Which technology solutions are most effective in reducing sodium intake?

In a recent study published in the journal NPJ Digital Medicineresearchers conducted a review and meta-analysis to determine whether behavioral changes through technology-assisted interventions can help reduce sodium intake and have a positive impact on health.

study: Technology-based behavior change interventions to reduce sodium intake in adults: A systematic review and meta-analysis.. Image credit: itor/Shutterstock.com

background

Cardiovascular disease is responsible for more than 1.5 million deaths each year, and one of the main risk factors for cardiovascular disease and hypertension is too much sodium in the diet.

The World Health Organization (WHO) recommends that adults consume less than 2 grams of sodium per day, and any sodium intake greater than 5 grams per day or above the WHO recommended level is considered excessive. .

Research shows that the average sodium intake for most adults is between 3.5 grams and 5.5 grams per day, significantly increasing the risk of high blood pressure, cardiovascular disease, disability, and death.

One of the strategies suggested by WHO to reduce sodium intake in adults is behavioral change through education.

Although these educational interventions have primarily been delivered face-to-face, technology-assisted interventions via digital devices, phones, mobile applications, and videos are becoming more popular because they can reach larger audiences at lower costs. I am.

However, the effectiveness of such technical-assisted interventions in bringing about behavioral changes toward salt reduction is still poorly understood.

About research

In this study, researchers conducted a systematic review of randomized controlled trials evaluating the effectiveness of technology-based interventions that produce behavioral changes to reduce sodium intake and change systolic and diastolic blood pressure. carried out.

This study also includes a meta-analysis to examine the characteristics of these interventions that effectively lower sodium intake.

The trials included in the review involved participants aged 18 years and older. They provide technology-based interventions aimed at changing participants' sodium intake behaviors, either entirely through tools such as digital devices, mobile applications, video, and telephone, or through hybrid methods of technology-based and face-to-face interventions. Evaluated through. .

Participants with chronic kidney disease were excluded from the meta-analysis. The outcome investigated was reporting of 24-hour urine sodium concentration.

Data extracted from studies consisted of sample size, health status of participants, proportion of female participants, intervention setting, mean age of the study population, follow-up period, type of technique used, and method of delivery of the intervention. I was there. , and whether the study was fully or partially technically supported.

Behavior change techniques were also identified using standard methods and independently validated by multiple reviewers.

The meta-analysis used a random-effects model to analyze systolic and diastolic blood pressure and 24-hour urine sodium.

Subgroup analyzes were performed on characteristics such as normal and hypertensive participants, type of technique used, single or multidisciplinary intervention provider, group-based or individualized intervention delivery, and family involvement. it was done.

Some frequently used behavior change techniques were also included in the subgroup analyses.

Additionally, continuous variables such as mean age, sample size, number of behavior change techniques in each randomized controlled trial, intervention and follow-up period were included in the meta-regression analysis.

result

The results showed that technology-based interventions aimed at reducing sodium intake and creating behavioral changes that help lower systolic and diastolic blood pressure are effective.

Characteristics such as frequency of intervention, behavior change techniques such as rehearsal and behavioral practice, and demonstration of behavior were significantly associated with positive decreases in 24-hour urinary sodium concentration.

The main type of technology used was also associated with instant messaging, which yielded a larger effect size and effectively changed sodium intake behavior. Intervention delivery mode, in which the intervention was delivered to the participant-family dyad, was also associated with larger effect sizes.

The reductions in systolic and diastolic blood pressure also indicate that the technology-based intervention produced changes in sodium intake behavior comparable to the face-to-face intervention.

conclusion

Overall, reviews and meta-analyses show that interventions using technological communication tools to induce behavioral changes that lower sodium intake and systolic and diastolic blood pressure outperform face-to-face interventions in producing positive behavioral changes. It turned out to be just as effective.

Some technology types and intervention delivery methods were found to be particularly effective. Additionally, characteristics such as intervention frequency and some behavior change techniques were found to be more effective than other intervention characteristics.