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Abstract

Background: Excessive sodium intake is the most widely recognized dietary risk factor among adults, as it leads to an increase in noncommunicable diseases (NCDs). This study aimed to identify factors that influence sodium consumption behaviors (SCBs) among university employees.

Methods: A cross-sectional study with a stratified multistage probability sampling design was conducted to collect data from 430 public university employees in the lower northern region of Thailand aged 20-69 years from October to November 2022. The data were collected through a self-administered questionnaire, analyzed using binary logistic regression, and presented using adjusted odds ratio (AOR) with 95% confidence interval (CI).

Results: Among all 430 participants, 74.7% were women, and the average age was 40.46 ± 8.04 years old. Factors influencing high SCBs were preferences for processed food (AOR 2.41, 95% CI: 1.52-3.89) followed by ordering food delivery (AOR 2.33, 95% CI: 1.51-3.61), a fondness for salty food (AOR 1.70, 95% CI: 1.04-2.80), working in non-health science departments (AOR 1.67, 95% CI: 1.06-2.63), eating out (AOR 1.63, 95% CI: 1.05-2.54), having a low level of applying to sodium information (AOR 2.11, 95% CI: 1.16-3.86), and having a low level of understanding of sodium information (AOR 2.04, 95% CI: 1.02-4.05).

Conclusions: Interventions to improve health literacy on sodium consumption of university employees are essential to improve understanding and application of sodium information. These interventions should especially focus on people who prefer processed food, order food delivery, are fond of salty food, and enjoy eating out.

Keywords: Adults, Health literacy on sodium consumption, Sodium consumption behavior, Thailand, University employees

References

[1] World Health Organization [WHO]. Noncommunicable diseases country profiles 2018. [cited 2022 Oct 18]. Available from: https://apps.who.int/iris/handle/10665/274512.

[2] Murray CJL, Aravkin AY, Zheng P, Abbafati C, Abbas KM, Abbasi-Kangevari M, et al. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020; 396(10258): 1223-49. doi: 10.1016/S0140-6736(20)30752-2.

[3] Malta D, Petersen KS, Johnson C, Trieu K, Rae S, Jefferson K, et al. High sodium intake increases blood pressure and risk of kidney disease. From the science of salt: a regularly updated systematic review of salt and health outcomes (August 2016 to March 2017). J Clin Hypertens. 2018; 20(12): 1654-65. doi: 10.1111/jch.13408.

[4] Allison SJ. Metabolism: High salt intake as a driver of obesity. Nat Rev Nephrol. 2018; 14(5): 285. doi: 10.1038/nrneph.2018.23.

[5] Wu X, Chen L, Cheng J, Qian J, Fang Z, Wu J. Effect of dietary salt intake on risk of gastric cancer: a systematic review and meta-analysis of case-control studies. Nutrients. 2022; 14(20): 4260. doi: 10.3390/nu14204260.

[6] Prevention and control of noncommunicable disease in Thailand: The case for investment. [cited 2022 Nov 9]. Available from: https://thailand.un.org/en/159788-prevention-and-control-noncommunicable-diseases-thailand-%E2%80%93-case-investment

[7] Żarnowski A, Jankowski M, Gujski M. Public awareness of diet-related diseases and dietary risk factors: a 2022 nationwide cross-sectional survey among adults in Poland. Nutrients. 2022; 14(16): 3285. doi: 10.3390/ nu14163285.

[8] World Health Organization. WHO global sodium benchmarks for different food categories. [cited 2022 Dec 5]. Available from: https://www.who.int/publications/i/item/9789240025097.

[9] Donfrancesco C, Lo Noce C, Russo O, Minutoli D, Di Lonardo A, Profumo E, et al.Trend of salt intake measured by 24-h urine collection in the Italian adult population between the 2008 and 2018 CUORE project surveys. Nutr Metab Cardiovasc Dis. 2021; 31(3): 802-13. doi: 10.1016/j.numecd.2020.10.017.

[10] Park HK, Lee Y, Kang BW, Kwon KI, Kim JW, Kwon OS, et al. Progress on sodium reduction in South Korea. BMJ Glob Health. 2020; (5): e002028. doi: 10.1136/bmjgh-2019-002028.

[11] Félix PV, De Castro MA, Nogueira-de-Almeida CA, Fisberg M. Prevalence of excess sodium intake and their corresponding food sources in adults from the 2017-2018 Brazilian national dietary survey. Nutrients. 2022; 14(19): 4018. doi: 10.3390/nu14194018.

