Awareness, behavior, and determinants of dietary salt intake in adults: results from the National NCD Monitoring Survey, India

Association of Cardiovascular Disease Risk Factors With Estimated Dietary Salt Consumption in Bangladeshi Adults: A Nationally Representative Cross-Sectional Study

This population-based, nationally representative cross-sectional study assessed the daily salt consumption status and its associated cardiovascular disease (CVD) risk factors using weighted data from the STEPwise approach to noncommunicable disease risk factor surveillance conducted in 2018 in Bangladesh. It included a non-institutionalized adults' population of 6189 men and women aged 18-69 years. Their daily salt consumption was estimated using the spot urine sodium concentration following the Tanaka equation and reported according to the standard nomenclature proposed by the World Hypertension League and partner organizations involved in dietary salt reduction. Out of a total of 6189 participants, 2.4% consumed the recommended amount of salt (<5 g/day), 67.8% consumed a high amount of salt (≥5-10 g/day), 27.2% consumed a very high amount of salt (>10-15 g/day), and 2.6% consumed an extremely high amount of salt (>15 g/day). In univariate analysis, a higher than recommended level of salt intake (≥5 g/day) was significantly prevalent among rural residents (high = 78.4%, very-high = 81.6%, extremely-high = 84.9%, p = 0.01), literates (high = 51.6%, very-high = 57.9%, extremely-high = 59.1%, p = 0.02), newly diagnosed hypertension (high = 20.6%, very-high = 23.6%, extremely-high = 24.1%, p = 0.008), and overweight/obese (high = 25.9%, very-high = 33.3%, extremely-high = 29.8%, p = 0.000). Similarly, in ordinal logistic regression analysis, the categories of daily salt consumption showed a significant association with rural residence (OR: 1.300, CI: 1.109-1.524, p = 0.001), literates (OR: 0.777, CI: 0.671-0.900, p = 0.001), newly diagnosed hypertension (OR: 1.204, CI: 1.022-1.419, p = 0.026), and overweight/obesity (OR: 1.353, CI: 1.145-1.598, p = 0.000). The current national pattern of salt consumption in Bangladesh may help reconstruct the salt reduction strategy considering the associated risk factors.

Awareness and Availability of Low Sodium Iodized Salt: Results from Formative Research of Promoting Uptake of Low SodiUm Iodized Salt by Rural and Urban HousehoLds in India-The PLURAL Study

Dietary sodium intake is high among adults in India. Use of low sodium iodized salt (LSIS) can help reduce sodium intake. However, contextually relevant and culturally appropriate interventions to promote LSIS uptake in India have not been developed and implemented. We carried out formative research to inform an intervention to promote uptake of LSIS among rural and urban households in north (Sonipat district) and south (Visakhapatnam and Anakapalli districts) India. Sixty-two in-depth interviews of six focus groups were held with a range of stakeholders-consumers, retailers and influencers. Participant views on availability, affordability, taste and safety of LSIS, along with views on hypertension, its risk factors and potential intervention design and delivery strategies were elicited. Thematic analysis of the data was carried out. While the awareness of hypertension and its risk factors was high among the participants, awareness of LSIS was low. There was also low demand for, and availability of, LSIS. Since cost of LSIS was higher than regular salt, participants preferred that a subsidy be provided to offset the cost. Based on these findings, an intervention to promote the uptake of LSIS was implemented by project staff using various educational materials such as posters, pamphlets and short videos.