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To inform strategies aimed at improving blood pressure (BP) control and reducing salt intake, we assessed educational inequalities in high blood pressure (HBP) awareness, treatment and control; physician's advice on salt reduction; and salt knowledge, perceptions and consumption behaviours in Eastern Europe and Central Asia. Data were collected in cross-sectional, population-based nationally representative surveys, using a multi-stage clustered sampling design. Five HBP awareness, treatment and control categories were created from measured BP and hypertension medication use. Education and other variables were self-reported. Weighted multinomial mixed-effects regression models, adjusted for confounders, were used to assess differences across education categories. Nine Eastern European and Central Asian countries (Armenia, Azerbaijan, Belarus, Georgia, Kyrgyzstan, Republic of Moldova, Tajikistan, Turkey and Uzbekistan). Nationally representative samples of 30 455 adults aged 25-65 years. HBP awareness, treatment and control varied substantially by education. The coverage of physician's advice on salt was less frequent among participants with lower education, and those with untreated HBP or unaware of their HBP. The education gradient was evident in salt knowledge and perceptions of salt intake but not in salt consumption behaviours. Improved salt knowledge and perceptions were more prevalent among participants who received physician's advice on salt reduction. There is a strong education gradient in HBP awareness, treatment and control as well as salt knowledge and perceived intake. Enhancements in public and patient knowledge and awareness of HBP and its risk factors targeting socio-economically disadvantaged groups are urgently needed to alleviate the growing HBP burden in low- and middle-income countries.

Background Excessive salt intake is a growing public health concern in Malaysia, largely due to the frequent consumption of processed and out-of-home meals. Despite awareness of its health risks, especially hypertension, there remains a gap between knowledge and actual dietary practices. Understanding the knowledge, attitudes, and practices (KAP) related to salt intake, along with perceptions, barriers, and enablers (PBE) of salt reduction, is crucial for designing effective interventions. Objective To assess salt-related KAP and PBE among students and staff at Sunway University and Sunway College. Methods A cross-sectional online survey was conducted among 415 participants (68.8% females; median age 21 ± 5 years). The questionnaire assessed KAP on salt intake and PBE of salt reduction. This study was part of a broader project titled “An Interventional Study of Salt and Sugar Reduction in Foods Sold on Campus at Sunway University and Sunway College”. Data were analysed using descriptive statistics and non-parametric tests to explore sex-based differences ( p  < 0.05). Results Most participants had good knowledge of the health risks of high salt intake, with hypertension most commonly identified. Females were significantly more likely to recognize these risks ( p  = 0.042). Attitudes toward salt reduction were generally positive (median score 7/10; p  = 0.059), though over half believed they consumed the “right amount” of salt. Salt-reducing practices were limited; many avoided table salt but added salty condiments when cooking. No significant sex difference was observed in practices ( p  = 0.318). Common strategies included avoiding processed foods (26%) and eating out less (11%). Although 73% believed Malaysians consumed too much salt, 80% rarely checked food labels, despite 83.6% finding the information helpful. Barriers included unclear labelling, limited low-salt options, and unmet requests for less salty food. The Ministry of Health’s campaign was rated poorly, with a significant sex difference in perception ( p  = 0.001). Suggested enablers included health promotion, clearer communication, mandatory reformulation, and stricter regulation of food vendors. Conclusion While salt-related knowledge is high, behaviour change remains limited. Addressing barriers through targeted interventions and policy support is essential to improve salt-reducing practices. Trial registration :ClinicalTrials.gov ID: NCT06473038, registered June 25, 2024.

Background Excessive intake of sodium is a major public health concern. Information on knowledge, perception, and practice (KPP) related to sodium intake in Malaysia is important for the development of an effective salt reduction strategy. This study aimed to investigate the KPP related to sodium intake among Malaysian adults and to determine associations between KPP and dietary sodium intake. Methods Data were obtained from Malaysian Community Salt Survey (MyCoSS) which is a nationally representative survey with proportionate stratified cluster sampling design. A pre-tested face-to-face questionnaire was used to collect information on socio-demographic background, and questions from the World Health Organization/Pan American Health Organization were adapted to assess the KPP related to sodium intake. Dietary sodium intake was determined using single 24-h urinary sodium excretion. Respondents were categorized into two categories: normal dietary sodium intake (< 2000 mg) and excessive dietary sodium intake (≥ 2000 mg). Out of 1440 respondents that were selected to participate, 1047 respondents completed the questionnaire and 798 of them provided valid urine samples. Factors associated with excessive dietary sodium intake were analyzed using complex sample logistic regression analysis. Results Majority of the respondents knew that excessive sodium intake could cause health problems (86.2%) and more than half of them (61.8%) perceived that they consume just the right amount of sodium. Overall, complex sample logistic regression analysis revealed that excessive dietary sodium intake was not significantly associated with KPP related to sodium intake among respondents ( P > 0.05). Conclusion The absence of significant associations between KPP and excessive dietary sodium intake suggests that salt reduction strategies should focus on sodium reduction education includes measuring actual dietary sodium intake and educating the public about the source of sodium. In addition, the relationship between the authority and food industry in food reformulation needs to be strengthened for effective dietary sodium reduction in Malaysia.

