Efforts on Reducing Dietary Salt Intake and its Associated Factors Among Medical Students in Universiti Putra Malaysia
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Abstract
Introduction: Increased dietary salt intake can cause retention of fluid and subsequently an increase in blood pres- sure. Excessive salt consumption is one of the main causes of hypertension. This study aims to determine efforts done by medical students to reduce dietary salt intake and its associated factors in Universiti Putra Malaysia (UPM). Methods: This is a cross-sectional study. A self-administered questionnaire looking into efforts to reduce dietary salt intake adapted from the WHO STEPS questionnaire was used. There were six efforts altogether which were; lim- iting consumption of processed food; looking into sodium contents on food labels; purchasing low salt or sodium alternatives; avoid eating out; using spices when cooking; and doing things specifically to control salt consumption. Other factors in this questionnaire are on socio-demographic, practice of salt consumption, awareness, perception, attitude of dietary salt intake. Results: A total of 362 respondents participated. The majority had good awareness on salt intake (98.1%). A larger proportion of females significantly made the effort to buy low salt alternatives (p=0.003) and avoided eating out (p=0.048). On salt consumption practice, there were a bigger proportion of those that rarely ate processed food, that avoided eating out (p=0.08), bought low salt/sodium alternatives (p<0.001), looked at the sodium contents on labels (p=0.027) and limited the consumption of processed food (p<0.001). Conclusion: There are significant associations between the female gender and practice of eating processed food with efforts to decrease salt intake. More studies are recommended to look into assisting efforts to reduce salt consumption.
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World Health Organisation. A global brief on Hypertension: Silent killer, global public health crisis. 2013.
Malaysian Society of Hypertension, Ministry of Health Malaysia, Academy of Medicine Malaysia.
CLINICAL PRACTICE GUIDELINES: Management of Hypertension 2018 (5th Edition). 2018.
World Health Organization WHO. Global status report on non-communicable diseases 2010. Geneva: WHO; 2011.
Rahman ARA, Rashid AA. Hypertension; East and West. 2017;10(1):353.
Mahadir Naidu B, Mohd Yusoff MF, Abdullah S, Musa KI, Yaacob NM, Mohamad MS, et al. Factors associated with the severity of hypertension among Malaysian adults. PLoS ONE [Internet]. 2019 Jan 3 [cited 2020 May 6];14(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6317782/
Castillo R. Prevalance and Management of Hypertension in Southeast Asia. J Hypertens. 2016 Sep;34(Supplement 1):e4.
Institute for Public Health. National Health and Morbidity Survey 2015 (NHMS 2015). Vol. II: Non-Communicable Diseases, Risk Factors & Other Health Problems. Vol. II. 2015. 1–291 p.
Chattopadhyay A, Taraphdar P, Sahu BK, Maulik S, Ghosh R, Sinha A, et al. A study on prevalence of Hypertension and its related risk factors among undergraduate medical students in Kolkata. IOSR J Dent Med Sci. 2014;13(11):01–7.
Lee P, TA, Ong, Muna S, Syed Alwi, SAR, Kamruddin, K. Do university students have high cardiovascular risk? A pilot study from Universiti Malaysia Sarawak (UNIMAS). 2010;5(1):3.
Ministry of Health Malaysia. CPG: Management of Hypertension 5 TH EDITION (2018). 2018;18. Available from: www.acadmed.org.my
World Health Organization. Hypertension [Internet]. 2017 [cited 2020 May 6]. Available from: https://www.who.int/news-room/fact-sheets/detail/hypertension
Rashidah A, Yeo, Pei Sein, Nooraini, Ahmad, Muhammad Fadhli, Mohd Yusof, Tahir, Aris, Feisul, Mustapha, et al. Sodium intake among normotensive health staff assessed by 24-hour urinary excretion: A cross-sectional study. Mal J Nutr. 2014;30(3):317–26.
Jia Jiet L, Soma R. M. High salt diets in young university adults and the correlation with blood pressure, protein intake and fat free mass. Biosci Horiz Int J Stud Res [Internet]. 2017 Jan 1 [cited 2020 May 6];10. Available from: https://academic.oup.com/biohorizons/article/doi/10.1093/biohorizons/hzx003/3077074
Institute for Public Health (IPH). Determination of Dietary Salt Intake Among the Ministry of Health Staff (MySalt). 2016.
Gilbert PA, Khokhar S. Changing dietary habits of ethnic groups in Europe and implications for health. Nutr Rev. 2008 Apr 1;66(4):203–15.
Moreno LA, Rodríguez G, Fleta J, Bueno-Lozano M, Lázaro A, Bueno G. Trends of Dietary Habits in Adolescents. Crit Rev Food Sci Nutr. 2010 Jan 29;50(2):106–12.
Nasreddine L, Akl C, Al-Shaar L, Almedawar MM, Isma’eel H. Consumer Knowledge, Attitudes and Salt-Related Behavior in the Middle-East: The Case of Lebanon. Nutrients. 2014 Nov;6(11):5079–102.
Sarmugam R, Worsley A, Wang W. An examination of the mediating role of salt knowledge and beliefs on the relationship between socio-demographic factors and discretionary salt use: a cross-sectional study. Int J Behav Nutr Phys Act. 2013 Feb 19;10(1):25.
