Dietary salt intake: knowledge, attitudes, and practices among outpatient andhypertensive clinic patients at the Teaching Hospital Peradeniya, Sri Lanka

Q: What are the key findings of this study?

Hypertension clinic attendees had higher satisfactory salt knowledge/attitudes (77.7% vs 59.2%, p<0.001) and practices (60.3% vs 47.6%, p=0.001) than outpatients, with 9.15 g/day mean intake.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension and general outpatient care (dietary salt intake) (n=403). Intervention: Hypertension Clinic attendance vs. Outpatient Department (OPD) attendance. Primary outcome: Satisfactory knowledge and attitudes regarding dietary salt intake (score ≥4 out of 8) (p=<0.001).

Q: What does this research mean for the field?

Hypertension clinic attendees demonstrate significantly higher satisfactory salt knowledge, attitudes, and dietary practices than general outpatient attendees, despite daily salt consumption remaining nearly double the WHO-recommended limit. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To assess knowledge, attitudes, and practices (KAP) related to dietary salt intake among adult attendees of an outpatient department and a hypertension clinic.

Buddhi Hanwellage Don; Savini Waduge; Dimuthu Galketiyawaththa; Wathsala Aththanayake; K. N. Marambe

doi:10.4038/jccpsl.v32i3.8908

October 13, 2026Journal of the College of Community Physicians of Sri LankaOpen Access

Dietary salt intake: knowledge, attitudes, and practices among outpatient andhypertensive clinic patients at the Teaching Hospital Peradeniya, Sri Lanka

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Key result

Hypertension clinic attendance linked to ~19-point higher satisfactory salt knowledge vs general outpatients.

P<0.001
n=403

Why the study?

Excessive dietary salt intake is a major modifiable risk factor for hypertension and non-communicable diseases, prompting an assessment of related knowledge, attitudes, and practices among outpatient and hypertension clinic attendees.

Key Points

To assess knowledge, attitudes, and practices (KAP) related to dietary salt intake among adult attendees of an outpatient department and a hypertension clinic.
Administered a pre-tested, self-administered questionnaire evaluating demographics, knowledge, attitudes, dietary practices, and sources of health information.
Evaluated associations using Chi-squared tests and estimated daily per capita salt intake based on household purchase data.
Hypertension clinic attendees demonstrated significantly higher satisfactory knowledge and attitudes (77.7%) than outpatient attendees (59.0%), but satisfactory dietary practices were low in both groups (60.3% vs. 47.6%).
Gender, age, and education level showed significant associations with knowledge and practices (p<0.001), with higher knowledge observed in females and participants aged 40 years or older.
Estimated mean daily salt consumption was 9.15 g, nearly double the WHO-recommended maximum limit of 5 g per day, with television (62%) and social media (24%) serving as primary information channels.

Study Design

Type

Cross-Sectional (n=403)

Multicenter

No

Structured PICO

P

Population

403 adults aged ≥20 years (54.6% female; 52.1% aged ≥40 years) attending the Hypertension Clinic (n=300) or Outpatient Department (n=103) at Teaching Hospital Peradeniya, Sri Lanka, excluding those with cognitive impairments or emergency medical needs.

C

Comparator

Outpatient Department (OPD) attendees (n=103) compared with Hypertension Clinic attendees (n=300)

O

Outcome

Knowledge, attitudes, and practices (KAP) related to dietary salt intake assessed via a pre-tested, self-administered questionnairepatient reported

Main Result

Absolute Event Rate: 77.7% vs 59.2%

p-value: p=<0.001

Despite higher awareness of dietary salt risks among hypertension clinic patients compared to general outpatients in Sri Lanka, actual salt consumption remains nearly double the WHO recommendation (9.15 g/day), highlighting a persistent gap between health knowledge and dietary practices.

Limitations

Cross-sectional design cannot establish causality between sociodemographic factors and KAP levels
Salt intake was estimated indirectly using household purchase data rather than 24-hour urinary sodium excretion
Consecutive sampling and single-centre design may introduce selection bias and limit generalizability
Self-administered questionnaire data are subject to self-reporting bias
Analysis did not adjust for potential confounders such as income level, comorbidities, or employment status
Self-administered questionnaire is subject to self-reporting bias

Implication

Awareness exceeds practices in dietary salt reduction among hypertensives; hypothesis-generating for counseling efficacy and should not yet change practice.

Abstract

Introduction: Excessive dietary salt intake is a major modifiable risk factor for hypertension and non-communicable diseases (NCDs). Objectives: To assess knowledge, attitudes and practices (KAP) related to dietary salt intake among adult attendees of the Outpatient Department (OPD) and Hypertension Clinic at the Teaching Hospital Peradeniya Methods: A descriptive cross-sectional study was conducted in 20242025 among 403 adults selected via consecutive sampling using a pre-tested, self-administered questionnaire. Data were analysed using Jamovi and Microsoft Excel. Chi-squared tests were applied to identify significant associations between demographics and KAP levels. Results: Hypertension clinic attendees demonstrated significantly higher satisfactory knowledge and attitudes (77.7%) compared to OPD participants (59.0%). However, satisfactory dietary practices were low in both groups (60.3% and 47.6%, respectively). Gender, age and education were significantly associated with knowledge and practices (p<0.001). Television was the predominant information source (62%), though younger OPD attendees frequently used social media. The estimated daily salt intake was 9.15 g, nearly double the WHO recommendation. Conclusions & Recommendations: A persistent gap exists between awareness and behaviour regarding salt intake. Strengthening structured dietary counselling in OPD settings and utilising mass media strategies are essential to support national NCD prevention strategies.

Discussion

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Cite This Study

Don et al. (2026) conducted a cross-sectional in Hypertension and general outpatient care (dietary salt intake) (n=403). Hypertension Clinic attendance vs. Outpatient Department (OPD) attendance was evaluated on Satisfactory knowledge and attitudes regarding dietary salt intake (score ≥4 out of 8) (p=<0.001). Hypertension clinic attendees had higher satisfactory salt knowledge/attitudes (77.7% vs 59.2%, p<0.001) and practices (60.3% vs 47.6%, p=0.001) than outpatients, with 9.15 g/day mean intake.

synapsesocial.com/papers/6ae28e56cbadf70daf6c419a https://doi.org/10.4038/jccpsl.v32i3.8908

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Dietary salt intake: knowledge, attitudes, and practices among outpatient andhypertensive clinic patients at the Teaching Hospital Peradeniya, Sri Lanka

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Dietary salt intake: knowledge, attitudes, and practices among outpatient andhypertensive clinic patients at the Teaching Hospital Peradeniya, Sri Lanka

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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