Background: Public beliefs about dietary risks, such as excessive salt intake, are often not isolated misconceptions but part of structured cognitive systems. This study aimed to explore how individuals organize their beliefs and misperceptions regarding salt-related health consequences. Material and Methods: Using data from an international online survey, we applied a system of multivariate proportional odds logistic regression (POLR) models to estimate conditional associations among beliefs about salt’s links to various diseases—including cardiovascular, metabolic, renal, neuropsychiatric, and mortality outcomes. In addition, exploratory and confirmatory factor analyses (EFA and CFA) were conducted to identify and validate latent constructs underlying the belief items. Beliefs were modeled as interdependent, controlling for latent constructs, sociodemographics, and self-reported health awareness. Statistically significant associations (p < 0.05) were visualized via a heatmap of beta coefficients. Results: Physicians showed almost universal agreement that salt contributes to hypertension (µ = 0.97), compared to non-medical respondents (µ = 0.85; p < 0.0001). Beliefs about mortality (µ = 1.55 for MDs vs. 0.99 for non-medical; p < 0.0001) emerged as central hubs in the belief network. Strong inter-item associations were observed, such as between hypertension and heart failure (β = −0.39), and between obesity and type 2 diabetes (β = −0.94). Notably, cognitive gaps were found, including a lack of association between atrial fibrillation and stroke, and non-reciprocal links between hypertension and heart failure. Conclusions: Beliefs about the health effects of salt are structured and sometimes asymmetrical, reflecting underlying reasoning patterns rather than isolated ignorance. Understanding these structures provides a systems-level view of health literacy and may inform more effective public health communication and education strategies.

The global increase of cardiovascular diseases is linked to the shift towards unbalanced diets with increasing salt and fat intake. This has led to a growing consumers’ interest in more balanced food products, which explains the growing number of health-related claims on food products (e.g., “low in salt” or “light”). Based on a within-subjects design, consumers (n = 129) evaluated the same cheese product with different labels. Participants rated liking, saltiness and fat flavor intensity before and after consuming four labeled cheeses. Even though the cheese products were identical, inclusion of health labels influenced consumer perceptions. Cheese with a “light” label had a lower overall expected and perceived liking compared to regular cheese. Although cheese with a “salt reduced” label had a lower expected liking compared to regular cheese, no lower liking was found when consumers actually consumed the labeled cheese. All labels also influenced the perceived intensities of the attributes related to these labels, e.g., for example salt intensity for reduced salt label. While emotional profiles of the labeled cheeses differed before tasting, little differences were found when actual tasting these cheeses. In conclusion, this study shows that health-related labels might influence the perceived flavor and emotional profiles of cheese products.

Objectives The significance of performing tongue brushing is uncertain and lacks sufficient clinical evidence. This study was conducted to assess the existing practices on tongue brushing among school children and their parents and its effect on optimal levels of salt and sugar concentration, the development of dental caries and body mass index among children. Results Of 191 students (52.9% male), 178 responded; 134 (57.3%) reported tongue brushing. Among 313 parents, 54.5% were female and 283 (91.6%) brushed. Initiation was mainly maternal (68.4%) or paternal (12.0%); only 3.3% of parents cited professional advice. Salt taste thresholds were identical between groups (median 1.5 g/200 mL); means were slightly higher in brushers (3.14 vs. 3.00; p  = 0.389). Sugar thresholds were also equivalent (means 3.25 vs. 3.09; NS). BMI correlated weakly with brushing score ( r  = 0.143, p  > 0.05). Sugar taste concentration showed a negative, non-significant correlation ( r = − 0.112, p  = 0.150). CPITN scores were higher in non-brushers, without significance. Conclusion Tongue brushing is a widely practiced habit, primarily adopted through parental influence rather than clinical advice. However, no significant associations were observed with sugar/salt taste thresholds, BMI, dental caries, or periodontal health. While tongue brushing may reduce halitosis and contribute to oral comfort. It should be promoted as an adjunctive, not primary, oral hygiene practice. Further longitudinal and interventional studies are warranted.