[12] Chailimpamontree W, Kantachuvesiri S, Aekplakorn W, Lappichetpaiboon R, Sripaiboonkij Thokanit N, Vathesatogkit P, et al. Estimated dietary sodium intake in Thailand: a nationwide population survey with 24-hour urine collections. J Clin Hypertens (Greenwich). 2021; (4): 744-54. doi: 10.1111/jch.14147.

[13] Kessuvan A, Thongpech A. COVID-19 and the new normal food consumption in Thailand. FFTC Journal of Agricultural Policy. 2021; 2: 52-62. [cited 2023 Jan 4]. Available from: https://ap.fftc.org.tw/journalarticle/2933.

[14] Study the feasibility of the development cloud kitchen business plan in Phisanulok Province. [cited 2022 Nov 9]. Available from: https://archive.cm.mahidol.ac.th/handle/123456789/4188.

[15] Nutbeam D, Levin-Zamir D, Rowlands G. Health literacy and health promotion in context. Glob. Health Promot. 2018; 25(4): 3-5. doi: 10.1177/175797591881443.

[16] Sørensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012; 12(80): 1-13. doi: 10.1186/1471-2458-12-80.

[17] Ahmadzadeh sani T, Vahedian-Shahroodi M, Tehrani H, Esmaily H. Relationship between health literacy and nutrition among middle-aged women. J Health Lit. 2019; 3(4): 9-15. doi: 10.22038/jhl.2019.36772.1019.

[18] Luta X, Hayoz S, Gréa Krause C, Sommerhalder K, Roos E, Strazzullo P, et al. The relationship of health/food literacy and salt awareness to daily sodium and potassium intake among a workplace population in Switzerland. Nutr Metab Cardiovasc Dis. 2018; 28(3): 270-7. doi: 10.1016/j.numecd.2017.10.028.

[19] Intarakamhang U, Khammungkul J, Boocha P. General health literacy scale for Thais and comparison between age groups. Heliyon. 2022; 8(5): e09462. doi: 10.1016/j.heliyon.2022.e09462.

[20] Chenary R, Karimi-Shahanjarini A, Bashirian S, Roshanaei G, Fazaeli AA, Jalilian M. Factors associated with the salt intake behaviors in women in a high-salt intake setting. Nutr. Food Sci. 2022; 52(1): 140-50. doi: 10.1108/NFS-02-2021-0048.

[21] Abdul Aziz NS, Ambak R, Othman F, He FJ, Yusof M, Paiwai F, et al. Risk factors related with high sodium intake among Malaysian adults: findings from the Malaysian Community Salt Survey (MyCoSS) 2017–2018. J Health Popul Nutr. 2021; 40(1): 14. doi: 10.1186/s41043-021-00233-2.

[22] Congprasert J, Vijitsoonthornkul. The factors related to excess salt and sodium consumption among population in 4 provinces. Dis Control J. 2022; 48(4): 886-98.

[23] Srikan P, Thatan S, Srichanpan W, Pinsakul C. Relationship between knowledge, self-care agency, sodium reduction behavior and urinary sodium level of students and employees of the Boromarajonnani College of Nursing Phayao. Journal of Boromarajonani College of Nursing, Bangkok. 2018; 34(3): 21-33.

[24] Aekplakorn W. Thai National Health Examination Survey VI (NHES VI) 2019-2020. [cited 2023 Jan 9]. Available from: https://www.hsri.or.th/media/printed-matter/detail/13443.

[25] Phitsanulok Provincial Health Office. Annual report 2021. [cited 2023 Jan 9]. Available from: www.plkhealth.go.th.

[26] Bureau of Non-Communicable Disease, Department of Disease Control, Ministry of Public Health. Strategies to reduce salt and sodium consumption in Thailand 2016-2025. Nonthaburi: Bureau of Non-communicable Disease; 2016.

[27] Ngamjarus C, Chongsuvivatwong V, McNeil E. n4Studies: Sample size calculation for an epidemiological study on a smart device. Siriraj Med J. 2016; 68: 160-70.

[28] Division of human resources, Statistic of Naresuan University employees; 2021. [cited 2021 Aug 5]. Available from: https://hrmis.nu.ac.th/static.aspx.

[29] Laohasiriwong W. Critical appraisal of public health research articles and developing research proposals. Khon Kaen: Klungnana Vitthaya Press; 2017.

