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Understanding knowledge, attitudes and behaviours related to dietary sodium intake in a multi-ethnic population in Singapore

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Mei Jun Chan, Borame Sue Lee Dickens, Mary Foong‐Fong Chong

Most people in this Singapore study knew that too much salt can harm health. But many still could not tell how much they should eat, or use a food label to find it.

Abstract

Objective: This study aimed to fill the current gap in the understanding of the knowledge, attitudes and behaviours (KAB) related to dietary Na among adult residents in Singapore. Design: A cross-sectional online survey was conducted between October and December 2020 on 955 participants selected through random sampling. Setting: The survey was conducted in Singapore. Participants: Participants were recruited from the Singapore Population Health Study Online Panel. Results: Participants’ mean age was 46·6 ± 14·1 years old and 58 % of them were females. Most of the participants were Chinese (82·1 %), 10·5 % were Indian and 4·5 % were Malay. Findings from the weighted data showed that most participants were aware of the health impact of high Na consumption. However, many participants were unaware of the recommended intake for salt (68%) and Na (83%), had misconceptions, and were unable to correctly use food labels to assess NA content (69%). Findings also alluded to the presence of knowledge gaps in the sources of Na in their diet. While 59 % of the participants reported to be limiting their consumption of Na, many reported facing barriers such as not knowing how to limit their Na intake. Participants also felt that there were limited options for lowNa foods when eating out and were lacking awareness of low-Na products. Conclusions: Findings highlighted substantial gaps in participants’ knowledge and skills in managing their Na consumption. This suggests the need for more public education and improvements in the food environment.

Transcript

Most people in this Singapore study knew that too much salt can harm health. But many still could not tell how much they should eat, or use a food label to find it. High sodium intake, largely through salt, is associated with high blood pressure, a key risk factor for heart and blood-vessel disease.

It is also associated with kidney disease, weakened bones, and stomach cancers. That is why limiting sodium intake matters, yet Singapore’s population has been consuming more salt than it should. The problem is not only what people eat; it is also whether they know how to change it.

Understanding knowledge, attitudes and behaviours related to dietary sodium in Singapore was lacking. That information can identify what people need before sodium-reduction efforts begin, and help assess whether those efforts work. Think of lowering salt like trying to manage a household budget without knowing which bills are largest.

People may focus on canned or processed foods, while overlooking sauces and seasonings added during cooking or eating. People were also spread fairly evenly between thinking they ate more than recommended, less, about the right amount, or simply not knowing. The study set out to understand knowledge, attitudes and behaviours related to dietary sodium among adult residents in Singapore.

That means the study set out to close a gap in knowledge, attitudes and behaviours about dietary sodium among adult residents of Singapore. The study used an online survey in Singapore between October and December twenty twenty.

Participants were Singapore citizens or permanent residents aged twenty-one and above who used the internet and could read English. One person was randomly invited from each household, and the questionnaire could be completed on a desktop, laptop, tablet, or mobile phone.

Most participants were aware of the health impact of high sodium consumption. But many were unaware of the recommended intake for salt and sodium, had misconceptions, and could not correctly use food labels to assess sodium content.

Participants were generally aware of the health impact of high sodium consumption, yet many did not know recommended amounts and could not correctly use food labels. At the same time, fifty-nine percent reported limiting sodium, while many said they faced barriers, including not knowing how to limit their intake.

The study found a gap between knowing the health effects of high sodium consumption and managing sodium in daily life: overall knowledge and behaviour scores related to dietary sodium intake were comparatively low. The findings can help inform future sodium-awareness campaigns in Singapore.

The barriers were not only personal. Participants felt there were limited options for low-sodium foods when eating out and lacked awareness of low-sodium products. The findings therefore point to two needs: more public education and improvements in the food environment.

Knowing salt is unhealthy does not automatically make lower-salt eating possible. People need clearer guidance, better food choices, and an environment that makes the healthier option easier to find.

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