Conducted via an online questionnaire across the US, UK, France, Japan, Indonesia, Thailand and Brazil, the study offered recommendations for businesses, public health organizations, and policymakers aiming to address the complex influences on sodium reduction attitudes.
Using data from 7,090 participants with an average age of 46, the researchers conducted a cross-sectional regression analysis to evaluate the impact of factors like gender, age, occupation, health status, and government interventions on sodium reduction attitudes. Their findings indicated that these factors varied widely across countries, making a single global approach impractical.
Sociodemographic factors: Gender, age and occupation
The study found that gender played a significant role in shaping attitudes toward sodium reduction, particularly in France, where women demonstrated lower awareness of sodium reduction than men (possibly due to traditional health and dietary beliefs). In Japan and Thailand, older individuals showed higher awareness, potentially due to increased health consciousness with age.
The researchers also found occupation to be significant variable, with grocery and food service employees in France and Japan exhibiting greater sodium reduction awareness. This might be due to their increased exposure to food-related information, which could play a role in their dietary choices and health consciousness.
Additionally, they observed a notable correlation between attitudes toward general nutrition and sodium reduction across France and Brazil. They found that individuals with positive attitudes toward reducing sugar intake or increasing vegetable consumption were more likely to support sodium reduction. This trend suggested that promoting general nutritional awareness may be key in fostering sodium reduction behaviours.
Government interventions and cultural influences
The study reported that differing cultural attitudes and social contexts had resulted in mixed reactions to government efforts to promote sodium reduction, with positive associations in Thailand and Brazil but negative correlations in France. They suggested that the resistance observed in France could have stemmed from a strong culinary culture opposed to changes in traditional diets, highlighting the need for culturally sensitive policy approaches.
Indeed, participants from countries with deeply rooted culinary traditions, such as France and Japan, appeared more resistant to dietary changes, indicating that sodium reduction strategies would need to incorporate local cultural and culinary values to be effective.
For example, dietary habits tied to cultural identities may influence an individual’s food choices and resistance to changes like sodium reduction. Understanding these dietary patterns can help public health campaigns and the food industry craft messaging that resonates with local populations, addressing both cultural identities and health goals.
The study also revealed a complex relationship between health status and sodium reduction attitudes. In the UK, individuals with heart disease were less likely to favour sodium reduction, possibly viewing dietary adjustments as challenging. Conversely, Brazilians with hypertension were more inclined to support sodium reduction, suggesting that perceptions of dietary change could vary with specific health conditions.
These findings emphasised the need for targeted interventions to address both the presence and absence of health conditions, as these factors had been found to influence attitudes in diverse ways.
Business and policy implications, study limitations and future directions
For food producers, restaurants, and grocery retailers, the study indicated that sodium reduction strategies might require customisation based on regional dietary preferences, age, gender, and professional exposure to food-related information.
For instance, industries in countries where salt intake largely comes from processed foods may need to prioritise reformulating products. However, regions with higher salt consumption from home-cooked meals may benefit more from educational campaigns that encourage individuals to adjust salt use in meal preparation.
The study’s authors also noted several limitations in their research. As an internet-based survey, the study may not have fully captured the attitudes of populations without digital access, potentially biasing the findings. Additionally, the study’s reliance on self-reported data introduced potential biases, including social desirability and recall biases.
The researchers also acknowledged the inherent limitations of using a seven-point Likert scale, which may not have precisely reflected the full spectrum of attitudes toward sodium reduction. Moreover, the study’s cross-sectional design did not establish causative relationships between the observed associations. As such, further research is needed to validate these results and explore new determinants of sodium reduction attitudes.
The study concluded: “Our findings highlight the need for multi-faceted and tailored approaches to reduce excessive sodium intake. These approaches should consider different attribute groups, such as gender, age and other relevant factors, to effectively address the varying attitudes and behaviours related to salt consumption across different segments of the population.”
Source: BMJ Open
“Analysis of factors associated with public attitudes towards salt reduction: a multicountry cross-sectional survey”
https://doi.org/10.1136/bmjopen-2024-086467
Authors: Yuta Tanoue, et al.
