Influence of Dietary Salt Knowledge, Perceptions, and Beliefs on Consumption Choices after Stroke in Uganda

J Stroke Cerebrovasc Dis. 2017 Dec;26(12):2935-2942. doi: 10.1016/j.jstrokecerebrovasdis.2017.07.016. Epub 2017 Aug 12.

Abstract

Background: Previous research on Uganda's poststroke population revealed that their level of dietary salt knowledge did not lead to healthier consumption choices.

Purpose: Identify barriers and motivators for healthy dietary behaviors and evaluate the understanding of widely accepted salt regulation mechanisms among poststroke patients in Uganda.

Methods: Convergent parallel mixed methods triangulation design comprised a cross-sectional survey (n = 81) and 8 focus group discussions with 7-10 poststroke participants in each group. We assessed participant characteristics and obtained insights into their salt consumption attitudes, perceptions, and knowledge. Qualitative responses were analyzed using an inductive approach with thematic analytic procedures. Relationships between healthy dietary salt compliance, dietary salt knowledge, and participant characteristics were assessed using logistic regression analyses.

Results: Healthy dietary salt consumption behaviors were associated with basic salt knowledge (P < .0001), but no association was found between compliance and salt disease-related knowledge (P = .314). Only 20% and 7% obtained health-related salt knowledge from their health facility and educational sources, respectively, whereas 44% obtained this information from media personalities; 92% of participants had no understanding of nutrition labels, and only 25% of the study population consumed potash-an inexpensive salt substitute that is both rich in potassium and low in sodium.

Conclusion: One barrier to healthy dietary consumption choices among Uganda's stroke survivors is a lack of credible disease-related information. Improving health-care provider stroke-related dietary knowledge in Uganda and encouraging the use of potash as a salt substitute would help reduce hypertension and thereby lower the risk of stroke.

Keywords: Sodium; Uganda; dietary salt; hypertension; stroke; sub-Saharan Africa.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Black People / psychology
  • Choice Behavior*
  • Complex Mixtures / administration & dosage
  • Comprehension
  • Cross-Sectional Studies
  • Cultural Characteristics
  • Diet, Healthy*
  • Diet, Sodium-Restricted*
  • Feeding Behavior / ethnology
  • Feeding Behavior / psychology*
  • Female
  • Focus Groups
  • Food Labeling
  • Health Knowledge, Attitudes, Practice* / ethnology
  • Humans
  • Hypertension / diagnosis
  • Hypertension / diet therapy*
  • Hypertension / ethnology
  • Hypertension / psychology
  • Logistic Models
  • Male
  • Middle Aged
  • Motivation
  • Multivariate Analysis
  • Nutritive Value
  • Odds Ratio
  • Patient Compliance
  • Patient Education as Topic
  • Qualitative Research
  • Risk Factors
  • Sodium Chloride, Dietary / adverse effects*
  • Stroke / diagnosis
  • Stroke / diet therapy*
  • Stroke / ethnology
  • Stroke / psychology
  • Surveys and Questionnaires
  • Uganda
  • Young Adult

Substances

  • Complex Mixtures
  • Sodium Chloride, Dietary
  • potash