期刊论文详细信息
International Journal of Behavioral Nutrition and Physical Activity
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
Wei Wang1  Anthony Worsley1  Rani Sarmugam1 
[1] School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
关键词: Mediation;    Sodium;    Salt;    Socio-demographic;    Beliefs;    Knowledge;   
Others  :  810778
DOI  :  10.1186/1479-5868-10-25
 received in 2012-06-13, accepted in 2013-02-06,  发布年份 2013
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【 摘 要 】

Background

Discretionary salt use varies according to socio-demographic factors. However, it is unknown whether salt knowledge and beliefs mediate this relationship. This study examined the direct and indirect effect of socio-demographic factors on salt knowledge and discretionary salt use in a sample of 530 Australian adults.

Methods

An internet based cross-sectional survey was used to collect data for this study. Participants completed an online questionnaire which assessed their salt knowledge, beliefs and salt use behaviour. Mplus was used to conduct structural equation modelling to estimate direct and indirect effects.

Results

The mean age of the participants was 49.2 years, and about a third had tertiary education. Discretionary salt use was inversely related to age (r=-0.11; p<0.05), and declarative salt knowledge (knowledge of factual information) scores (r = -0.17; p<0.01), but was positively correlated with misconceptions about salt (r = 0.09; p<0.05) and beliefs about the taste of salt (r = 0.51; p<0.001). Structural equation modelling showed age, education and gender were indirectly associated with the use of discretionary salt through three mediating pathways; declarative salt knowledge, misconceptions about salt and salt taste beliefs.

Conclusions

Inequalities observed between socio-demographic groups in their use of discretionary salt use can potentially be reduced through targeted salt knowledge and awareness campaigns.

