

Reduce Sodium Intake ◽

The Right

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Readying Senior Adults to Reduce Sodium Intake

Journal of the American Dietetic Association ◽

10.1016/j.jada.2005.05.185 ◽

2005 ◽

Vol 105 (8) ◽

pp. 33

Author(s):

L. Tansman

Keyword(s):

Sodium Intake ◽

Senior Adults ◽

Reduce Sodium Intake

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Sodium intake, health implications, and the role of population-level strategies

Nutrition Reviews ◽

10.1093/nutrit/nuaa042 ◽

2020 ◽

Author(s):

Ghadeer S Aljuraiban ◽

Arun Pulikkottil Jose ◽

Priti Gupta ◽

Krithiga Shridhar ◽

Dorairaj Prabhakaran

Keyword(s):

Sodium Intake ◽

Population Level ◽

World Health ◽

Current Evidence ◽

Health Implications ◽

High Sodium ◽

Reduce Sodium Intake ◽

Matters Of Concern

Abstract Evidence to date suggests that high sodium intake affects health adversely, yet the role of a population-level strategy to reduce sodium intake is often contested. This review focuses on current available evidence on regional sodium intake levels, health implications of sodium intake, and population-level strategies implemented worldwide. The limitations in evidence, the difficulties in implementing population-wide strategies to reduce sodium intake, and the need for such strategies are critically reviewed. Evidence clearly shows that sodium has an adverse effect on blood pressure, cardiovascular disease, and mortality. However, whether reduced sodium intake benefits all individuals or only hypertensive individuals is still unclear. Methodological issues and publication bias in current evidence are other matters of concern in sodium-related research. While it is essential to continue working toward the World Health Organization’s target of 30% reduction in sodium intake, due consideration should be given to improving the quality of research, reducing bias in publications, and reviewing evidence more critically.

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Mapping Dietary Sodium Reduction Policies and Initiatives in the Region of the Americas

Current Developments in Nutrition ◽

10.1093/cdn/nzaa064_004 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1714-1714

Author(s):

Nadia Flexner ◽

Mary L'Abbé ◽

Barbara Legowski ◽

Ruben Grajeda Toledo

Keyword(s):

Sodium Intake ◽

Cost Effective ◽

Dietary Sodium ◽

World Health ◽

Significant Advance ◽

Relative Reduction ◽

Sodium Reduction ◽

Pan American ◽

Reduce Sodium Intake ◽

Health Organization

Abstract Objectives To map existing country policies addressing population dietary sodium reduction in the Americas; to identify policy gaps in the region following what is outlined in the World Health Organization (WHO) “Best Buys” most cost-effective recommendations for the prevention and control of diet-related noncommunicable diseases (NCDs); and to discuss priorities for future work in the Region. Methods This study used mixed methods to analyze data from 34 countries. Data were collected through a structured review, of mostly national official sources, to identify current policies in place to reduce population sodium intake. Also, responses from the last Pan American Health Organization (PAHO) online Survey on National Initiatives for Sodium Reduction in the Americas were included. Finally, country profiles were prepared and sent to each country's Public Health Agency for validation and comments. Results Almost all countries (n = 23/34) had a recommendation to reduce salt intake included in policies related to NCDs. Only six countries had specific and comprehensive policies to reduce sodium intake, and only one of them was a National Law. Adoption of the WHO “Best Buys” in national policies included: reformulation of food products with voluntary (n = 9/34) and mandatory targets (n = 2/34); establishment of a supportive environment in public institutions (n = 14/34); and implementation of front-of-pack labelling (n = 5/34). Some countries have implemented regulations restricting marketing of foods high in sodium to children (n = 5/34); nutritional labelling that includes sodium content, either voluntary (n = 9/34) or mandatory (n = 10/34); and no country has yet implemented taxes on high sodium foods. Conclusions In recent years, there has been a significant advance in policies to reduce sodium intake in the Region of the Americas. However, this review identified that the level of implementation in practice is complex to assess and quite heterogeneous. Reducing sodium consumption is a cost-effective intervention that can save many lives, by preventing and reducing the burden of diet related NCD's. Therefore, a further call to action is needed for governments to accelerate efforts in order to meet the 2025 global target of a 30% relative reduction in mean population intake of sodium. Funding Sources Pan American Health Organization (PAHO/WHO).

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