Consumer attitudes, knowledge, and behavior related to salt consumption in sentinel countries of the Americas Rafael Moreira Claro,1 Hubert Linders,2 Camila Zancheta Ricardo,3 Branka Legetic,4 and Norm R. C. Campbell 5
Claro RM, Linders H, Ricardo CZ, Legetic B, Campbell NRC. Consumer attitudes, knowledge, and behavior related to salt consumption in sentinel countries of the Americas. Rev Panam Salud Publica. 2012;32(4):265–73.
Objective. To describe individual attitudes, knowledge, and behavior regarding salt intake, its dietary sources, and current food-labeling practices related to salt and sodium in five sentinel countries of the Americas. Methods. A convenience sample of 1 992 adults (≥ 18 years old) from Argentina, Canada, Chile, Costa Rica, and Ecuador (approximately 400 from each country) was obtained between September 2010 and February 2011. Data collection was conducted in shopping malls or major commercial areas using a questionnaire containing 33 questions. Descriptive estimates are presented for the total sample and stratified by country and sociodemographic characteristics of the studied population. Results. Almost 90% of participants associated excess intake of salt with the occurrence of adverse health conditions, more than 60% indicated they were trying to reduce their current intake of salt, and more than 30% believed reducing dietary salt to be of high importance. Only 26% of participants claimed to know the existence of a recommended maximum value of salt or sodium intake and 47% of them stated they knew the content of salt in food items. More than 80% of participants said that they would like food labeling to indicate high, medium, and low levels of salt or sodium and would like to see a clear warning label on packages of foods high in salt. Conclusions. Additional effort is required to increase consumers’ knowledge about the existence of a maximum limit for intake and to improve their capacity to accurately monitor and reduce their personal salt consumption. Sodium; attitude; knowledge; behavior; consumer organizations; Americas.
Excessive salt intake is a major public health concern (1). It causes hyperten1
Universidade de São Paulo–Nutrição, São Paulo, Brazil. Send correspondence to: Rafael Claro, firstname.lastname@example.org Consumers International, Santiago, Chile. Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, São Paulo, Brazil. Pan American Health Organization, Washington, D.C., United States of America. Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
sion (2), and epidemiologic and pathophysiologic evidence associates excessive intake of salt with several adverse health conditions such as stroke and coronary heart disease (2), kidney stones (3), gastric cancer (4), osteoporosis (5), and, indirectly, even with obesity (6). Cardiovascular diseases are a major cause of mortality worldwide and increased blood pressure is the most important risk factor for cardiovascular
disease (7). Estimates indicate that increased blood pressure is responsible for approximately half of the global cardiovascular disease burden (7). The World Health Organization (WHO) recommends a maximum level of salt intake per person of < 5 g/day (1). Although reliable, national representative information on salt consumption remains scarce; available data indicate that most populations worldwide have an av-
Rev Panam Salud Publica 32(4), 2012
Claro et al. • Consumer attitudes, knowledge, and behavior related to salt consumption
erage salt intake per person > 6 g/day; in many Eastern European and Asian countries, it is even higher than 12 g/day (8). Specifically, in the Americas, excessive levels of salt intake are found in recent estimates from Argentina (12 g/day) (9), Brazil (11 g/day) (10), Canada (8 g/day) (11), Chile...