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Open AccessArticle

The Association of Knowledge and Behaviours Related to Salt with 24-h Urinary Salt Excretion in a Population from North and South India

The George Institute for Global Health, Box M201 Missenden Rd, Sydney 2006, Australia
School of Public Health, Department of Medicine, The University of Sydney, Sydney 2006, Australia
Public Health Foundation of India, New Delhi 110070, India
Centre for Chronic Disease Control, New Delhi 122002, India
George Institute for Global Health, Hyderabad 500034, India
Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London EC1M 6BQ, UK
All India Institute of Medical Sciences, New Delhi 110029, India
George Institute for Global Health, University of Oxford, Oxford OX1 3PA, UK
Charles Perkins Centre, University of Sydney, Sydney 2050, Australia
School of Public Health, Imperial College, London SW7 2AZ, UK
Royal Prince Alfred Hospital, Sydney 2050, Australia
Author to whom correspondence should be addressed.
Nutrients 2017, 9(2), 144;
Received: 19 December 2016 / Revised: 24 January 2017 / Accepted: 3 February 2017 / Published: 16 February 2017
(This article belongs to the Special Issue Reducing Dietary Sodium and Improving Human Health)
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 (all p < 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. View Full-Text
Keywords: India; salt; urinary sodium excretion; knowledge; attitude; behaviour India; salt; urinary sodium excretion; knowledge; attitude; behaviour
MDPI and ACS Style

Johnson, C.; Mohan, S.; Rogers, K.; Shivashankar, R.; Thout, S.R.; Gupta, P.; He, F.J.; MacGregor, G.A.; Webster, J.; Krishnan, A.; Maulik, P.K.; Reddy, K.S.; Prabhakaran, D.; Neal, B. The Association of Knowledge and Behaviours Related to Salt with 24-h Urinary Salt Excretion in a Population from North and South India. Nutrients 2017, 9, 144.

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