Salt reduction interventions in Sub-Saharan Africa : a systematic review

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Abstract

Background:

Salt intake is associated with hypertension, the leading risk factor for cardiovascular disease. To promote population-level salt reduction, the World Health Organization recommends intervention around three core pillars: Reformulation of processed foods, consumer awareness, and environmental changes to increase availability and affordability of healthy food. This review investigates salt reduction interventions implemented and evaluated in sub-Saharan Africa (SSA).

Methods:

MEDLINE and google scholar electronic databases were searched for articles meeting inclusion criteria. Studies that reported evaluation results of a salt intervention in SSA were identified. Titles and abstracts were screened, and articles selected for full-text review. Quality of included articles was assessed, and a narrative synthesis of the findings undertaken. PROSPERO registration number CRD42015019055.

Results:

Seven studies representing four countries—South Africa, Nigeria, Ghana, and Tanzania—were included. Two examined product reformulation, one in hypertensive patients and the other in normotensive volunteers. Four examined consumer awareness interventions, including individualised counselling and advisory health sessions delivered to whole villages. One study used an environmental approach by offering discounts on healthy food purchases. All the interventions resulted in at least one significantly improved outcome measure including reduction in systolic blood pressure (BP), 24 hour urinary sodium excretion, or mean arterial BP.

Conclusions:

More high quality studies on salt reduction interventions in the region are needed, particularly focused on consumer awareness and education in urban populations given the context of rapid urbanisation; and essentially, targeting product reformulation and environmental change, for greater promise for propagation across a vast, diverse continent.

Item Type: Journal Article
Subjects: Q Science > QP Physiology
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Salt -- Physiological effect, Nutrition, Salt in the body
Journal or Publication Title: PLoS One
Publisher: Public Library of Science
ISSN: 1932-6203
Official Date: 10 March 2016
Dates:
Date
Event
10 March 2016
Published
3 February 2016
Accepted
13 November 2015
Submitted
Volume: 11
Number: 3
Number of Pages: 11
Page Range: pp. 1-11
Article Number: e0149680
DOI: 10.1371/journal.pone.0149680
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons open licence)
Date of first compliant deposit: 6 April 2016
Date of first compliant Open Access: 6 April 2016
Funder: National Institute for Health Research (Great Britain) (NIHR), Collaborations for Leadership in Applied Health Research and Care (CLAHRC)
URI: https://wrap.warwick.ac.uk/78355/

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