【 授权许可】

   
2013 Sarmugam et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]He FJ, MacGregor GA: Effect of modest salt reduction on blood pressure: A meta-analysis of randomized trials. Implications for public health. J Hum Hypertens 2002, 16(11):761-770.
  • [2]Rose G, Stamler J, Stamler R, Elliott P, Marmot M, Pyorala K, Kesteloot H, Joossens J, Hansson L, Mancia G, et al.: Intersalt: An international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion. Br Med J 1988, 297(6644):319-328.
  • [3]Strazzullo P, D’Elia L, Kandala N-B, Cappuccio FP: Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. BMJ 2009, 339:b4567.
  • [4]Gardener H, Rundek T, Wright CB, Elkind MSV, Sacco RL: Dietary sodium and risk of stroke in the Northern Manhattan study. Stroke 2012, 43(5):1200-1205.
  • [5]World Health Organization: The World Health Report 2002 – Reducing risks, promoting healthy life. World Health Organization, Geneva; 2002.
  • [6]Charlton K, Yeatman H, Houweling F, Guenon S: Urinary sodium excretion, dietary sources of sodium intake and knowledge and practices around salt use in a group of healthy Australian women. Aust N Z J Public Health 2010, 34(4):356-363.
  • [7]Beard TC, Woodward DR, Ball PJ, Hornsby H, von Witt RJ, Dwyer T: The Hobart Salt Study 1995: Few meet national sodium intake target. Med J Aust 1997, 166:404-407.
  • [8]O’Reilly SL, Brinkman M, Giles G, English D, Nowson CA: Sodium intake and use of discretionary salt in an Australian population sample [abstract]. Proc Nutr Soc 2010, 69:E84.
  • [9]National Health and Medical Research Council: Nutrient reference values for Australia and New Zealand, including recommended dietary intakes. [http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n35.pdf webcite]
  • [10]Loria CM, Mussolino ME, Cogswell ME, Gillespie C, Gunn JP, Labarthe DR, Saydah S, Pavkov ME: Usual sodium intakescompared with current dietary guidelines — United States, 2005–2008. MMWR Morb Mortal Wkly Rep 2011, 60(41):1413-1444.
  • [11]Medical Research Council: An assessment of dietary sodium levels among adults (aged 19–64) in the UK general population in 2008, based on analysis of dietary sodium in 24 hour urine samples. [http://www.food.gov.uk/multimedia/pdfs/08sodiumreport.pdf webcite]
  • [12]Woodward E, Eyles H, Ni Mhurchu C: Key opportunities for sodium reduction in New Zealand processed foods. Aust N Z J Public Health 2012, 36(1):84-89.
  • [13]Moshfegh AJ, Holden JM, Cogswell ME, Kuklina EV, Patel SM, Gunn JP, Gillespie C, Hong Y, Merritt R, Galuska DA: Vital signs: Food categories contributing the most to sodium consumption - United States, 2007–2008. MMWR Morb Mortal Wkly Rep 2012, 61(5):92-98.
  • [14]Thomson BM: Nutritional modelling: Distributions of salt intake from processed foods in New Zealand. Br J Nutr 2009, 102(5):757-765.
  • [15]Food Standards Australia New Zealand: How much sodium and salt are we eating?. [http://www.foodstandards.gov.au/scienceandeducation/factsheets/factsheets/howmuchsaltareweeating/ webcite]
  • [16]Food Standards Australia New Zealand: Sodium and salt. [http://www.foodstandards.gov.au/scienceandeducation/factsheets/factsheets/sodiumandsalt.cfm webcite]
  • [17]FSA Salt Model. UK Salt Intakes: Modelling Salt Reductions. [http://www.food.gov.uk/multimedia/spreadsheets/saltmodel.xls webcite]
  • [18]Wyness LA, Butriss JL, Stanner SA: Reducing the population’s sodium intake: The UK Food Standards Agency’s salt reduction programme. Public Health Nutr 2012, 15(2):254-261.
  • [19]Australian Bureau of Statistics: Causes of Death, Australia. 2010. [http://www.abs.gov.au/ausstats/abs@.nsf/Products/6BAD463E482C6970CA2579C6000F6AF7?opendocument webcite]
  • [20]Australian Institute of Health and Welfare: Cardiovascular disease: Australian facts 2011. Cardiovascular disease series. Cat. no. CVD 53. AIHW, Canberra; 2011.
  • [21]Australian Institute of Health and Welfare: Socioeconomic inequalities in cardiovascular disease in Australia. AIHW, Canberra; 2006.
  • [22]Hjartåker A, Lund E: Relationship between dietary habits, age, lifestyle, and socio-economic status among adult Norwegian women. The Norwegian Women and Cancer Study. Eur J Clin Nutr 1998, 52(8):565-572.
  • [23]Groth MV, Fagt S, Brøndsted L: Social determinants of dietary habits in Denmark. Eur J Clin Nutr 2001, 55(11):959-966.
  • [24]Kant AK, Graubard BI: Secular trends in the association of socio-economic position with self-reported dietary attributes and biomarkers in the US population: National Health and Nutrition Examination Survey (NHANES) 1971–1975 to NHANES 1999–2002. Public Health Nutr 2007, 10(02):158-167.
  • [25]Mullie P, Clarys P, Hulens M, Vansant G: Dietary patterns and socioeconomic position. Eur J Clin Nutr 2010, 64(3):231-238.
