Restricted accessResearch articleFirst published online 2012-4
Hold the Salt! Effects of Sodium Information Provision,Sodium Content,and Hypertension on Perceived Cardiovascular Disease Risk and Purchase Intentions
Excessive sodium intake is a major cause of hypertension, a significant risk factor for several forms of cardiovascular disease, including coronary heart disease, stroke, and heart failure. Despite this finding, the average intake among Americans is 150% of the maximum recommended level. The goal of this research is to obtain greater consumer insight into this important public health issue. The authors analyze data from the National Health and Nutrition Examination Survey 2005–2006 and conduct two experiments using a nationwide panel of consumers. The results indicate that hypertension status has a significant effect on consumers’ attention to sodium on the Nutrition Facts panel (Study 1) and moderates the influence of sodium disclosure on perceived cardiovascular disease risk and purchase intentions for restaurant items (Study 2). In addition, the authors find that sodium level on a Nutrition Facts panel interacts with the provision of health-related sodium educational materials to influence disease risk perceptions and purchase intentions (Study 3). They offer potential implications of their findings for public policy makers, the public health community, and consumers.
ToddAlwyn S., MacGinleyRobert J., SchollumJohn B.W., JohnsonRichard J., WilliamsSheila M., SutherlandWayne H.F. (2010), “Dietary Salt Loading Impairs Arterial Vascular Reactivity,”American Journal of Clinical Nutrition, 91(March), 557–56.
2.
CraigAndrews J., NetemeyerRichard G., and BurtonScot (1998), “Consumer Generalization of Nutrient Content Claims in Advertising,”Journal of Marketing, 62(October), 62–75.
3.
BaronReuben M., and KennyDavid A. (1986), “The Moderator– Mediator Variable Distinction in Social Psychological Research: Conceptual, Strategic, and Statistical Considerations,”Journal of Personality and Social Psychology, 51(6), 1173–82.
4.
Bibbins-DomingoKirsten, ChertowGlenn M., CoxsonPamela G., MoranAndrew, LightwoodJames M. (2010), “Projected Effect of Dietary Salt Reductions on Future Cardiovascular Disease,”New England Journal of Medicine, 362(7), 590–99.
5.
BouwmanLaura I., KoelenMaria A., and HiddinkGerrit J. (2008), “The Personal Factor in Nutrition Communication,” in Personalized Nutrition: Principles and Applications, KokF., BouwmanL., and DesiereF., eds. Boca Raton, FL: CRC Press, 169–84.
6.
BurtonScot, Craig AndrewsJ., and NetemeyerRichard G. (2000), “Nutrition Ad Claims and Disclosures: Interaction and Mediation Effects for Consumer Evaluations of the Ad and the Brand,”Marketing Letters, 11(August), 235–48.
7.
BurtonScot, BiswasAbhijit, and NetemeyerRichard (1994), “Effects of Alternative Nutrition Label Formats and Nutrition Reference Information on Consumer Perceptions, Comprehension, and Product Evaluation,”Journal of Public Policy & Marketing, 13(Spring), 36–47.
8.
BurtonElizabeth, CreyerH., KeesJeremy, and HugginsKyle (2006), “Attacking the Obesity Epidemic: The Potential Health Benefits of Providing Nutrition Information in Restaurants,”American Journal of Public Health, 96(9), 1669–75.
9.
BurtonElizabeth Howlett, and TangariAndrea (2009), “Food for Thought: How Will the Nutrition Labeling of Quick Service Restaurant Menu Items Influence Consumers’ Product Evaluations, Purchase Intentions, and Choices?”Journal of Retailing, 85(3), 258–73.
CDC (2009b), “Application of Lower Sodium Intake Recommendations to Adults—United States, 1999–2006,”Journal of the American Medical Association, 301(17), 1759–60.
FordGary T., HastakManoj, MitraAnusree, and RingoldDebra Jones (1996), “Can Consumers Interpret Nutrition Information in the Presence of a Health Claim? A Laboratory Investigation,”Journal of Public Policy & Marketing, 15(Spring), 16–27.
16.
GarretsonJudith, and BurtonScot (2000), “The Nutrition Facts Panel and Package Claims: The Role of Nutrient Values, Multiple Claims, and Congruent Information on Attitudes, Disease-Related Risks and Consumer Trust,”Journal of Public Policy & Marketing, 19(Fall), 213–27.
17.
HavasStephen, DickinsonBarry D., and WilsonModena (2007), “The Urgent Need to Reduce Sodium Consumption,”Journal of the American Medical Association, 298(12), 1439–41.
18.
HeJiang, OgdenLorraine G., VupputuriSuma, BazzanoLydia A., LoriaCatherine, and WheltonPaul K. (1999), “Dietary Sodium Intake and Subsequent Risk of Cardiovascular Disease in Overweight Adults,”Journal of the American Medical Association, 282(21), 2027–34.