Isma’eel H, Schoenhagen P, Webster J. Salt intake reduction efforts: advances and challenges. Cardiovasc Diagn Ther. 2015 Jun;5(3):169–71.
Kloss L, Meyer JD, Graeve L, Vetter W. Sodium intake and its reduction by food reformulation in the European Union — A review. NFS J. 2015 Jun 1;1:9–19.
Cobb LK, Appel LJ, Anderson CAM. Strategies to Reduce Dietary Sodium Intake. Curr Treat Options Cardiovasc Med. 2012 Aug;14(4):425–34.
Lwanga S, Lemeshow S. Sample size determination in health studies: A practical manual, 1991. World Health Organ Geneva. 1991;88.
Bhattacharya S, Thakur JS, Singh A. Knowledge attitude, and practice regarding dietary salt intake among urban slum population of North India. J Fam Med Prim Care. 2018;7(3):526–30.
NCDs | The STEPS Instrument and Support Materials [Internet]. WHO. [cited 2020 Feb 15]. Available from: http://www.who.int/ncds/surveillance/steps/instrument/en/
Mahat D, Isa Z, Tamil AM, Mahmood MI, Othman F, Ambak R. The Association of Knowledge, Attitude and Practice with 24 Hours Urinary Sodium Excretion among Malay Healthcare Staff in Malaysia. 2017;7(2):11.
Farapti F, Fatimah AD, Astutik E, Hidajah AC, Rochmah TN. Awareness of Salt Intake among Community-Dwelling Elderly at Coastal Area: The Role of Public Health Access Program [Internet]. Vol. 2020, Journal of Nutrition and Metabolism. Hindawi; 2020 [cited 2020 Jul 15]. p. e8793869. Available from: https://www.hindawi.com/journals/jnme/2020/8793869/
Piaseu N, Boonsiri C, Panichkul K, Putwantana S, Kantachuvesiri S. View of Effects of Program Promoting Food Consumption for Sodium Reduction on Knowledge, Sodium Consumption Behaviors, and Urinary Sodium in Nursing Students_ A Multi-Setting Study.pdf. Bangk Med J. 2020 Feb;16(1):44–9.
Adams J, Hofman K, Moubarac J-C, Thow AM. Public health response to ultra-processed food and drinks. BMJ [Internet]. 2020 Jun 26 [cited 2020 Jul 15];369. Available from: https://www.bmj.com/content/369/bmj.m2391
Andrade GC, Gombi-Vaca MF, Louzada ML da C, Azeredo CM, Levy RB. The consumption of ultra-
processed foods according to eating out occasions. Public Health Nutr. 2020 Apr;23(6):1041–8.
Gan W, Mohd Nasir M, Hazizi A, Zalilah, MS. Differences in Eating Behaviours, Dietary Intake and Body Weight Status between Male and Female Malaysian University Students. :16.
Neupane D, Rijal A, Henry ME, Kallestrup P, Koirala B, Mclachlan CS, et al. Mean dietary salt intake in Nepal: A population survey with 24-hour urine collections. J Clin Hypertens. 2020;22(2):273–9.
Bryła P. Selected Predictors of the Importance Attached to Salt Content Information on the Food Packaging (a Study among Polish Consumers). Nutrients. 2020 Feb;12(2):293.
Nanakorn S, Osaka R, Chusilp K, Tsuda A, Maskasame S, Ratanasiri A. Gender Differences in Health-Related Practices among University Students in Northeast Thailand. Asia Pac J Public Health. 1999 Jan;11(1):10–5.
Iaccarino Idelson P, D’Elia L, Cairella G, Sabino P, Scalfi L, Fabbri A, et al. Salt and Health: Survey on Knowledge and Salt Intake Related Behaviour in Italy. Nutrients. 2020 Feb;12(2):279.
Juneau T. Masculinity and Health – How Gender Shapes Male Attitudes towards Health. Int J Bus Soc Sci [Internet]. 2020 [cited 2020 Jul 13];11(3). Available from: http://ijbssnet.com/journal/index/4394
He Feng J., Marrero Naomi M., MacGregor Graham A. Salt Intake Is Related to Soft Drink Consumption in Children and Adolescents. Hypertension. 2008 Mar 1;51(3):629–34.
Stewart JE, Feinle-Bisset C, Golding M, Delahunty C, Clifton PM, Keast RSJ. Oral sensitivity to fatty acids, food consumption and BMI in human subjects. Br J Nutr. 2010 Jul 14;104(1):145–52.
Sanghyo K, Seong-Yoon H. Consumer Awareness and Evaluation on Processed Foods: A National Survey for Consumption of Processed Foods in Korea [Internet]. FFTC Agricultural Policy Platform. 2019 [cited 2020 May 7]. Available from: http://ap.fftc.agnet.org/ap_db.php?id=1055
Yeo GB, Neal A. A Multilevel Analysis of Effort, Practice, and Performance: Effects; of Ability, Conscientiousness, and Goal Orientation. J Appl Psychol. 2004;89(2):231–47.