Assessment of a Salt Reduction Intervention on Adult Population Salt Intake in Fiji

Pillay, Arti; Trieu, Kathy; Santos, Joseph Alvin; Sukhu, Arleen; Schultz, Jimaima; Wate, Jillian; Bell, Colin; Moodie, Marj; Snowdon, Wendy; Ma, Gary; Rogers, Kris; Webster, Jacqui

doi:10.3390/nu9121350

Cited by 28 publications

(41 citation statements)

References 32 publications

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“…Other studies also report that the implementation of intervention programs with the aid of behavioral change theories resulted in a significant reduction in salt intake (39)(40)(41). Along with our results, an intervention by Pillay in Fiji was succeed to reduce the mean salt intake by 1.4 g/day (42). A study based on theory of planned behavior could reduce the mean salt intake by 4.73 g/day in Yazd, Iran (43).…”

Section: Discussionsupporting

confidence: 86%

Using Social Marketing to Reduce Salt Intake in Iran

Layeghiasl

Malekzadeh

Shams

et al. 2020

Front. Public Health

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Objectives: WHO has recommended that the average salt intake must be <5 grams per day. However, people consume salt much more in many countries. In this study, we design and implement an intervention based on social marketing model to reduce salt consumption in Yasuj, Iran. Materials and Methods: This study employed a quasi-experimental pretest-posttest with control group design which consisted of a formative research (qualitative-quantitative) and an interventional phase. To collect the qualitative data, six focus group discussions by participating of 66 people were established. The qualitative data were analyzed manually using directed content analysis. In quantitative study, 166 people aged 25-50 years completed a KAP questionnaire, and their average salt intake was determined through measuring sodium in their urine sample. By analyzing the data, marketing mix components were determined for designing an intervention. An educational package (including posters for installing in the kitchen, pamphlets, phone counseling, four educational classes, and brief interventions done by physicians and other health personnel) focused on reducing salt intake and using alternatives was developed. For one month, program was implemented for intervention group. Two months later, KAP survey and measuring the urine sodium were repeated for intervention and control groups. The data was compared for two groups, before and after the intervention by using independent t-test, paired t-tests and repeated measures ANOVA. Results: The qualitative findings showed that most participants agreed that the salt intake was high in Iran. Most of them recommended home-based and family-driven strategies to reduce salt intake, offered using healthier alternatives for salt, and recognized physicians and health care providers in healthcare facilities as the most important to encourage people to reduce salt intake. After the intervention, the mean and standard deviation of KAP were improved significantly in intervention group. The mean salt intake decreased significantly by 3.01 ± 2.38 in the intervention group and repeated measures ANOVA showed significant change over time (P < 0.001) and a significant difference between two groups (P = 0.04). Also, the interaction between time and group was significant (P = 0.001). Layeghiasl et al. Social Marketing to Reduce Salt Intake Conclusion: The mean salt intake among the study population was approximately three times more than the level recommended by the WHO. The social marketing-based intervention succeeded in reducing the salt intake of the study subjects by ∼3 grams on average.

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Section: Discussionsupporting

confidence: 86%

Using Social Marketing to Reduce Salt Intake in Iran

Layeghiasl

Malekzadeh

Shams

et al. 2020

Front. Public Health

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“…The proportion of males and females were nearly equal across all studies, and age ranged between 18 and 90 years. The majority of studies used 24-hour urine volume and creatinine to assess the completeness of 24-hour urine collection 16,17,[19][20][21][22][23][24][25][26][27] ; while two studies used para-amino benzoic acid (PABA). 28,29 Details on the representativeness of each study are presented in Table 1 (with references).…”

Section: Description Of Studiesmentioning

confidence: 99%

The Science of Salt: Updating the evidence on global estimates of salt intake

Thout

Santos

McKenzie

et al. 2019

J of Clinical Hypertension

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The Global Burden of Disease (GBD) 2010 study estimated national salt intake for 187 countries based on data available up to 2010. The purpose of this review was to identify studies that have measured salt intake in a nationally representative population using the 24‐hour urine collection method since 2010, with a view to updating evidence on population salt intake globally. Studies published from January 2011 to September 2018 were searched for from MEDLINE, Scopus, and Embase databases using relevant terms. Studies that provided nationally representative estimates of salt intake among the healthy adult population based on the 24‐hour urine collection were included. Measured salt intake was extracted and compared with the GBD estimates. Of the 115 identified studies assessed for eligibility, 13 studies were included: Four studies were from Europe, and one each from the United States, Canada, Benin, India, Samoa, Fiji, Barbados, Australia, and New Zealand. Mean daily salt intake ranged from 6.75 g/d in Barbados to 10.66 g/d in Portugal. Measured mean population salt intake in Italy, England, Canada, and Barbados was lower, and in Fiji, Samoa, and Benin was higher, in recent surveys compared to the GBD 2010 estimates. Despite global targets to reduce population salt intake, only 13 countries have published nationally representative salt intake data since the GBD 2010 study. In all countries, salt intake levels remain higher than the World Health Organization's recommendation, highlighting the need for additional global efforts to lower salt intake and monitor salt reduction strategies.

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“…The impact of the population-wide intervention program was assessed through cross-sectional surveys of salt consumption patterns in a national sample at baseline and after 20 months [ 10 ]. The results of the impact evaluation were recently published in Nutrients [ 11 ]. The evaluation showed a 1.4 g/day drop in salt intake from a baseline of 11.7 g/day, however, this was not statistically significant.…”

Section: Introductionmentioning

confidence: 99%

Process Evaluation and Costing of a Multifaceted Population-Wide Intervention to Reduce Salt Consumption in Fiji

et al. 2018

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This paper reports the process evaluation and costing of a national salt reduction intervention in Fiji. The population-wide intervention included engaging food industry to reduce salt in foods, strategic health communication and a hospital program. The evaluation showed a 1.4 g/day drop in salt intake from the 11.7 g/day at baseline; however, this was not statistically significant. To better understand intervention implementation, we collated data to assess intervention fidelity, reach, context and costs. Government and management changes affected intervention implementation, meaning fidelity was relatively low. There was no active mechanism for ensuring food companies adhered to the voluntary salt reduction targets. Communication activities had wide reach but most activities were one-off, meaning the overall dose was low and impact on behavior limited. Intervention costs were moderate (FJD $277,410 or $0.31 per person) but the strategy relied on multi-sector action which was not fully operationalised. The cyclone also delayed monitoring and likely impacted the results. However, 73% of people surveyed had heard about the campaign and salt reduction policies have been mainstreamed into government programs. Longer-term monitoring of salt intake is planned through future surveys and lessons from this process evaluation will be used to inform future strategies in the Pacific Islands and globally.

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Assessment of a Salt Reduction Intervention on Adult Population Salt Intake in Fiji

Cited by 28 publications

References 32 publications

Using Social Marketing to Reduce Salt Intake in Iran

Using Social Marketing to Reduce Salt Intake in Iran

The Science of Salt: Updating the evidence on global estimates of salt intake

Process Evaluation and Costing of a Multifaceted Population-Wide Intervention to Reduce Salt Consumption in Fiji

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