Measuring Salt Consumption to Guide Behavior Change in Applied Settings: A Critical Review

Abstract

A critical review of the accuracy of salt consumption measurement can enhance future dietary sodium interventions. A review of the measures of salt consumption was conducted with a focus on the measurement that may facilitate behavior modification. Measures were critiqued for factors known to threaten the validity of behavioral measurement in applied settings. The review included observational, interventional, and measurement studies that used at least one measure of behavior indicative of salt consumption. Eighteen articles were retrieved by examining their definitions of salt consumption to ensure a measurement of behavior and a discussion of factors known to influence behavior and its measurement. Articles meeting the above criteria were critically reviewed for factors related to a valid measurement of behavior: participant and setting characteristics, measurement definitions, and measurement procedures. The results indicate that imprecise definitions of salt consumption and insensitive measurement tools limit valid measurement of salt-eating behaviors. Further research is needed to improve the specificity of measures of behaviors that are indicative of salt consumption and to produce tools that clinicians and patients may use for more accurate, and possibly real-time, salt consumption measurement. The increasing burden of cardiovascular disease in the aging U.S. population demands better methods to assess and subsequently control salt consumption in applied settings.