Background. Controlling and reducing salt intake are one of the solutions to overcome hypertension. This study aimed at determining the predictors related to salt control methods in Saqez urban population. Methods and Materials. In the present cross-sectional study, the sample population was randomly selected through cluster sampling. Data collection was performed using valid questionnaires, demographic, family economic status, knowledge, perception, intention, salt intake behaviors, and salt control methods, along with measuring body mass index (BMI) and hypertension levels. Descriptive, analytical statistical methods and multivariate logistic regression analysis were used to determine the predictors of desirable salt control methods. The variables of sex, age, family economic status, knowledge, perception, perceived social support, self-efficacy, and intention were analyzed as independent variables. Data analysis was performed using SPSS software version 24 at a significance level of 0.05. Results. Out of 766 participants, 73% were women, with mean (M) 32.83, standard deviation (SD) 9.52 years, and 77.2% were married. There were significant sex differences in employment (P=0.01) and economic status (P=0.016). The M (SD) of blood pressure (systolic/diastolic) was 110.65 (0.0212) (P=0.441). The salt intake control methods between men and women did not show significant differences (P=0.368). Among totally 88.5%, 87.7% men and 88.9% women followed desirable behaviors. The predictors that determine the adoption of salt control methods were sex (man) (OR = 0.71, 95% CI (0.38–1.29)), age (OR = 1.02, 95% CI = (0.99–1.05)), SES/FAS (medium, high level) (OR = 1.37, 95% CI = (0.754–2.47); OR = 0.46, 95% CI = (0.047–4.55)), blood pressure (OR = 1.33, 95% CI = (0.16–11.23)), knowledge (have) (OR = 1.01, 95% CI = (0.39–1.63)), intent to reduce salt (OR = 1.047, 95% CI = (1.03–1.06)), perceived salt reduction importance (OR = 1.02, 95% CI = (1.01–1.04)), perceived emotional support (health staff) (OR = 1.02, 95% CI = (1.01–1.04)), media (OR = 1.01, 95% CI = 0.99–1.02), perceived practical support (spouse) (OR = 1.02, 95% CI = 0.99–1.04)), and perceived self-efficacy (OR = 1.01, 95% CI = (0.99–1.03)). Conclusion. The support of health staff and spouse seems to be effective in controlling the salt intake behaviors of healthy individuals. In parallel with the development and change of people’s lifestyles, new approaches (legal and services) for salt control based on the support of media and social media were expected.

Farmers have a pivotal responsibility in soil conservation: they can either preserve or deplete it through their choices. The responsibility of agriculture increases when practised in delicate ecosystems, such as lagoonal ones. The Venetian Lagoon islands, which are increasingly subjected to natural and anthropic subsidence, occasional flooding events (acqua alta), and eustatic sea level rise, are constantly exposed to erosive processes that challenge farmers to play with their adaptive capability. This research was carried out on the islands of Sant’Erasmo and Vignole, the most representative of island agriculture in the Venetian Lagoon: they almost exclusively rely on agriculture, which is almost nil in the other islands. This empirical research aimed to explore farmers’ agricultural practices, perceptions of soil changes, and how they adapt to them. It was fundamental for this study that the field research involved direct human contact with farmers (through semi-structured interviews) for data collection and using qualitative methods for data analysis, integrating scientific and non-scientific forms of knowledge and actors. The final purpose was to demonstrate the sustainability (valued on the potential depletion or regeneration capability) of agricultural practices and adaptation strategies on a theoretical basis. Despite their polycultural landscape (maintained by low-input farming systems), escaped from the predominant landscape oversimplification, Sant’Erasmo and Vignole are also subjected to unsustainable agricultural practices, including heavy mechanisation and synthetic inputs. Coupled with natural soil salinity that is exacerbated by increasing drought periods, these practices can contribute to soil degradation and increased salinity. The reported adaptation strategies, such as zeroed, reduced, or more conscious use of machines, were guided by the need to reduce the negative impact of soil changes on productivity. Our research revealed some of them as sustainable and others as unsustainable (such as increasing irrigation to contrast soil salinity). Participatory action research is needed to support farmers in designing effective sustainable agricultural practices and adaptation strategies.

Behavioural risk factors for non-communicable diseases (NCDs) are rising among refugees, increasing chronic disease prevalence that causes morbidity and mortality. This study aimed to ascertain the prevalence, awareness and management of behavioural risk factors for NCDs among South African Durban-based refugees. A once-off quantitative, cross-sectional design was conducted on the behavioural risk factors for NCDs among 122 randomly selected Durban-based refugees using a modified version of the World Health Organisation (WHO) STEPwise approach to NCDs surveillance (STEPS) instrument. Participants’ awareness and management of risk factors for NCDs were determined with a behavioural NCD awareness and management of behavioural NCD risk factor questionnaire. Smoking and alcohol prevalence were 4.1% and 20.7%, respectively, with 40.8% consuming fewer than five servings of fruit and/or vegetables daily. Participants performed more than 150 min of moderate physical activity per week. A significant 30.8% (p < 0.001) was aware that consuming alcohol poses an extremely large risk, similarly for smoking (38.7%; p < 0.001]. A significant 56.2% (p < 0.001) believe that regularly eating raw vegetables presents no risk, likewise for being physically active (51.7%; p < 0.001). A significant 40.6% (p < 0.001) of the participants always drink water or non-alcoholic drinks to manage their alcohol consumption, 54.2% (p < 0.001) manage their unhealthy diet by sometimes filling half their plates with fruits and vegetables, and 49.2% manage their physical activity levels by sometimes choosing a range of physical activities (p < 0.001). Refugees’ lack of awareness of behavioural risk factors for NCDs highlights the importance for health service providers to present health promotion programs to make refugees aware of their behavioural NCD’s risk factors and how it impacts their health.