A Study On Salt Intake And Related Factors Of Adult Residents In Six Counties Of China

BackgroundHigh salt diet is a major risk factor for diseases such as hypertension,stroke and stomach cancer.At present,the daily salt intake of residents in China is still at a high level.Salt reduction is one of the most cost-effective strategies for prevention and control of chronic diseases recommended by WHO.Based on the knowledge-attitude-practice model,salt reduction health education is an important intervention means.An accurate understanding of 24-hour urine sodium,knowledge-attitude-practice on salt,and its influencing factors is of great reference value for the formulation of salt reduction intervention strategies and measures.ObjectiveThe purpose of this study was to understand the current situation of 24-hour urinary sodium among adult residents in six counties in China as well as the knowledge,attitude and practice on salt,to explore the factors affecting all of them,to find the key points of salt reduction,and to provide intervention suggestions for subsequent salt reduction activities.MethodsBased on the baseline survey of Action on Salt China-Home Cook Intervention Study,this study was held in Renxian(Hebei),Luobei(Heilongjiang),Hengfeng(Jiangxi),Jinshi(Hunan),Panzhihua(Sichuan),Guide(Qinghai).The survey was conducted among residents aged 18 to 75 in 60 communities from October to December in 2018.The subjects were investigated by questionnaires and physical measurements.The urine sodium was measured by 24-hour urine collection.Different knowledges,attitudes and behaviors were assigned,and after summation,the comprehensive index was produced,named the salt-related KAP scores.In the data statistical analysis,t test,variance analysis or rank sum test were used for comparison between quantitative data,and variance analysis trend test was used for trend analysis between numerical values.Chi-square test was used for comparison between qualitative data groups,and Cochran Armitage test was used for trend analysis of rate.Three-level variance component models were constructed to analyze influencing factors of the 24-hour urine sodium and the KAP scoresResultsA total of 1,484 subjects were included in this study.The mean 24-hour urinary sodium was 4.41±1.93 g,approximately 11.22±4.91 g sodium chloride.Univariate analysis of 24-hour urinary sodium showed that different salt-related KAP scores were associated with different 24-hour urinary sodium.Multivariate analysis,taking into account regional and family clustering,showed that 24-hour urinary sodium levels were higher in men,aged 18-44 years,with more family members,lower annual family income,salty taste,drinking,overweight and obesity,central obesity,and those unaware of low sodium salt.According to ICC,family aggregation played an important role in 24-hour urinary sodium.Among the 1,484 respondents,the awareness rates of"recommended daily amount of salt for adults","low sodium salt","salt index in food labels","eating too much salt lead to high blood pressure easily"and"eating less salt will not cause weakness"were 16.51%,19.34%,31.60%,76.75%and 19.81%,respectively.The willingness rate of"put less salt in the meal" was 80.93%,and 75.81%of the respondents could "eat less salt".The consumption rate of low sodium salt was 4.51%,the non-edible rate of preserved food was 55.46%,the non-edible rate of salty snacks was 93.06%,and active request for less salt when eating out/ordering takeaway was 7.01%.The average scores of salt-related KAP of the surveyed population was 43.71±15.96.Considering the regional and familial clustering,younger age,higher education level,higher annual family income,light diet and no drinking were the promotion factors to the KAP scores.According to ICC,family aggregation played an important role in the KAP scoresConclusionThe 24-hour urine sodium level among the surveyed population was high,and the intake of salt was far beyond the limit standard daily amount of salt recommended by the dietary guidelines for Chinese residents,although the attitude of salt reduction was positive,the level of knowledge and practice on salt were lower.Family aggregation played an important role in the 24-hour urine sodium and the salt-related KAP score.It is recommended to carry out salt reduction intervention activities in households,with the focus on home cook intervention,aimed at the key population,health education should be taken as the means,to vigorously promote low sodium salt,so as to achieve the goal of reducing residents' salt intake.