Hypertension prevention through nutrition education in youth: a school-based program involving parents

One approach to the prevention of high blood pressure may be the reduction of sodium intake early in life. To test the effect of nutrition education for salt use in third-grade students (ages 7 to 9), three teaching programs involving a classroom curriculum, a home-based curriculum, or the combination were compared to a control group. Thirty-one schools with 1,839 students were included. Measurements were made at the beginning and end of the school year. Participation rates exceeded 90% for school-based programs and 80% for those at home. Knowledge about salt increased significantly, with the classroom program showing the largest gains. However, reported salting behavior and sodium measured by 24-hr recall and overnight urines failed to show consistent and significant differences between treatments. Further analysis suggested that most ingested salt was hidden in processed foods with only a small fraction added in cooking or at meals (less than 7%). If sodium intake is to be reduced significantly in healthy children, more attention must be paid to hidden sources, particularly processed foods.