[30] Sponselee HCS, Kroeze W, Poelman MP, Renders CM, Ball K, Steenhuis IHM. Food and health promotion literacy among employees with a low and medium level of education in the Netherlands. BMC Public Health. 2021 Jun 30;21(1):1273. doi: 10.1186/s12889-021-11322-6

[31] Panuthai S, Codrington S, Duangjina T, Tosanguan R. Food literacy and eating behaviors among Chiang Mai university personnel. Nursing Journal CMU.2023; 50 (1): 55-67.

[32] Agarwal S, Huang P, Luo C, Qin Y, Zhan C. Assessment of Online Food Ordering and Delivery in Singapore During the COVID-19 Pandemic. JAMA Netw Open. 2021 Sep 1;4(9):e2126466. doi: 10.1001/jamanetworkopen.2021.26466.

[33] Hayashi F, Takemi Y. Determinants of changes in the diet quality of Japanese adults during the coronavirus disease 2019 pandemic. Nutrients. 2022; 15(1):131. doi: 10.3390/nu15010131.

[34] Pilic L, Lubasinski NJ, Berk M, Ward D, Graham CA-M, Da Silva Anastacio V, et al. The associations between genetics, salt taste perception and salt intake in young adults. Food Qual Prefer. 2020; 84:103954: 1-8. doi: 10.1016/j.foodqual.2020.103954.

[35] Sonuch P, Kantachuvesiri S, Vathesatogkit P, Lappichetpaiboon R, Chailimpamontri W, Thokanit NS, Aekplakorn W. Estimation of sodium consumption by novel formulas derived from random spot and 12-hour urine collection. PLoS One. 2021 Dec 2;16(12):e0260408. doi: 10.1371/journal.pone.0260408.

[36] Ruiz AMP, Lima MG, Medina LPB, Pinto RL, Barros MBA, Filho AAB. Can Meals Outside Homes Impact Sodium Intake? Curr Dev Nutr. 2020 May 29;4(6):nzaa091. doi: 10.1093/cdn/nzaa091.

[37] Salleh R, Ganapathy SS, Ibrahim Wong N, Cheong SM, Ahmad MH, Palaniveloo L, Othman F, Baharudin A, Megat Radzi MR, Selamat R, Abd Aziz NS, Ambak R, Aris T. Is socio-demographic status, body mass index, and consumption of food away from home associated with high sodium intake among adults in Malaysia?: findings from the Malaysian Community Salt Survey (MyCoSS). J Health Popul Nutr. 2021 May 31;40(Suppl 1):12. doi: 10.1186/s41043-021-00236-z.

[38] Shahavandi M, Ghorbaninejad P, Mohammadpour S, Djafari F, Shahinfar H, Sheikhhossein F, et al. Higher health literacy score is associated with better healthy eating index in Iranian adults. Nutrition. 2021 Oct;90:111262. doi: 10.1016/j.nut.2021.111262.

[39] Lee Y, Kim T, Jung H. The relationships between food literacy, health promotion literacy and healthy eating habits among young adults in South Korea. Foods. 2022; 11(16): 2467:1-17. doi: 10.3390/foods11162467.

[40] Dunford EK, Poti JM, Popkin BM. Emerging Disparities in Dietary Sodium Intake from Snacking in the US population. Nutrients. 2017; 9(6): 610. doi: 10.3390/nu9060610.

[41] Vidgen HA, Gallegos D. Defining food literacy and its components. Appetite. 2014 May;76:50-9. doi: 10.1016/j.appet.2014.01.010.

[42] Hong JW, Noh JH, Kim DJ. Factors Associated With High Sodium Intake Based on Estimated 24-Hour Urinary Sodium Excretion: The 2009-2011 Korea National Health and Nutrition Examination Survey. Medicine (Baltimore). 2016 Mar;95(9):e2864. doi: 10.1097/MD.0000000000002864.

[43] Cheah YK, Anera S, Chee Cheong K, Lim K, Omar A. Sociodemographic factors associated with consumption of high-sodium foods: evidence from Malaysia. Mal J Nutr. 2022; 28: 43-51. doi: 10.31246/mjn-2021-0088.

[44] Khalesi S, Williams E, Irwin C, Johnson DW, Webster J, McCartney D, et al. Reducing salt intake: a systematic review and meta-analysis of behavior change interventions in adults. Nutr Rev. 2022; 80(4): 723-40.

[45] Sakaguchi K, Takemi Y, Hayashi F, Koiwai K, Nakamura M. Effect of workplace dietary intervention on salt intake and sodium to potassium ratio of Japanese employees: a quasi-experimental study. J Occup Health. 2021; 63: e12288. doi: 10.1002/1348-9585.12288.

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