Health Literacy Regarding Sodium Consumption of Undergraduate Students in the Lower Northern Region, Thailand


Waraporn Youngiam Pajaree Abdullakasim Nipa Maharachpong


At present, the sodium intake of Thai youth is about twice as high as recommended. Health literacy has been confirmed to be an important factor in disease prevention, health promotion, and quality of life improvement. However, few studies have concentrated on the sodium health literacy among university students. This cross-sectional survey study aimed to describe health literacy regarding sodium consumption of undergraduate students in the lower northern region of Thailand and to identify factors affecting the students’ sodium consumption behaviors. An online self-administered questionnaire was used to collect data from 395 first-year students of a selected university. Binary Logistic Regression (BLR) was performed to analyze factors affected high sodium consumption behaviors. Results of the study revealed that, most of the students were female (68.6%), age over 18 years old (61.6%), studied in non-health science areas (74.0%). The number of students who had underweight and obese were similar (28.6% and 26.3%, respectively). Approximately half of participants were self-cooking (52.9%), and eating late at night (55.2%). Most of them love spicy taste food (74.4%) and using social media about food (81.0%). Regarding health literacy about sodium consumption, majority of the students (79.5%) had low cognitive skills; they had moderate skills on accessibility to information (44.6%), communication (55.9%), self-management (49.1%), and media literacy (44.1%); and had high decision-making skills (44.6%). Results of the BLR analysis using enter method showed the characteristic factors of the students that affected their high sodium consumption behaviors (OR>1.0) were love to eat spicy taste food (OR=2.20; 95%CI: 1.18-4.09) followed by had underweight BMI (OR=2.12; 95%CI: 1.17-3.85), and male students (OR=1.95; 95%CI: 1.16-3.28). When health literacy regarding sodium consumption were considered, low communication skills had the highest affected on high sodium consumption behaviors (OR=3.08; 95%CI: 1.33-7.10) followed by low cognitive skills (OR=2.35; 95%CI: 1.18-4.80). In order to reducing high sodium consumption behaviors of the youth, health literacy about sodium consumptions should be enhanced through behavioral modification program specifically communication skills and cognitive skills. Additionally, students who love to eat spicy taste food should be emphasized. This result provides factors affected to high sodium consumption behaviors should be considered for interventions to reduce high sodium consumption among university students.

