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Effect of Salt Reduction Education on Dietary Salt Consumption among Adults in Nigeria

Abstract

Excessive dietary salt consumption is an important public health concern because high sodium intake is associated with elevated blood pressure and increased risk of cardiovascular and other non-communicable diseases. Salt reduction education provides adults with information about the health consequences of excessive salt intake, recommended dietary practices, sources of dietary salt, appropriate use of salt during cooking and at the table, interpretation of food labels, identification of high-sodium processed foods, healthier alternatives to salt, and practical strategies for reducing salt intake without compromising food acceptability. Dietary salt consumption refers to the amount and frequency of salt and sodium-containing foods consumed by individuals through household cooking, discretionary salt use, processed foods, restaurant meals, snacks, and other dietary sources. In Nigeria, excessive dietary salt consumption may be influenced by traditional cooking practices, frequent use of seasoning products, consumption of processed foods, limited nutrition knowledge, taste preferences, and inadequate awareness of the health implications of high sodium intake. Effective salt reduction education may improve adults' knowledge, awareness, confidence, and adoption of lower-salt dietary practices. Against this background, this study investigates the effect of salt reduction education on dietary salt consumption among adults in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and the Knowledge-Attitude-Practice framework. The Health Belief Model provides a framework for understanding adults' decisions to reduce dietary salt through perceived susceptibility to salt-related health problems, perceived severity, perceived benefits of salt reduction, perceived barriers, and cues to action. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, environmental conditions, and dietary behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how salt reduction education may improve adults' knowledge and attitudes and influence dietary salt consumption. Collectively, these theoretical perspectives provide a suitable framework for explaining how salt reduction education may influence dietary salt consumption among adults in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from adults in selected communities, workplaces, healthcare facilities, and other appropriate settings in Nigeria using a structured interviewer-administered questionnaire, salt-related nutrition knowledge assessment, and dietary salt consumption assessment tool. A multistage sampling technique will be employed to select states, local government areas, communities, households, and eligible adult participants. Where feasible, selected communities or participant groups will be assigned to intervention and comparison groups. Adults in the intervention group will receive structured salt reduction education covering the health effects of excessive salt consumption, common sources of dietary salt, household cooking practices, discretionary salt use, processed and packaged foods, food-label interpretation, healthier alternatives to salt, portion considerations, and practical strategies for reducing sodium intake. Dietary salt consumption will be assessed using indicators such as frequency of adding salt during cooking or at the table, consumption of processed and high-sodium foods, use of seasoning products, reported frequency of eating meals prepared outside the home, and overall dietary salt intake. Where feasible, self-reported dietary information will be complemented by dietary recall, food-frequency assessment, or urinary sodium measurement where resources and ethical approval permit. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, dietary habits, previous nutrition education, salt-related knowledge, and dietary salt consumption. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple regression analysis, will be used to determine the effect of salt reduction education on dietary salt consumption. Where appropriate, dietary salt consumption before and after the intervention will be compared. Diagnostic tests will also be conducted to assess the reliability of the research instruments, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that salt reduction education has a significant positive effect on dietary salt consumption among adults in Nigeria. Adults exposed to structured salt reduction education are expected to demonstrate improved knowledge of the health consequences of excessive salt intake and greater awareness of major dietary sources of sodium. Education may encourage participants to reduce discretionary salt use, limit consumption of high-sodium processed foods, compare food labels, reduce reliance on heavily seasoned meals, and adopt healthier cooking practices. Practical demonstrations and culturally appropriate nutrition education are expected to improve participants' confidence in reducing salt without significantly affecting food acceptability. However, education alone may not guarantee sustained reductions in salt consumption because dietary behaviour may be influenced by cultural food preferences, taste adaptation, food prices, availability of lower-sodium alternatives, household cooking practices, and widespread use of processed foods and seasoning products. Consequently, salt reduction education is expected to be most effective when supported by nutrition-friendly food environments, improved food labelling, access to healthier food alternatives, community nutrition programmes, and broader public health interventions addressing excessive sodium consumption. The study is expected to contribute to the literature on salt reduction, nutrition education, dietary behaviour, non-communicable disease prevention, cardiovascular health, nutrition literacy, community health, and public health in Nigeria by providing empirical evidence on the effect of salt reduction education on dietary salt consumption among adults. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, state ministries of health, National Primary Health Care Development Agency, hospitals, primary healthcare centres, nutrition and dietetics departments, public health practitioners, community health workers, nutrition educators, food regulatory authorities, development partners, and policymakers regarding strategies for reducing excessive dietary salt consumption. The study will also provide evidence-based recommendations for integrating salt reduction education into community and primary healthcare programmes, strengthening nutrition education, promoting healthier cooking practices, improving consumer understanding of sodium information on food labels, encouraging reformulation of high-sodium food products, and promoting population-level strategies for reducing dietary salt consumption among Nigerian adults.

Keywords: Salt reduction education, dietary salt consumption, adults, Nigeria, sodium intake, nutrition education, dietary behaviour, salt reduction, nutrition literacy, non-communicable diseases, cardiovascular health, healthy eating, community health, public health.