The association of knowledge, attitudes and behaviours related to salt with 24-hour urinary sodium excretion.
OBJECTIVE
Salt reduction efforts usually have a strong focus on consumer education. Understanding the association between salt consumption levels and knowledge, attitudes and behaviours towards salt should provide insight into the likely effectiveness of education-based programs.


METHODS
A single 24-hour urine sample and a questionnaire describing knowledge, attitudes and behaviours was obtained from 306 randomly selected participants and 113 volunteers from a regional town in Australia.


RESULTS
Mean age of all participants was 55 years (range 20-88), 55% were women and mean 24-hour urinary salt excretion was 8.8(3.6) g/d. There was no difference in salt excretion between the randomly selected and volunteer sample. Virtually all participants (95%) identified that a diet high in salt can cause serious health problems with the majority of participants (81%) linking a high salt diet to raised blood pressure. There was no difference in salt excretion between those who did 8.7(2.1) g/d and did not 7.5(3.3) g/d identify that a diet high in salt causes high blood pressure (p=0.1). Nor was there a difference between individuals who believed they consumed "too much" 8.9(3.3) g/d "just the right amount" 8.4(2.6) g/d or "too little salt" 9.1(3.7) g/d (p=0.2). Likewise, individuals who indicated that lowering their salt intake was important 8.5(2.9) g/d vs. not important 8.8(2.4) g/d did not have different consumption levels (p=0.4).


CONCLUSIONS
The absence of a clear association between knowledge, attitudes and behaviours towards salt and actual salt consumption suggests that interventions focused on knowledge, attitudes and behaviours alone may be of limited efficacy.
The George Institute for Global Health, Sydney Medical School, The University of Sydney, PO BOX M201, Missenden Road, Camperdown, Sydney, NSW, Australia. maland@georgeinstitute.org.au.
Mary-Anne
MA
Land
Jacqui
J
Webster
Anthea
A
Christoforou
Claire
C
Johnson
Helen
H
Trevena
Frances
F
Hodgins
John
J
Chalmers
Mark
M
Woodward
Federica
F
Barzi
Wayne
W
Smith
Victoria
V
Flood
Paul
P
Jeffery
Caryl
C
Nowson
Bruce
B
Neal
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D001794:Blood Pressure / Q000187:drug effects; D003430:Cross-Sectional Studies; D005247:Feeding Behavior; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors; D012964:Sodium / Q000652:urine*; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage* / Q000009:adverse effects; D011795:Surveys and Questionnaires; D055815:Young Adult
D017673:Sodium Chloride, Dietary; D012964:Sodium