NCD and CVD
Oddly enough, non-communicable diseases are one of the most dangerous groups of conditions at the moment.
Although they cannot be transmitted directly from person to person, the death rate from these diseases is many times higher than the death rate from any other source. Besides, nearly half of NCD deaths are attributed to cardiovascular disease, and there are 1.7 million annual deaths attributable to improper salt or sodium intake.
The mention of these components is not accidental since it is with them that the increased risks of CVD and hypertension are caused. There are strict guidelines for the consumption of these elements established by the World Health Organization. To reduce the risk of coronary heart disease, stroke, and myocardial infarction, it is recommended to consume less than 5 grams of salt and less than 2 grams of sodium per day.
However, these recommendations are not always followed.
UAE Situation
In the United Arab Emirates, the statistics regarding the NCD are even more disturbing. Non-communicable diseases cause nearly ¾ of all deaths, and 40 percent are associated with CVD.
Reducing salt intake is one of the most cost-effective methods to improve citizens’ health, and research is being conducted on the need to apply this policy in the UAE. As the scientists’ reports show, the UAE’s diet has changed dramatically in recent years, as there has been a shift from traditional food to high-energy fast food. Foods currently consumed are high in fat, cholesterol, sugar, and sodium.
Besides, the daily intake of salt and sodium in the UAE is almost double the norm.
In this regard, there is a need to conduct a study, which includes assessing the knowledge, opinions, and practices of UAE residents connected with salt consumption and evaluating the actual consumption of these components, including also fats.
Design and Instrument
A cross-sectional study of UAE residents based on students from the University of Sharjah is used to achieve these goals.
The study took place during the 2017-2018 academic year and included 401 students. Although the students were selected at random, particular attention was paid to the absence of a history of hypertension and the use of any medications associated with this area.
Each of the study participants was examined from different points of view and underwent a survey to assess knowledge. To calculate body mass index, anthropometric parameters were taken, including height and weight, and blood pressure was measured to determine hypertension’s predisposition.
To achieve the second goal of this study, a 24-hour food intake assessment was performed.
Finally, a survey was conducted that included questions related to salt intake using a multi-component KAP model (knowledge, attitudes, practices).
KAP Model
This three-component model is an assessment method that allows you to get both qualitative and quantitative information on the topic under study. This technique enables getting and recording the study group’s opinion, which is then used to analyze the results.
The Knowledge part was devoted to assessing students’ knowledge regarding such topics as cardiovascular diseases, hypertension, diabetes in the context of salt intake and identifying opinions regarding the benefits or harms of salt intake.
In the Attitude part, attention was focused on 5 questions related to assessing a participant’s opinion on salt/sodium. Questions included views on the importance of reducing salt use, overall salt use, and the quality of food consumed.
Finally, the last part of the method involved the use and verification of food labels when shopping for food and cooking and eating habits at home.
Salt-Related Knowledge
According to the survey results, it was found that only one-third (33.5%) of the participants were able to indicate the amount of sodium in salt correctly. However, most of the surveyed students, from 60 to 70 percent, accurately described the relationship between frequent salt intake and several diseases, including cardiovascular diseases. Besides, 84% of the participants agreed that reducing salt intake is beneficial for the human body. In general, the vast majority of students gave correct answers to questions related to salt consumption theory. However, only 12 percent of the participants worry about the amount of salt they take since they believe that their intake is within the normal range, and there is no need to reduce it. In this regard, only 5-9 percent attach importance to the labels on the products and the amount of salt indicated on them when buying food.
Assessment of Dietary Intake
The results of the questionnaire are confirmed and supplemented by the results of the dietary intake analysis.
Although most students understand the need to reduce their salt intake, they do not apply it to themselves, believing that they do not exceed the established norms. However, as practice shows, sodium intake exceeds the established value of 2300 milligrams per day for both women and men, being equal to about 3500 milligrams per day.
Virtually all students, 89 percent, do not meet sodium intake guidelines, and absolutely all are consuming less potassium than necessary.
Thus, about a quarter (122) of study participants did not comply with dietary recommendations, exhibiting increased fat and protein consumption.
Dietary Knowledge
The results of this assessment can be summarized as follows. First, the participants showed quite good theoretical knowledge regarding the relationship between salt intake and the risk of developing various diseases. However, at the same time, the overwhelming majority of students believed that they did not exceed the consumption rate, which was refuted by the quantitative assessment. This is because participants have limited knowledge regarding foods containing salt in their diet. The primary sources are various types of bread, including traditional ones, which is confirmed by the study of the Gulf countries. Both Kuwait, Qatar, and Lebanon have certain types of bread in their culture, which are the second most crucial salt source in the diet of these countries’ representatives. Thus, despite the presence of theoretical knowledge, the research participants do not use it in their lives without studying the food they eat and analyzing their salt intake.
Nutritional Education
In this regard, there is a need for some reform of education in food consumption.
In addition to the consumption of various types of bread, the Middle Eastern diet is also characterized by the high use of table salt in cooking, multiple types of herbs and spices, and pickles. All of these foods are sources of sodium, which explains the excess consumption of this component in the Gulf countries. Therefore, it becomes necessary to refer to the principles of food preparation.
People should be encouraged to use less salt and fat when cooking. Besides, this practice also needs to be extended to the food industry, for example, by introducing modifications to restaurant menus so that dishes correspond to the right proportions of micronutrients.
Finally, a 20-30 percent reduction in salt levels in bread is underway to reduce the NCD burden on the region’s countries.
Further Prevention
The measures described above are a good reason for further work; however, more severe changes are needed to completely correct the situation.
First, the review found a high prevalence of cardiometabolic disease, coupled with increased fat intake, which has led to a threefold increase in obesity in recent decades. Therefore, there is a need for the early development of intervention strategies to disseminate nutritional knowledge.
Given that young people consume fast food the most, it is necessary to use means that will allow you to reach this target audience. These means can be mass media, combined with the Internet, for example, social networks. Using general and university media, media campaigns should focus on highlighting the benefits of fruits and vegetables as healthy food choices. Only by introducing large-scale companies is it possible to change food consumption habits.
Conclusion
Thus, this study with participants in the form of students from the University of Sharjah showed theoretical knowledge of health issues in the population and the specific daily practices.
Despite a fairly good level of awareness, many people neglect to analyze their food in detail, believing that the level of salt is sufficient, which is refuted by testing.
Since the consumption of salt, sodium, and fat is directly related to the risk of cardiovascular and other diseases, it is necessary to introduce several measures to reduce these components’ consumption.
At the moment, there is already a reduction in the amount of salt in bread, which is widely consumed in the Gulf countries. However, it is also necessary to address the nutritional education population to reduce salt, spices, and pickles in food preparation.
Finally, large-scale awareness campaigns need to be launched to encourage people to consume healthy foods such as vegetables and fruits.
Reference
Cheikh Ismail, L., Hashim, M., H Jarrar, A., N Mohamad, M., T Saleh, S., Jawish, N., Bekdache, M., Albaghli, H., Kdsi, D., Aldarweesh, D., & S Al Dhaheri, A. (2019). Knowledge, attitude, and practice on salt and assessment of dietary salt and fat intake among University of Sharjah students.Nutrients, 11(5), 941. Web.