Research Brief| Volume 52, ISSUE 12, P1139-1147, December 2020

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Knowledge, Attitudes, and Practices Regarding Dietary Sodium in College Students



      Test a dietary sodium survey in a US adult population of college students using a survey previously validated in a non-US adult population.


      Cross-sectional study of a convenience sample of college students from a Midwest (n = 168) and Pacific Island (n = 152) university. Main outcome measures were knowledge, attitudes, and practices regarding dietary sodium (38 items). Sum scores and percentages for constructs were calculated. A score <75% was considered unfavorable; t test or ANOVA were used to examine group differences.


      Midwest students were primarily non-Hispanic White individuals (81%) and 65% female. Pacific Island students were predominantly Asian (51%) and 66% female. Mean ± SD construct scores (percentage) for knowledge, attitudes, and practices were 58.69 ± 10.62, 63.96 ± 16.18, 66.00 ± 12.34 (Midwest) and 57.54 ± 10.93, 64.84 ± 14.96, 64.94 ± 13.18 (Pacific Island), respectively; there were no significant differences between schools or race.

      Conclusions and Implications

      College students scored low in knowledge, attitudes, and practices regarding sodium. Results from this formative study may inform assessment strategies in future dietary sodium interventions.

      Key Words

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        • Fryar CD
        • Ostchega Y
        • Hales CM
        • Zhang G
        • Kruszon-Moran D
        Hypertension prevalence and control among adults: United States, 2015-2016.
        NCHS Data Brief. 2017; 289: 1-8
      1. National Heart, Lung, and Blood Institute. High blood pressure. Accessed October 19, 2020.

        • Cutler JA
        • Follmann D
        • Allender PS
        Randomized trials of sodium reduction: an overview.
        Am J Clin Nutr. 1997; 65: 643S-651S
        • Sacks FM
        • Svetkey LP
        • Vollmer WM
        • et al.
        Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group.
        N Engl J Med. 2001; 344: 3-10
        • McGuire S.
        Institute of Medicine. 2010. Strategies to reduce sodium intake in the United States. Washington, DC: The National Academies Press.
        Adv Nutr. 2010; 1: 49-50
        • Burke JD
        • Reilly RA
        • Morrell JS
        • Lofgren IE
        The University of New Hampshire's Young Adult Health Risk Screening Initiative.
        J Am Diet Assoc. 2009; 109: 1751-1758
        • National Academies of Sciences, Engineering, and Medicine
        • Health and Medicine Division
        • Food and Nutrition Board
        • Committee to Review the Dietary Reference Intakes for Sodium and Potassium
        Dietary Reference Intakes for Sodium and Potassium.
        National Academies Press, Washington, DC2019
      2. Centers for Disease Control and Prevention. Prevalence of excess sodium intake in the United States — NHANES, 2009–2012. Accessed October 19, 2020.

        • Anding JD
        • Suminski RR
        • Boss L
        Dietary intake, body mass index, exercise, and alcohol: are college women following the dietary guidelines for Americans?.
        J Am Coll Heal. 2001; 49: 167-171
        • Strong KA
        • Parks SL
        • Anderson E
        • Winett R
        • Davy BM
        Weight gain prevention: identifying theory-based targets for health behavior change in young adults.
        J Am Diet Assoc. 2008; 108: 1708-1715
        • Racette SB
        • Deusinger SS
        • Strube MJ
        • Highstein GR
        • Deusinger RH
        Weight changes, exercise, and dietary patterns during freshman and sophomore years of college.
        J Am Coll Heal. 2005; 53: 245-251
        • Driskell JA
        • Kim YN
        • Goebel KJ
        Few differences found in the typical eating and physical activity habits of lower-level and upper-level university students.
        J Am Diet Assoc. 2005; 105: 798-801
        • Nelson MC
        • Story M
        • Larson NI
        • Neumark-Sztainer D
        • Lytle LA
        Emerging adulthood and college-aged youth: an overlooked age for weight-related behavior change.
        Obesity (Silver Spring). 2008; 16: 2205-2211
        • Nasreddine L
        • Akl C
        • Al-Shaar L
        • Almedawar M
        • Isma'eel H
        Consumer knowledge, attitudes and salt-related behavior in the Middle-East: the case of Lebanon.
        Nutrients. 2014; 6: 5079-5102
        • Yahia N
        • Brown CA
        • Rapley M
        • Chung M
        Level of nutrition knowledge and its association with fat consumption among college students.
        BMC Public Health. 2016; 16: 1047
        • Patel D
        • Cogswell ME
        • John K
        • Creel S
        • Ayala C
        Knowledge, attitudes, and behaviors related to sodium intake and reduction among adult consumers in the United States.
        Am J Heal Promot. 2017; 31: 68-75
        • John KA
        • Cogswell ME
        • Zhao L
        • et al.
        Change in US adult consumer knowledge, attitudes, and behaviors related to sodium intake and reduction: SummerStyles 2012 and 2015.
        Am J Health Promot. 2018; 32: 1357-1364
      3. Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System: BRFSS questionnaires. Accessed October 19, 2020.

