Knowledge, Attitudes, and Behaviors Related to Sodium Intake and Reduction Among Adult Consumers in the United States

Patel, Deesha A.; Cogswell, Mary E.; John, Katherine A; Creel, Stephanie; Ayala, Carma

doi:10.4278/ajhp.150102-quan-650

Cited by 28 publications

(22 citation statements)

References 21 publications

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“…Less than half of all individuals with an undergraduate-level qualification had heard of inorganic nitrate, and these participants were generally unsure about the physiological effects, habitual consumption, sources and metabolism of nitrate. This finding is broadly consistent with previous studies which show greater knowledge of single dietary compounds such as sodium in individuals with a higher education level 41. Greater coverage of nitrate in undergraduate-level nutrition courses could be of particular value.…”

Section: Discussionsupporting

confidence: 92%

Knowledge and beliefs about dietary inorganic nitrate among UK-based nutrition professionals: development and application of the KINDS online questionnaire

et al. 2019

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ObjectivesTo examine knowledge and beliefs about the biological roles of dietary inorganic nitrate in UK-based nutrition professionals, and to explore potential differences by participants’ education level.SettingAn online questionnaire was administered to UK-based nutrition professionals, exploring knowledge and/or beliefs across five areas: (1) health and performance effects of nitrate; (2) current and recommended intake values for nitrate; (3) dietary sources of nitrate; (4) methods of evaluating nitrate intake and (5) nitrate metabolism.ParticipantsOne hundred and twenty-five nutrition professionals.Primary outcomeKnowledge and beliefs about inorganic nitrate.ResultsMost nutrition professionals taking part in the survey had previously heard of inorganic nitrate (71%) and perceived it to be primarily beneficial (51%). The majority believed that nitrate consumption can improve sports performance (59%) and reduce blood pressure (54%), but were unsure about effects on cognitive function (71%), kidney function (80%) and cancer risk (70%). Knowledge of dietary sources of nitrate and factors affecting its content in food were generally good (41%–79% of participants providing correct answers). However, most participants were unsure of the average population intake (65%) and the acceptable daily intake (64%) of nitrate. Most participants (65%) recognised at least one compound (ie, nitric oxide or nitrosamines) that is derived from dietary nitrate in the body. Knowledge of nitrate, quantified by a 23-point index created by summing correct responses, was greater in individuals with a PhD (p=0.01; median (IQR)=13 (9–17)) and tended to be better in respondents with a masters degree (p=0.054; 13 (8–15)) compared with undergraduate-level qualifications (10 (2–14)).ConclusionsUK-based nutrition professionals demonstrated mixed knowledge about the physiology of dietary nitrate, which was better in participants with higher education. More efficient dissemination of current knowledge about inorganic nitrate and its effects on health to nutrition professionals will support them to make more informed recommendations about consumption of this compound.

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Section: Discussionsupporting

confidence: 92%

Knowledge and beliefs about dietary inorganic nitrate among UK-based nutrition professionals: development and application of the KINDS online questionnaire

et al. 2019

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“…The study demonstrates mixed levels of consumer knowledge and behaviors around sodium and high levels of support for changes to sodium content in food. Results from the present study are consistent with previous, albeit limited, studies suggesting that most consumers are aware of the potential harm of excessive sodium intake (Patel, Cogswell, John, Creel, & Ayala, 2015), but few can correctly identify and understand daily sodium intake guidelines and recommendations (Newsom et al, 2013). Similarly, high levels of consumer support for the food industry to reduce sodium content, as found in the present study, complements the results from previous U.S. surveys, which showed strong support among the general public for population-based sodium reduction strategies (Morain & Mello, 2013;Patel, Gunn, Tong, & Cogswell, 2014).…”

Section: Discussionsupporting

confidence: 90%

Consumer Knowledge, Attitudes, and Behaviors of Sodium Intake and Reduction Strategies in Los Angeles County

Wickramasekaran

Gase

Green

et al. 2016

CALIF J HEALTH PROMOT

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Background and Purpose: In Los Angeles County, over 27% of the population has been diagnosed with hypertension and over 60% is considered overweight or obese. To help address the burden of hypertension and other diet-associated diseases, the Los Angeles County Department of Public Health launched its sodium reduction initiative to scale sodium reduction approaches and, ultimately, reduce sodium intake in the region. The purpose of this study was to gain a better understanding of consumer knowledge, attitudes, and behaviors related to sodium consumption and reduction to inform ongoing program efforts. Methods: A cross-sectional Internet panel survey was administered from December 2014 to January 2015 to a panel of Los Angeles County adult residents (n=848). Results: Results suggest low levels of consumer knowledge of recommended daily sodium intake limits (5.9%), high levels of support for reduction of sodium in the food supply (>70%), and moderate levels of healthy behavior change (e.g., 48.1% reported determining their food purchases based on the sodium content, 56.3% reported watching their sodium intake). Conclusions: These findings support the continued need to work at multiple levels (consumer, food supplier/manufacturer, retail) to reduce sodium intake in Los Angeles County.

