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Marakis G, Marques Domingues A, Crispo A, Magriplis E, Vasara E, Kontopoulou L, Triantafyllou C, Skepastianos P, Papadopoulou SK, Rodopaios NE, Hassapidou M, Zampelas A, Cappuccio FP, Breda J. Pertinence of Salt-Related Knowledge and Reported Behaviour on Salt Intake in Adults: A Cross-Sectional Study. Nutrients 2023; 15:4114. [PMID: 37836397 PMCID: PMC10574173 DOI: 10.3390/nu15194114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
The association between salt-related knowledge, attitude, behaviour (KAB) and actual salt consumption in Greek adults is uncertain. This study investigates the correlation between salt intake, gauged by 24-h urinary sodium excretion, with salt-related KAB. It further explores how socio-demographic factors influence these behaviors. Salt consumption was evaluated using a 24-h urinary sodium test, and compared to self-reported KAB data. Knowledge and behavior scores related to salt were computed. An overall cohort-adjusted model examined the relationship between daily salt consumption, knowledge and behavior scores, and certain covariates. Through the stratification by the cohort random effect, two models were established (Cohort I Adults; Cohort II Students) examining the same relationships of the overall cohort model. 463 Greek adults participated. The average salt intake was 9.54 g/day, nearly double the WHO recommendation. Significant differences in knowledge scores were noted based on sex, age, education, and BMI. A trend suggesting lower discretionary salt use with increased salt intake was observed (p = 0.06). However, comprehensive analysis revealed no direct correlation between salt intake and either knowledge (p = 0.562) or behavior scores (p = 0.210). The results emphasize the need for food product reforms by industry stakeholders and accelerated efforts towards reducing salt intake.
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Affiliation(s)
- Georgios Marakis
- Hellenic Food Authority, 124 Kifisias Av. & 2 Iatridou Str., 11526 Athens, Greece; (G.M.); (A.Z.)
| | - Ana Marques Domingues
- WHO Athens Quality of Care and Patient Safety Office, Ploutarchou 3, 10675 Athens, Greece; (A.M.D.); (A.C.); (C.T.)
| | - Anna Crispo
- WHO Athens Quality of Care and Patient Safety Office, Ploutarchou 3, 10675 Athens, Greece; (A.M.D.); (A.C.); (C.T.)
- Istituto Nazionale dei “Tumori Fondazione G. Pascale”, Via Mariano Semmola 52, 80131 Napoli, Italy
| | - Emmanuella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 11855 Athens, Greece;
| | - Eleni Vasara
- School of Biology, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece;
| | - Lamprini Kontopoulou
- Department of Nursing, University of Thessaly, Gaiopolis Campus, Larissa-Trikala Ring-Road, 41500 Larissa, Greece;
| | - Christos Triantafyllou
- WHO Athens Quality of Care and Patient Safety Office, Ploutarchou 3, 10675 Athens, Greece; (A.M.D.); (A.C.); (C.T.)
| | - Petros Skepastianos
- Department of Medical Laboratory Studies, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (M.H.)
| | | | - Maria Hassapidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (M.H.)
| | - Antonis Zampelas
- Hellenic Food Authority, 124 Kifisias Av. & 2 Iatridou Str., 11526 Athens, Greece; (G.M.); (A.Z.)
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 11855 Athens, Greece;
| | - Francesco P. Cappuccio
- Medical School, University of Warwick, Coventry CV4 7AL, UK;
- WHO Collaborating Centre for Nutrition, Warwick Medical School, Coventry CV4 7AL, UK
| | - João Breda
- WHO Athens Quality of Care and Patient Safety Office, Ploutarchou 3, 10675 Athens, Greece; (A.M.D.); (A.C.); (C.T.)
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Uerling J, Nieckula E, Mico K, Rosas AB, Cohen E, Pachón H. Salt-Containing Recipes in Popular Magazines with the Highest Circulation in the United States Do Not Specify Iodized Salt in the Ingredient List. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4595. [PMID: 36901606 PMCID: PMC10002291 DOI: 10.3390/ijerph20054595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/21/2023] [Accepted: 02/25/2023] [Indexed: 06/18/2023]
Abstract
Iodine deficiency is a public health problem in the US, with the iodine status of women of reproductive age decreasing in recent years. This may be attributable to voluntary salt iodization in the US. Magazines, a common source of recipes and nutritional information, may influence salt use and iodine intake. The aim of this study is to assess whether the magazines with the highest circulation in the US include recipes that contain salt and, if so, whether they specify "iodized salt" in the recipes. Recipes in eight of the top ten magazines by circulation in the US were examined. Standardized information was collected on the presence and type of salt in recipes in the last 12 issues reviewed per magazine. About 73% of the 102 issues reviewed contained recipes. A total of 1026 recipes were surveyed for salt; 48% of the recipes listed salt as an ingredient. None of the 493 recipes containing salt specified iodized salt as the type of salt to be used. About half of the recipes in the last 12 issues of popular magazines published in the US included salt in the ingredient list; however, none recommend the use of iodized salt. There is potential for editorial changes among magazines to call for iodized salt in recipes, which may further prevent iodine deficiency in the US.