  • [26]Turrell G, Stanley L, de Looper M, Oldenburg B: Health Inequalities in Australia: Morbidity, health behaviours, risk factors and health service use. In Health Inequalities Monitoring Series No 2 AIHW Cat No PHE 72. Queensland University of Technology and the Australian Institute of Health and Welfare, Canberra; 2006.
  • [27]Henderson L, Irving K, Gregory J, Bates CJ, Prentice A, Perks J, Swan G, Farron M: The National Diet and Nutrition Survey: adults aged 19 to 64 years—vitamin and mineral intake and urinary analysis. HMSO, London, United Kingdom; 2003.
  • [28]Grimes CA, Riddell LJ, Nowson CA: The use of table and cooking salt in a sample of Australian adults. Asia Pac J Clin Nutr 2010, 19(2):256-260.
  • [29]Monsivais P, Aggarwal A, Drewnowski A: Are socio-economic disparities in diet quality explained by diet cost? J Epidemiol Community Health 2010, 66(6):530-535.
  • [30]Larson NI, Story MT, Nelson MC: Neighborhood environments: Disparities in access to healthy foods in the U.S. Am J Prev Med 2009, 36(1):74-81. e10
  • [31]Parmenter K, Waller J, Wardle J: Demographic variation in nutrition knowledge in England. Health Educ Res 2000, 15(2):163-174.
  • [32]Leganger A, Kraft P: Control constructs: Do they mediate the relation between educational attainment and health behaviour? J Health Psychol 2003, 8(3):361-372.
  • [33]Wardle J, Steptoe A: Socioeconomic differences in attitudes and beliefs about healthy lifestyles. J Epidemiol Community Health 2003, 57(6):440-443.
  • [34]Dallongeville J, Marécaux N, Cottel D, Bingham A, Amouyel P: Association between nutrition knowledge and nutritional intake in middle-aged men from Northern France. Public Health Nutr 2001, 4(01):27-33.
  • [35]De Vriendt T, Matthys C, Verbeke W, Pynaert I, De Henauw S: Determinants of nutrition knowledge in young and middle-aged Belgian women and the association with their dietary behaviour. Appetite 2009, 52(3):788-792.
  • [36]Lin C-TJ, Yen ST: Knowledge of dietary fats among US consumers. J Am Diet Assoc 2010, 110(4):613-618.
  • [37]Hendrie GA, Coveney J, Cox D: Exploring nutrition knowledge and the demographic variation in knowledge levels in an Australian community sample. Public Health Nutr 2008, 11(12):1365-1371.
  • [38]Eckel RM, Kris-Etherton PPRD, Lichtenstein AD, Wylie-Rosett JERD, Groom AM, Stitzel KMR, Yin-Piazza SM: Americans’ awareness, knowledge, and behaviors regarding fats: 2006–2007. J Am Diet Assoc 2009, 109(2):288.
  • [39]Dickson-Spillmann M, Siegrist M: Consumers’ knowledge of healthy diets and its correlation with dietary behaviour. J Hum Nutr Diet 2011, 24(1):54-60.
  • [40]Webster JL, Li N, Dunford EK, Nowson CA, Neal BC: Consumer awareness and self-reported behaviours related to salt consumption in Australia. Asia Pac J Clin Nutr 2010, 19(4):550-554.
  • [41]World Health Organization: Strategies to monitor and evaluate population sodium consumption and sources of sodium in the diet: report of a joint technical meeting convened by WHO and the Government of Canada, October. World Health Organisation, Canada; 2010:1-42.
  • [42]Rogers F, Richarme M: The Honesty of Online Survey Respondents: Lessons Learned and Prescriptive Remedies. [http://www.decisionanalyst.com/publ_art/onlinerespondents.dai webcite]
  • [43]Sarmugam R, Worsley A, Flood V: Development and validation of a salt knowledge questionnaire. review 2012.
  • [44]Colman AM: A dictionary of psychology. 3rd edition. Oxford University Press, United Kingdom; 2012.
  • [45]Worsley A: Nutrition knowledge and food consumption: can nutrition knowledge change food behaviour? Asia Pac J Clin Nutr 2002, 11(s3):S579-S585.
  • [46]Australian Bureau of Statistics: Census Community Profile Series. Australia; 2006. [http://www.censusdata.abs.gov.au/ABSNavigation/prenav/ViewData?&action=404&documentproductno=0&documenttype=Details&tabname=Details&areacode=0&issue=2006&producttype=Community%20Profiles&&producttype=Community%20Profiles&javascript=true&textversion=false&navmapdisplayed=true&breadcrumb=PLD&&collection=census&period=2006&producttype=Community%20Profiles&#Basic%20Community%20Profile webcite]
  • [47]Australian Bureau of Statistics: Occasional paper: Measuring dietary habits in the 2001 National Health Survey Australia. 2001. [http://www.abs.gov.au/ausstats/abs@.nsf/mf/4814.0.55.001#APPENDIX%20A%3A%202001%20NHS%20DIETARY%20INDI webcite]
  • [48]Australian Bureau of Statistics: National Nutritional Survey Users’ Guide 1995. Canberra; 1998. [http://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/0/CA25687100069892CA256889002102FD/$File/48010_1995.pdf webcite]
  • [49]Muthén LK, Muthén BO: Mplus User’s Guide. Sixth edition. Muthén & Muthén, Los Angeles, CA; 1998–2011.
  • [50]Hayes AF: Beyond Baron and Kenny: Statistical mediation analysis in the new millennium. ComM 2009, 76(4):408-420.
  • [51]Mackinnon DP, Dwyer JH: Estimating mediated effects in prevention studies. Eval Rev 1993, 17(2):144-158.