Keywords: Health literacy, sodium consumption, undergraduate students, Thailand


Boonsiri, C., Piaseu, N., Putwatana, P., & Kantachuvesiri, S. ( 2017). Effects of program promoting food consumption for sodium reduction on knowledge and urinary sodium in nursing students. Thai Journal of Nursing Council, 32(3), 104-119.
Buja, A., Grotto, G., Montecchio, L., De Battisti, E., Sperotto, M., Bertoncello, C., . . . Baldo, V. (2021). Association between health literacy and dietary intake of sugar, fat and salt: A systematic review. Public Health Nutrition, 24(8), 2085-2097.
Cha, E., Kim, K. H., Lerner, H. M., Dawkins, C. R., Bello, M. K., Umpierrez, G., & Dunbar, S. B. (2014). Health literacy, self-efficacy, food label use, and diet in young adults. American Journal of Health Behavior, 38(3), 331-339.
Chaikate, S. (2016). Factors associated with sodium from food consumption among students at Srinakharinwirot University, Prasarnmit Campus. Journal of Research Unit on Science, Technology and Environment for Learning, 7(1), 103-114.
Chailimpamontree, W., Kantachuvesiri, S., Aekplakorn, W., Lappichetpaiboon, R., Sripaiboonkij Thokanit, N., Vathesatogkit, P., . . . Garg, R. (2021). Estimated dietary sodium intake in Thailand: A nationwide population survey with 24-hour urine collections. The Journal of clinical hypertension (Greenwich, Conn.), 23(4), 744-754.
Chau, P. H., Leung, A. Y. M., Li, H. L. H., Sea, M., Chan, R., & Woo, J. (2015). Development and validation of Chinese health literacy scale for low salt consumption - Hong Kong population (CHLSalt-HK). Public Library of Science ONE, 10(7), e0132303.
Department of Deseases Control, Ministry of Public Health, & Thailand. (2016). National strategy on salt and sodium reduction 2016-2025. Nonthaburi: Ministry of Public Health.
Fleary, S. A., Joseph, P., & Pappagianopoulos, J. E. (2018). Adolescent health literacy and health behaviors: A systematic review. Journal of Adolescence, 62, 116-127.
Health Education Division, Department of Health Service Support, & Ministry of Public Health. (2018.). Health promotion, health literacy evaluation and health behavior for children and adolescent 7-14 years old and aged over 15 years old. Bangkok: New Thammada Press.
Institute of Medicine (US). (2010). In Henney JE, Taylor CL, & Boon CS (Eds.), Strategies to reduce sodium intake in the United States, 3 Taste and flavor roles of sodium in foods: A unique challenge to reducing sodium intake. Washington (DC): National Academies Press (US).
Ismail, L., Hashim, M., Jarrar, A., Mohamad, M., Saleh, S., Jawish, N., . . . Al Dhaheri, A. (2019). Knowledge, attitude, and practice on salt and assessment of dietary salt and fat nntake among University of Sharjah students. Nutrients, 11, 941.
Jia Jiet, L., & Soma R, M. (2017). High salt diets in young university adults and the correlation with blood pressure, protein intake and fat free mass. Bioscience Horizons: The International Journal of Student Research, 10, hzx003-hzx003.
Kaboudi, M., Kianipour, N., Ziapour, A., & Dehghan, F. (2017). A study of health literacy components and their relationships with health-promoting behaviors in students at Kermanshah University of Medical Sciences. International Journal of Pediatrics, 5(12), 6721-6729.
Kadam, P., & Bhalerao, S. (2010). Sample size calculation. International Journal of Ayurveda Research, 1(1), 55-57. doi:10.4103/0974-7788.59946
Kontis, V., Cobb, L. K., Mathers, C. D., Frieden, T. R., Ezzati, M., & Danaei, G. (2019). Three public health interventions could save 94 million lives in 25 years. Circulation, 140(9), 715-725. http://dx.
Leite, G., & Kunkulberga, D. (2018). Dietary sodium intake and the main sources of salt in the diet of young adults in Latvia. Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences., 72, 49 - 53.
Malta, D., Petersen, K. S., Johnson, C., Trieu, K., Rae, S., Jefferson, K., . . . Arcand, J. (2018). High sodium intake increases blood pressure and risk of kidney disease. From the science of salt: A regularly updated systematic review of salt and health outcomes (August 2016 to March 2017). Journal of clinical hypertension (Greenwich, Conn.), 20(12), 1654-1665.
Ministry of Public Health. (2015). Annual epidemiological surveilance report 2015: Hypertension. Retrieved from
Mouritsen, O. G. (2012). Umami flavour as a means of regulating food intake and improving nutrition and health. Nutrition and Health, 21(1), 56-75.
Ngamjarus C., & Chongsuvivatwong V. (2014). n4Studies: Sample size and power calculations for iOS. Songkla: The Royal Golden Jubilee Ph.D. Program, The Thailand Research Fund & Prince of Songkla University.
Nutbeam, D., & Lloyd, J. E. (2020). Understanding and responding to health literacy as a social determinant of health. Retrieved from
Othman, F., Ambak, R., Siew Man, C., Zaki, A., Ahmad, M., Aziz, N., . . . Aris, T. (2019). Factors associated with high sodium intake assessed from 24-hour urinary excretion and the potential effect of energy intake. Journal of Nutrition and Metabolism, 2019, 1-8.
Pan, W. H., & Yeh, W. T. (2008). How to define obesity? Evidence-based multiple action points for public awareness, screening, and treatment: an extension of Asian-Pacific recommendations. Asia Pacific Journal of Clinical Nutrition, 17(3), 370-374.
Pilic, L., Lubasinski, N. J., Berk, M., Ward, D., Graham, C. A.-M., Da Silva Anastacio, V., . . . Mavrommatis, Y. (2020). The associations between genetics, salt taste perception and salt intake in young adults. Food Quality and Preference, 84, 103954.
Siripitchtrakul, P., Vatanasomboon, P., Satheannoppakao, W., & Sujirarat, D. (2020). Nutrition literacy among grade 9 students of Bangkok metropolitan administration schools. Thai Journal of Public Health, 50(1), 61-75.
Sprake, E. F., Russell, J. M., Cecil, J. E., Cooper, R. J., Grabowski, P., Pourshahidi, L. K., & Barker, M. E. (2018). Dietary patterns of University students in the UK: a cross-sectional study. Nutrition Journal, 17(1), 90-90.
Srikan, P., Thatan, S., Srichanpan, W., & Pinsakul, C. (2018). Relationship between knowledge, self-care agency, sodium reducion behavior and urinary sodium level of students and employees of the Boromarajonnani College of Nursing Phayao. Journal of Boromarajonani College of Nursing, 34(3 ), 21-33.
Suon, M., & Ruaisungnoen, W. (2019). Health literacy on sodium restriction and associated factors among patients with hypertension in Phnom Penh, Cambodia. Nursing Science Journal of Thailand, 37(4), 32-41.
Visedkaew, K., & Muktabhant, B. (2020). Association between nutrition literacy and the consumption of snacks and sweetened beverages among undergraduate students in the Health Sciences Faculties of Khon Kaen University. Srinagarind Medical Journal, 35(2), 183-192.
Wadhera, D., & Wilkie, L. M. (2018). College-aged men view more foods as snacks than women do. Food Quality and Preference, 69, 53-56.
World Health Organization. (2012). Guideline: Sodium intake for adults and children. Retrieved from
Zamora, M. C. V. (2019). Applying health and food literacy models to college students’ nutrition knowledge and salt consumption. The Normal Lights, 13(1), 229 - 255.

Research Articles


How to Cite
YOUNGIAM, Waraporn; ABDULLAKASIM, Pajaree; MAHARACHPONG, Nipa. Health Literacy Regarding Sodium Consumption of Undergraduate Students in the Lower Northern Region, Thailand. Naresuan University Journal: Science and Technology (NUJST), [S.l.], v. 30, n. 4, p. 1-11, sep. 2022. ISSN 2539-553X. Available at: <>. Date accessed: 30 jan. 2023. doi: