Global sodium consumption (4,310 mg/day), particularly in low- and middle-income countries, including Thailand, remains considerably higher than the World Health Organization (WHO) recommendation for adults (2,000 mg/day) (1). The mean sodium intake of Thai adults (3,636, SD1,722 mg/day) is more than double the WHO recommendation, and especially high in southern Thailand (4,108, SD1,677 mg/day) (2). Currently, there is insufficient data on the sodium content of traditional food in southern Thailand. This study aimed to determine the amount of sodium in traditional food and determinants of sodium consumption behaviours among adults in southern Thailand.
A cross-sectional study recruited adults with hypertension on treatment from clinics in the Sichon district of Nakhon Si Thammarat Province, southern Thailand. A self-administered questionnaire was used including questions ondemographics, perceived self-efficacy and practise of sodium consumption behaviour, access to low-sodium food, and salt/sodium substitute products. The questionnaire was reviewed by 3 health experts. Overall content validity was high at 0.84. The index of item objective congruence was above 0.5 and questionnaire reliability, measured by Cronbach’s alpha, was acceptable at 0.73. In addition, a salt meter determined the quantity of sodium chloride in food with total dissolved solids by measuring the electrical conductivity of sodium chloride in food expressed in 100 mg/100 mL (equivalent to 39.3 mg of sodium/100 mL) (3). Statistical analysis used SPSS v29.0. This study was reviewed and approved by the Human Research Ethics Committee of Walailak University, Thailand.
A total of 469 adults completed the questionnaire, 316 (67%) were female with median age 62 years (IQR=42-95). Majority 220 (47%) were overweight or obese, and 413 (88%) usually ate home cooked foods. The majority were non-smokers (80%) and did not consume alcohol (67%). Most participants agreed that they avoid purchasing foods high in salt and sodium (70%) and consider manufacturers of salt and sodium substitute products to be reputable and trustworthy (68%). Additionally, 61% reported that they sometimes read nutrition labels before selecting pre-packaged food.
1,876 samples of foods were provided by participants for analysis of sodium chloride. In spicy curry (938 samples) the majority (89%) were classified as very salty (>0.9% salt), followed by 9% at safe levels (0.7-0.9% salt) and 2% as slightly salty (<0.7% salt) while sodium chloride concentration in clear soup (938 samples) were very salty (40%), followed by safe levels (30%), and slightly salty (30%). The average amount of sodium in spicy curry was 507, SD118 mg/100 mL, which was significantly higher (p<0.01) than that of clear soup (342, SD99 mg/100 mL).
Despite most participants reporting positive self-reported dietary behaviours, they are still consuming high sodium in both spicy curry and clear soup. These findings support public health campaigns to reduce sodium intake.