  • [52]Hayes AF, Preacher KJ, Myers TA: Mediation and the estimation of indirect effects in political communication research. In Sourcebook for political communication research: Methods, measures, and analytical techniques. Edited by Bucy EP, Holbert L. Routledge, New York; 2011:434-465.
  • [53]Hu LT, Bentler PM: Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Model 1999, 6(1):1-55.
  • [54]Wardle J, Haase AM, Steptoe A, Nillapun M, Jonwutiwes K, Bellisle F: Gender differences in food choice: the contribution of health beliefs and dieting. Ann Behav Med 2004, 27(2):107-116.
  • [55]Shepherd R, Farleigh CA: Attitudes and personality related to salt intake. Appetite 1986, 7(4):343-354.
  • [56]McLeod ER, Campbell KJ, Hesketh KD: Nutrition knowledge: A mediator between socioeconomic position and diet quality in Australian first-time mothers. J Am Diet Assoc 2011, 111(5):696-704.
  • [57]Wardle J, Parmenter K, Waller J: Nutrition knowledge and food intake. Appetite 2000, 34(3):269-275.
  • [58]Lahelma E, Martikainen P, Laaksonen M, Aittomäki A: Pathways between socioeconomic determinants of health. J Epidemiol Community Health 2004, 58(4):327-332.
  • [59]Kristal AR, Bowen DJ, Curry SJ, Shattuck AL, Henry HL: Nutrition knowledge, attitudes and perceived norms as correlates of selecting low-fat diets. Health Educ Res 1990, 5:467.
  • [60]Kempen E, Muller H, Symington E, Van Eeden T: A study of the relationship between health awareness, lifestyle behaviour and food label usage in Gauteng. S Afr J Clin Nutr 2012, 25(1):15-21.
  • [61]Satia JA, Galanko JA, Neuhouser ML: Food nutrition label use is associated with demographic, behavioral, and psychosocial factors and dietary intake among African Americans in North Carolina. J Am Diet Assoc 2005, 105(3):392-402.
  • [62]Webster JL, Dunford EK, Hawkes C, Neal BC: Salt reduction initiatives around the world. J Hypertens 2011, 29(6):1043-1050.
  • [63]Brug J, Oenema A, Campbell M: Past, present, and future of computer-tailored nutrition education. Am J Clin Nutr 2003, 77(4):1028S-1034S.
  • [64]Institute of Medicine (US) Committee on Strategies to Reduce Sodium Intake: The Food Environment: Key to Formulating Strategies for Change in Sodium Intake. Washington; 2010. [http://www.nap.edu/catalog.php?record_id=12818 webcite]
  • [65]Campbell Soup Company: Campbell Continues to Provide Consumers with an Array of Lower-Sodium Choices. [http://investor.campbellsoupcompany.com/phoenix.zhtml?c=88650&p=irol-newsArticle&ID=1586923&highlight= webcite]
  • [66]Bertino M, Beauchamp GK, Engelman K: Long-term reduction in dietary sodium alters the taste of salt. Am J Clin Nutr 1982, 36(6):1134-1144.
  • [67]Blais CA, Pangborn RM, Borghani NO: Effect of dietary sodium restriction on taste responses to sodium chloride: A longitudinal study. Am J Clin Nutr 1986, 44(2):232-243.
  • [68]Cobiac LJ, Vos T, Veerman JL: Cost-effectiveness of interventions to reduce dietary salt intake. Heart 2010, 96(23):1920-1925.
  • [69]Dunford EK, Eyles H, Mhurchu CN, Webster JL, Neal BC: Changes in the sodium content of bread in Australia and New Zealand between, and 2010: Implications for policy. Med J Aust 2007, 195(6):346-349.
  • [70]Pietinen P, Valsta LM, Hirvonen T, Sinkko H: Labelling the salt content in foods: a useful tool in reducing sodium intake in Finland. Public Health Nutr 2008, 11(04):335-340.
  • [71]Barr SI: Reducing dietary sodium intake: The Canadian context. Appl Physiol Nutr Metab 2010, 35(1):1-8.
  • [72]Grimes CA, Riddell LJ, Nowson CA: Consumer knowledge and attitudes to salt intake and labelled salt information. Appetite 2009, 53(2):189-194.
  • [73]Mittelmark MB, Sternberg B: Assessment of salt use at the table: comparison of observed and reported behavior. Am J Public Health 1985, 75(10):1215-1216.
  • [74]Leclercq C, Avalle V, Ranaldi L, Toti E, Ferro-Luzzi A: Simplifying the lithium-marker technique used to assess the dietary intake of household sodium in population studies. Clin Sci 1990, 79(3):227-231.
  • [75]Mattes RD, Donnelly D: Relative contributions of dietary sodium sources. J Am Coll Nutr 1991, 10(4):383-393.
  • [76]Jeffery P, Nowson C, Riddell L, Land M-A, Shaw J, Webster J, Chalmers J, Smith W, Flood V, Neal B: Salt intake in Victorian adults. In Seminar - World salt awareness week. Melbourne, Victoria; 2012.
  • [77]Garriguet D: Sodium consumption at all ages. Health Rep 2007, 18(2):47-52.
  • [78]Huggins CE, O’Reilly S, Brinkman M, Hodge A, Giles GG, English DR, Nowson CA: Relationship of urinary sodium and sodium-to-potassium ratio to blood pressure in older adults in Australia. Med J Aust 2011, 195(3):128-132.
  • [79]Cortina JM: What is coefficient alpha? An examination of theory and applications. J Appl Psychol 1993, 78(1):98-104.
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