Taste, Salt Consumption, and Local Explanations around Hypertension in a Rural Population in Northern Peru.

M Amalia Pesantes,J Jaime Miranda,Francisco Diez-Canseco,Vilarmina Ponce-Lucero,Antonio Bernabé-Ortiz

doi:10.3390/nu9070698

Abstract

Interventions to promote behaviors to reduce sodium intake require messages tailored to local understandings of the relationship between what we eat and our health. We studied local explanations about hypertension, the relationship between local diet, salt intake, and health status, and participants’ opinions about changing food habits. This study provided inputs for a social marketing campaign in Peru promoting the use of a salt substitute containing less sodium than regular salt. Qualitative methods (focus groups and in-depth interviews) were utilized with local populations, people with hypertension, and health personnel in six rural villages. Participants were 18–65 years old, 41% men. Participants established a direct relationship between emotions and hypertension, regardless of age, gender, and hypertension status. Those without hypertension established a connection between eating too much/eating fried food and health status but not between salt consumption and hypertension. Participants rejected dietary changes. Economic barriers and high appreciation of local culinary traditions were the main reasons for this. It is the conclusion of this paper that introducing and promoting salt substitutes require creative strategies that need to acknowledge local explanatory disease models such as the strong association between emotional wellbeing and hypertension, give a positive spin to changing food habits, and resist the “common sense” strategy of information provision around the causal connection between salt consumption and hypertension.

Highlights

Hypertension is an important public health problem especially in low and middle-income countries [1]
The data we present was collected during the formative phase of our intervention oriented to promote the use of a salt substitute containing less sodium than regular salt in Tumbes, Peru
The goal of this study was to learn about local perceptions about hypertension, diet, and salt consumption that could generate insights for later designing a context-relevant social marketing campaign promoting a salt substitution strategy in rural Tumbes in Peru

Summary

Introduction

Hypertension is an important public health problem especially in low and middle-income countries [1]. In 2006, approximately 14% of the Peruvian population aged 20 and older had hypertension [2]. There is, geographical variation of hypertension rates within the country. In Tumbes, a region located in Peru’s northern coast, one in every four adults aged. ≥35 years has hypertension, which is much higher than other regions in the country [3]. There are numerous strategies to prevent and control hypertension. One of the more common approaches focuses on reducing sodium intake [4,5], as recommended by several international bodies [6,7,8]. In Latin America, such strategies have translated into regulations to change sodium

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