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Salt and Health: Public awareness, attitudes and practices in Sri Lanka to inform a behavior change communication campaign to reduce dietary salt

By Achala Upendra Jayatilleke, Nalika Gunawardena, Angela de Silva, Champika Wickramasinghe, Lakshman Gamlath, Thilak Siriwardena, Vindya Kumarapeli, Janaki Vidanapathirana, Shanthi Gunawardena, AMAAP Alagiyawanna, Ishanka Thalagala, Aravinda Wickramasinghe, Prabha Kumari Abeykoon, Prasad Ranatunga, Sapumal Dhanapala, Razia Pendse

Posted 28 Jul 2020
medRxiv DOI: 10.1101/2020.07.25.20162081

Background Sri Lankan citizens consume almost double the recommended daily amount of salt. Objective of this study was to assess the knowledge, attitudes and practices related to health effects of dietary salt among adults and adolescents in Sri Lanka to inform a national behavior change communication campaign. Methods We conducted a descriptive household survey among adults (n=1016) and adolescents (n=505) in 10 districts. An, interviewer administered questionnaire was used for data collection. The approximate amount of dietary salt intake of the individuals was estimated based on household purchases. Findings The recommended salt limit was identified by 40% of the population. Majority, adults (90.8%) and adolescents (86.1%) knew the adverse health effects of high salt intake. Although household monthly purchase of salt indicated consumption is much higher than recommended, 48.3% of adults and 45.9% of adolescents believed that they consume "just the right" amount. Discretionary salt added to home cooking was a major contributor to intake, with approximately half (50%) adding salt when cooking rice, the staple. For health-related information most preferred (adults-72%, adolescents-69%) media is television. Interpretation The study identified gaps as well strengths in knowledge, attitudes and practices of Sri Lankans related to salt and health and recommends that the communication campaign include specific messaging to address gaps and leveraging on strengths. The survey identified adult females to be a key target group for the campaign and television is recommended as the mode of delivery.

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