Assessing Knowledge, Attitudes, and Practices Concerning Sodium Intake in College Students
Authors: Webster Alison , Gibby Cheryl , Gunther Carolyn , Lim Eunjung , Rose Angela , Banna Jinan 
Published: November 2023

Sodium consumption is above the recommended intake in college students, a risk factor for hypertension, cardiovascular disease, and stroke. Poor nutrition knowledge and negative attitudes are determinants of unhealthy dietary practices, which contribute to a low diet quality, including high sodium intake. Little is known about the psychosocial factors and behaviors surrounding sodium intake in college students. The objective of this study was to assess knowledge, attitudes, and practices concerning dietary sodium in college students utilizing a previously validated self‐administered online survey. Students enrolled in introductory level courses were invited to participate in the survey, which included questions assessing: 1) demographic characteristics; 2) knowledge (27 items with 5 response options including ‘definitely wrong’, ‘probably wrong’, ‘not sure’, ‘probably true’, and ‘definitely true’; a score of 1 was assigned for correct answers and 0 for incorrect answers including ‘not sure’ with a higher score representing greater knowledge); 3) attitudes (4 items on 5‐point Likert scale from ‘strongly agree’ to ‘strong disagree’ with a higher score representing a more positive attitude); and 4) practices (8 items: 6 items on a 5‐point Likert scale from ‘never’ to always’ (selection of ‘always’ for positive practices and ‘never’ for negative practices were scored as 1, with all others scored as 0) and 1 item on a 3‐point Likert scale from ‘too much’ to ‘too little’ (selection of ‘right amount’ for positive items was scored as 1 and other options including ‘don't know’ were scored as 0), and 1 forced choice question (‘yes’ or ‘no’) (selection of ‘yes’ for positive behavior was scored as 1 and 'no’ scored as 0) with a higher score representing more positive dietary practices. One hundred and fifty six eligible subjects completed the survey. Sixty six percent were female and mean (SD) age was 19.3 y (2.7). Fifty percent were Asian and 36% were non‐Hispanic White. More than half (55%) were freshman. Mean (SD) BMI (kg/m2) was 23.4 (4.3). Forty one percent of respondents reported a family history of hypertension, heart disease, stroke, or related conditions. The mean (SD) score for knowledge was 13.1 (3.8) (out of 27) with females (13.6 (3.8)) scoring significantly higher than males (12.0 (3.5)) (p=0.011). The mean (SD) score for attitude was 12.5 (3.0) (out of 20) with non‐Hispanic Whites vs Other category (included Hispanic/Latinos (6%), Hawaiian (3%), and Unspecified (5%)) having a significantly more positive attitude (p=0.011). The mean (SD) score for practices was 2.0 (1.5) (out of 8) with non‐Hispanic Whites scoring significantly higher than Other category (p=0.02). Results from this study demonstrate an overall low level of knowledge, as well as poor attitudes and practices related to sodium intake in college students with males vs females having less knowledge and certain racial/ethnic minority groups having worse attitudes and behaviors compared to their non‐Hispanic White counterparts. To address these issues, existing food policies should be modified to better address the needs of the nutritionally at‐risk population of college students for improved diet and health.Support or Funding InformationSupported by NIH grant U54MD007584