      4. Porter Novelli. PN Styles: ConsumerStyles & YouthStyles. Accessed October 19, 2020

        • Zhang J
        • Xu A
        • Ma J
        • et al.
        Dietary sodium intake: knowledge, attitudes and practices in Shandong Province, China, 2011.
        PLoS One. 2013; 8: e58973
        • Grimes CA
        • Riddell LJ
        • Nowson CA
        Consumer knowledge and attitudes to salt intake and labelled salt information.
        Appetite. 2009; 53: 189-194
        • Bailey RL
        • Parker EA
        • Rhodes DG
        • et al.
        Estimating sodium and potassium intakes and their ratio in the American diet: data from the 2011-2012 NHANES.
        J Nutr. 2015; 146: 745-750
        • 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: 265-273
        • Sarmugam R
        • Worsley A.
        Current levels of salt knowledge: a review of the literature.
        Nutrients. 2014; 6: 5534-5559
        • Naeeni MM
        • Jafari S
        • Fouladgar M
        • et al.
        Nutritional Knowledge, Practice, and Dietary Habits among school children and adolescents.
        Int J Prev Med. 2014; 5: S171—S178
      5. The Ohio State University. Statistical summary. Columbus, OH: The Ohio State University; 2015. Accessed October 19, 2020.

      6. University of Hawaiʻi at Mānoa. About UH Mānoa. Accessed October 19, 2020.

        • Sarmugam R
        • Worsley A
        • Flood V
        Development and validation of a salt knowledge questionnaire.
        Public Health Nutr. 2014; 17: 1061-1068
        • Banna JC
        • Vera Becerra LE
        • Kaiser LL
        • Townsend MS
        Using qualitative methods to improve questionnaires for Spanish speakers: assessing face validity of a food behavior checklist.
        J Am Diet Assoc. 2010; 110: 80-90
      7. Willis GB. Cognitive Interviewing: A “How To” Guide. Research Triangle Park, NC: Research Triangle Institute; 2019.;jsessionid=71CC295F5AF0F2D2C4B4804BF5CE5C9C?doi= Accessed October 19, 2020

        • Board on Children, Youth, and Families
        • Institute of Medicine
        • National Research Council
        Improving the Health, Safety, and Well-Being of Young Adults: Workshop Summary.
        The National Academies Press, Washington, DC2013
        • Firestone MJ
        • Beasley JM
        • Kwon SC
        • Ahn J
        • Trinh-Shevrin C
        • Yi SS
        Asian American dietary sources of sodium and salt behaviors compared with other racial/ethnic groups, NHANES, 2011-2012.
        Ethn Dis. 2017; 27: 241-248
        • Ganda O
        • Fonseca V
        Salt sensitivity, insulin resistance, and public health in India.
        Endocr Pract. 2010; 16: 940-944
        • Katsuya T
        • Ishikawa K
        • Sugimoto K
        • Rakugi H
        • Ogihara T
        Salt sensitivity of Japanese from the viewpoint of gene polymorphism.
        Hypertens Res. 2003; 26: 521-525
        • Vollmer WM
        • Sacks FM
        • Ard J
        • et al.
        Effects of diet and sodium intake on blood pressure: subgroup analysis of the DASH-sodium trial.
        Ann Intern Med. 2001; 135: 1019-1028
        • Cronbach LJ.
        Coefficient alpha and the internal structure of tests.
        Psychometrika. 1951; 16: 297-334