Rural and semi-urban differences in salt intake, and its dietary sources, in Ashanti, West Africa.
OBJECTIVE
To provide a socioeconomic profile of rural and semi-urban settings in Ashanti, West Africa and to investigate the relationship between urbanization and sources of salt in the diet.


METHODS
12 villages (6 rural, 6 semi-urban) participating in a cluster randomized controlled trial of a health promotion in the Ashanti region of Ghana.


METHODS
1013 adult men (N = 385) and women (N = 628), aged 40-75.


METHODS
Between June 2001 and June 2002, participants completed a detailed questionnaire on demography, occupation and education, housing, radio and television use, personal and family medical history, drug therapy, smoking, alcohol consumption, and diet.


RESULTS
532 subjects lived in semi-urban and 481 in rural communities. Ninety-two percent of the participants were of the Ashanti tribe and 94% spoke Twi. The semi-urban villages were closer to Kumasi, the second largest city in Ghana, had larger population (1727 vs 1100 people) and household sizes (14.6 vs 8.8 persons per household; P < .001), had fewer farmers (53% vs 81%; P < .001) and more traders (22% vs 7%; P < .001), and had more homes with electricity (81% vs 17%; P < .001) and piped water (28% vs 0.2%; P < .05). Semi-urban villagers had higher systolic blood pressure than rural villagers (129 vs 121 mm Hg difference 8 mm Hg [95% CI 5-11]; P < .001). Salt is almost invariably added to food in cooking (98%), and salted foods such as fish and meat are eaten in both communities. Salt is often added at the table (52%), more often in rural villages than in semi-urban settings (59% vs 45%; P < .01), although the total salt consumed as measured by urinary sodium was similar (99 vs 103 mmol/day). Potassium levels were higher in rural villages (58 vs 40 mmol/day difference 18 mmol/day [95% CI 11-26]; P < .001).


CONCLUSIONS
In this mainly farming community were clear differences in housing, population structure, and blood pressure between rural and semi-urban communities. While no significant differences were in the amount of salt consumed, the sources of salt differed between rural and semi-urban settings. Finally, rural villagers ate more potassium than semi-urban participants.
Kerry
Sally M
SM
Department of Community Health Sciences, St. George's Hospital Medical School, Cranmer Terrace, London.
Emmett
Lynsey
L
Micah
Frank B
FB
Martin-Peprah
Ruby
R
Antwi
Sampson
S
Phillips
Richard O
RO
Plange-Rhule
Jacob
J
Eastwood
John B
JB
Cappuccio
Francesco P
FP
D000328:Adult; D000368:Aged; D016000:Cluster Analysis; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006266:Health Education; D006297:Health Services Accessibility; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage*; D013383:Suburban Population; D011795:Surveys and Questionnaires
D017673:Sodium Chloride, Dietary