title: The Association of Knowledge and Behaviours Related to Salt with 24-h Urinary Salt Excretion in a Population from North and South India.
abstract: Consumer knowledge is understood to play a role in managing risk factors associated with cardiovascular disease and may be influenced by level of education. The association between population knowledge, behaviours and actual salt consumption was explored overall, and for more-educated compared to less-educated individuals. A cross-sectional survey was done in an age-and sex-stratified random sample of 1395 participants from urban and rural areas of North and South India. A single 24-h urine sample, participants' physical measurements and questionnaire data were collected. The mean age of participants was 40 years, 47% were women and mean 24-h urinary salt excretion was 9.27 (8.87-9.69) g/day. Many participants reported favourable knowledge and behaviours to minimise risks related to salt. Several of these behaviours were associated with reduced salt intake-less use of salt while cooking, avoidance of snacks, namkeens, and avoidance of pickles (allp< 0.003). Mean salt intake was comparable in more-educated (9.21, 8.55-9.87 g/day) versus less-educated (9.34, 8.57-10.12 g/day) individuals (p= 0.82). There was no substantively different pattern of knowledge and behaviours between more-versus less-educated groups and no clear evidence that level of education influenced salt intake. Several consumer behaviours related to use of salt during food preparation and consumption of salty products were related to actual salt consumption and therefore appear to offer an opportunity for intervention. These would be a reasonable focus for a government-led education campaign targeting salt.
authors.affiliation: The George Institute for Global Health, Box M201 Missenden Rd, Sydney 2006, Australia. cjohnson@georgeinstitute.org.au.|School of Public Health, Department of Medicine, The University of Sydney, Sydney 2006, Australia. cjohnson@georgeinstitute.org.au.
authors.forename: Claire
authors.initials: C
authors.lastname: Johnson
authors.affiliation: Public Health Foundation of India, New Delhi 110070, India. smohan@phfi.org.
authors.forename: Sailesh
authors.initials: S
authors.lastname: Mohan
authors.affiliation: The George Institute for Global Health, Box M201 Missenden Rd, Sydney 2006, Australia. krogers@georgeinstitute.org.
authors.forename: Kris
authors.initials: K
authors.lastname: Rogers
authors.affiliation: Public Health Foundation of India, New Delhi 110070, India. roopa@ccdcindia.org.|Centre for Chronic Disease Control, New Delhi 122002, India. roopa@ccdcindia.org.
authors.forename: Roopa
authors.initials: R
authors.lastname: Shivashankar
authors.affiliation: George Institute for Global Health, Hyderabad 500034, India. traj@georgeinstitute.org.in.
authors.forename: Sudhir Raj
authors.initials: SR
authors.lastname: Thout
authors.affiliation: Public Health Foundation of India, New Delhi 110070, India. priti@ccdcindia.org.
authors.forename: Priti
authors.initials: P
authors.lastname: Gupta
authors.affiliation: Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London EC1M 6BQ, UK. f.he@qmul.ac.uk.
authors.forename: Feng J
authors.initials: FJ
authors.lastname: He
authors.affiliation: Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London EC1M 6BQ, UK. g.macgregor@qmul.ac.uk.
authors.forename: Graham A
authors.initials: GA
authors.lastname: MacGregor
authors.affiliation: The George Institute for Global Health, Box M201 Missenden Rd, Sydney 2006, Australia. jwebster@georgeinstitute.org.au.|School of Public Health, Department of Medicine, The University of Sydney, Sydney 2006, Australia. jwebster@georgeinstitute.org.au.
authors.forename: Jacqui
authors.initials: J
authors.lastname: Webster
authors.affiliation: All India Institute of Medical Sciences, New Delhi 110029, India. kanandiyer@yahoo.com.
authors.forename: Anand
authors.initials: A
authors.lastname: Krishnan
authors.affiliation: George Institute for Global Health, Hyderabad 500034, India. pmaulik@georgeinstitute.org.in.|George Institute for Global Health, University of Oxford, Oxford OX1 3PA, UK. pmaulik@georgeinstitute.org.in.
authors.forename: Pallab K
authors.initials: PK
authors.lastname: Maulik
authors.affiliation: Public Health Foundation of India, New Delhi 110070, India. ksrinath.reddy@phfi.org.
authors.forename: K Srinath
authors.initials: KS
authors.lastname: Reddy
authors.affiliation: Public Health Foundation of India, New Delhi 110070, India. dprabhakaran@ccdcindia.org.|Centre for Chronic Disease Control, New Delhi 122002, India. dprabhakaran@ccdcindia.org.
authors.forename: Dorairaj
authors.initials: D
authors.lastname: Prabhakaran
authors.affiliation: The George Institute for Global Health, Box M201 Missenden Rd, Sydney 2006, Australia. bneal@georgeinstitute.org.au.|School of Public Health, Department of Medicine, The University of Sydney, Sydney 2006, Australia. bneal@georgeinstitute.org.au.|Charles Perkins Centre, University of Sydney, Sydney 2050, Australia. bneal@georgeinstitute.org.au.|School of Public Health, Imperial College, London SW7 2AZ, UK. bneal@georgeinstitute.org.au.|Royal Prince Alfred Hospital, Sydney 2050, Australia. bneal@georgeinstitute.org.au.
authors.forename: Bruce
authors.initials: B
authors.lastname: Neal
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012424:Rural Population; D012964:Sodium / Q000652:urine*; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage* / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D014505:Urban Population
chemical_list: D017673:Sodium Chloride, Dietary; D012964:Sodium
keywords: India; attitude; behaviour; knowledge; salt; urinary sodium excretion