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“…Licensed data provided to the CDC did not include individual identifiers, making it exempt from CDC institutional review board approval. Consumer Styles 2012 has been used previously to ascertain US consumer seat belt use, in addition to, examining knowledge, attitudes, and behaviors related to sodium reduction (Patel et al, 2015) (Bhat, Beck, Gergen, & Kresnow, 2015). …”

Section: Methodsmentioning

confidence: 99%

“…Health characteristics included weight status as determined by body mass index (BMI) from self-reported height and weight data, cardiovascular health (self-reported high blood pressure or high cholesterol during the past year), and cardiovascular disease history (self-reported stroke or heart failure during the past year) (Havranek et al, 2015). Sodium-related attitudes or behaviors were assessed through the following questions: “In your opinion, how harmful to your health is eating too much salt/sodium?” and “Are you currently watching or reducing your sodium/salt intake?” (Patel et al, 2015). …”

Section: Methodsmentioning

confidence: 99%

“…Given the availability of commercial foods targeted specifically to babies or toddlers and the high sodium content of some types of these foods (Cogswell, Gunn, Yuan, Park, & Merritt, 2015), our objective was to examine the prevalence and correlates of US adult consumer attitudes toward sodium in baby and toddler foods.We hypothesized that parents of children younger than two years, individuals with or at higher risk of cardiovascular disease, and those who agree that too much sodium intake is harmful or who are trying to reduce sodium intake would be more likely to agree that toddler foods should be low in sodium (Havranek et al, 2015) (Patel, Cogswell, John, Creel, & Ayala, 2015). As indicated by the IOM in a report on Strategies to Reduce Sodium Intake in the United States (Institute of Medicine [IOM], 2010), knowledge of consumer attitudes can support strategies to encourage reduction of sodium in processed foods.…”

Section: Introductionmentioning

confidence: 99%

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US consumer attitudes toward sodium in baby and toddler foods

et al. 2016

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Dietary data from a nationally representative survey indicate about 80% of US toddlers aged 1–3 years consume too much dietary sodium, which can influence their preference for salty foods in later life. Information on consumer attitudes can inform strategies to reduce sodium in baby and toddler foods. Data were obtained from a 2012 online survey sent to a sample of 11636 US adults aged ≥18 years enrolled in a national probability-based consumer panel; 6378 completed the survey and had nonmissing responses to the question of interest, “It is important for baby and toddler foods to be low in sodium.” Prevalence of agreement was estimated. Logistic regression was used to describe associations of respondent characteristics with agreement. The majority of respondents were non-Hispanic white and had a household income ≥$60,000. About 7 in 10 (68%, 95% CI: 66%–70%) respondents agreed it is important for baby or toddler foods to be low in sodium. More than 6 of 10 respondents in most subgroups agreed. Among parents with a child currently aged <2 years (N = 390), 82% agreed (95% CI: 77% –87%); the highest agreement included parents who thought sodium was very harmful to their own health (92%, 95% CI: 85%–99%) or who were watching/reducing their own sodium intake (95%, 95% CI: 90%–100%). After adjusting for sex, age, race-ethnicity, agreement was most strongly associated with being a parent of a child <2 years, thinking sodium was harmful, and watching/reducing sodium intake (adjusted odds ratios ≥ 2.5, 95% CI’s ≠ 1.0). The majority of respondents including most parents agreed it is important for baby and toddler foods to be low in sodium, suggesting wide consumer support for strategies to lower sodium in these foods.

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Knowledge, Attitudes, and Behaviors Related to Sodium Intake and Reduction Among Adult Consumers in the United States

Cited by 28 publications

References 21 publications

Knowledge and beliefs about dietary inorganic nitrate among UK-based nutrition professionals: development and application of the KINDS online questionnaire

Knowledge and beliefs about dietary inorganic nitrate among UK-based nutrition professionals: development and application of the KINDS online questionnaire

Consumer Knowledge, Attitudes, and Behaviors of Sodium Intake and Reduction Strategies in Los Angeles County

US consumer attitudes toward sodium in baby and toddler foods

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