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Affiliation(s)
- Josephine Uerling
- Emory College of Arts and Sciences, Emory University, Atlanta, GA 30322, USA
| | - Emily Nieckula
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Katarina Mico
- Emory College of Arts and Sciences, Emory University, Atlanta, GA 30322, USA
| | | | - Emmie Cohen
- Emory College of Arts and Sciences, Emory University, Atlanta, GA 30322, USA
| | - Helena Pachón
- Emory College of Arts and Sciences, Emory University, Atlanta, GA 30322, USA
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
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Endaltseva A, Coeurquetin P, Thomas-Danguin T, Poulain JP, Tibère L, Dupuy A. Eater-oriented knowledge framework for reducing salt and dietary sodium intake (scoping review). Front Nutr 2023; 10:1110446. [PMID: 36925961 PMCID: PMC10011657 DOI: 10.3389/fnut.2023.1110446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/31/2023] [Indexed: 03/08/2023] Open
Abstract
Salt and dietary sodium are ubiquitously present in daily food practices and, at the same time, reducing salt intake presents an important public health issue. Given such an ambivalent position of salt in human diet, we argue that public health guidelines toward dietary sodium reduction require an eater-oriented knowledge framework. In this article we are making the first steps toward a flexible interdisciplinary database which would include nutritional, socio-economic, cultural, material, and socio-psychological determinants of salt consumption for comprehensive public health campaigns. We employ an explorative scoping review of academic articles and reports, limiting our review to the original data on salt or sodium consumption published in English or French between 2000 and 2022. We describe salt consumption as research object, identifying its representation in different research fields, data sources, methodologies, samples, and links with nutritional recommendations. We synthesize existing approaches via four eater-oriented categories: Socio-demographic and cultural descriptors of salt consumers; Knowledge, attitudes, and beliefs on nutritional norms; Salt practices associated with dietary or medical regimes; Salt materialities: interactions and contexts. In each category, we identify the dominant relational features, i.e., what kind of 'eater-salt' relation is being put forward. We thus build an interdisciplinary documentary base of dietary sodium consumption factors. We discuss the results, suggesting that comprehensive nutritional policies for global salt reduction require interdisciplinary eater-oriented data frameworks.
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Affiliation(s)
| | - Paul Coeurquetin
- LISST-Cers UMR, University of Toulouse Jean Jaurès, Toulouse, France
| | - Thierry Thomas-Danguin
- Centre des Sciences du Goût et de l'Alimentation (CSGA), CNRS, INRAE, Institut Agro, Université de Bourgogne Franche-Comté, Dijon, France
| | - Jean-Pierre Poulain
- CERTOP UMR CNRS, University of Toulouse Jean Jaurès, Toulouse, France.,ISTHIA, University of Toulouse Jean Jaurès, Toulouse, France
| | - Laurence Tibère
- CERTOP UMR CNRS, University of Toulouse Jean Jaurès, Toulouse, France.,ISTHIA, University of Toulouse Jean Jaurès, Toulouse, France
| | - Anne Dupuy
- CERTOP UMR CNRS, University of Toulouse Jean Jaurès, Toulouse, France.,ISTHIA, University of Toulouse Jean Jaurès, Toulouse, France
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Heimberg K, Martin A, Ehlers A, Weißenborn A, Hirsch-Ernst KI, Weikert C, Nagl B, Katsioulis A, Kontopoulou L, Marakis G. Knowledge and awareness about and use of iodised salt among students in Germany and Greece. BMC Public Health 2022; 22:1851. [PMID: 36195843 PMCID: PMC9531348 DOI: 10.1186/s12889-022-14008-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Iodine is an essential trace element, which is important for human metabolism, growth and mental development. Iodine deficiency may still occur in Europe and the use of iodised salt is an effective measure to enhance iodine intake. Knowledge and awareness about the importance of iodine in nutrition and health can have a positive impact on the use of iodised salt. Therefore, the aim of this study was to assess the knowledge about and use of iodised salt among university students in two European countries. METHOD Data from two countries (Germany and Greece) were extracted from a multi-centre cross-sectional survey, conducted among non-nutrition science/non-medical students from October 2018 to April 2019. RESULTS Among the 359 participants in Germany (35% females, median age: 22 years) and the 403 participants in Greece (51% females, median age: 21 years), 41% and 37%, respectively, reported use of iodised salt at home. Users and non-users did not differ by age, gender and Body Mass Index or general interest in nutrition in both cohorts. However, those who had a better knowledge about iodine and (iodised) salt or had previously attended nutrition classes were more likely to report iodised salt usage. CONCLUSION The results suggest that strengthening the imparting of nutritional information and additional education of young adults are needed and may improve knowledge about and usage of iodised salt.
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Affiliation(s)
- Katharina Heimberg
- German Federal Institute for Risk Assessment, Max-Dohrn-Str. 8-10, 10589, Berlin, Germany.
| | - Annett Martin
- German Federal Institute for Risk Assessment, Max-Dohrn-Str. 8-10, 10589, Berlin, Germany
| | - Anke Ehlers
- German Federal Institute for Risk Assessment, Max-Dohrn-Str. 8-10, 10589, Berlin, Germany
| | - Anke Weißenborn
- German Federal Institute for Risk Assessment, Max-Dohrn-Str. 8-10, 10589, Berlin, Germany
| | | | - Cornelia Weikert
- German Federal Institute for Risk Assessment, Max-Dohrn-Str. 8-10, 10589, Berlin, Germany
| | - Britta Nagl
- German Federal Institute for Risk Assessment, Max-Dohrn-Str. 8-10, 10589, Berlin, Germany
| | | | | | - Georgios Marakis
- Hellenic Food Authority, Kifisias Ave. 124 & Iatridou St. 2, 11526, Athens, Greece
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