19.
HowlettElizabeth, BurtonScot, and KozupJohn (2008), “How Modification of the Nutrition Facts Panel Influences Consumers at Risk for Heart Disease: The Case of Trans Fat,”Journal of Public Policy & Marketing, 27(Spring), 83–97.
Institute of Medicine (2010), Strategies to Reduce Sodium Intake in the United States, HenneyJane E., TaylorChristine L., and BoonCaitlin S., eds. Washington, DC: The National Academies Press.
23.
IrwinJulie R., and McClellandGary H. (2001), “Misleading Heuristics and Moderated Multiple Regression Models,”Journal of Marketing Research, 38(February), 100–109.
24.
JemmottJohn B., DittoPeter H., and CroyleRobert T. (1986), “Judging Health Status: Effects of Perceived Prevalence and Personal Relevance,”Journal of Personality and Social Psychology, 50(5), 899–905.
25.
KellerScott B., OlsonJeanne, LandryMike, VelliquetteAnne M., BurtonScot, and Craig AndrewsJ. (1997), “The Effects of Nutrition Package Claims, Nutrition Facts Labels, and Motivation to Process Nutrition Information on Consumer Product Evaluations,”Journal of Public Policy & Marketing, 16(Fall), 256–69.
26.
KozupJohn, CreyerElizabeth H., and BurtonScot (2003), “Making Healthful Food Choices: The Influence of Health Claims and Nutrition Information on Consumer's Evaluations of Packaged Food Products and Restaurant Menu Items,”Journal of Marketing, 67(April), 19–34.
LevyAlan S., FeinSara B., and SchuckerRaymond E. (1996), “Performance Characteristics of Seven Nutrition Label Formats,”Journal of Public Policy & Marketing, 15(Spring), 1–15.
29.
LichtensteinAlice, AppelLawrence J., BrandsMichael, CarnethonMercedes, DanielsStephen, FranchHarold A. (2006), “Diet and Lifestyle Recommendations Revision 2006: A Scientific Statement from the American Heart Association Nutrition Committee,”Journal of the American Heart Association, 114(1), 82–96.
Lloyd-Jones, Donald, Robert J. Adams, Todd M. Brown, Mercedes Carnethon, Shifan Dai, et al., on Behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee (2010), “Heart Disease and Stroke Statistics—2010 Update: A Report from the American Heart Association,”Circulation, 1(21), e46–e215.
32.
MillerEdgar R., ErlingerThomas P., YoungDeborah R., JehnMegan, CharlestonJeanne, RhodesDonna (2002), “Results of the Diet, Exercise, and Weight Loss Intervention Trial (DEW-IT),”Journal of the American Heart Association, 40(5), 612–18.
33.
MitraAnu, HastakManoj, FordGary T., and RingoldDebra J. (1999), “Can the Educationally Disadvantaged Interpret the FDA-Mandated Nutrition Facts Panel in the Presence of an Implied Health Claim,”Journal of Public Policy & Marketing, 18(Spring), 106–117.
34.
MullerDominique, JuddCharles M., and YzerbytVincent Y. (2005), “When Moderation Is Mediated and Mediation Is Moderated,”Journal of Personality & Social Psychology, 89(6), 852–63.
35.
New York City Department of Health and Mental Hygiene (2010), “Health Department Announces Proposed Targets for Voluntary Salt Reduction in Packaged and Restaurant Foods,” (accessed April 15, 2010), [available at http://www.nyc.gov/html/doh/html/pr2010/pr002-10.shtml].
PalarKartika, and SturmRoland (2009), “Potential Societal Savings from Reduced Sodium Consumption in the U.S. Adult Population,”The American Journal of Health Promotion, 24(1), 49–57.
38.
RaghunathanRajagopal, NaylorRebecca Walker, and HoyerWayne D. (2006), “The Unhealthy = Tasty Intuition and Its Effects on Taste Inferences, Enjoyment, and Choice of Food Products,”Journal of Marketing, 70(October), 170–84.
39.
RobertoChristina A., AgnewHenry, and BrownellKelly D. (2009), “An Observational Study of Consumers’ Accessing of Nutrition Information in Chain Restaurants,”American Journal of Public Health, 99(5), 820–21.
40.
RothmanA.J., and SchwarzNorbert (1998), “Constructing Perceptions of Vulnerability: Personal Relevance and the Use of Experiential Information in Health Judgments,”Personality and Social Psychology Bulletin, 24(10), 1053–64.
41.
SobelMilton E. (1982), “Asymptotic Intervals for Indirect Effects in Structural Equations Models,” in Sociological Methodology 1982, LeinhartS., ed. San Francisco: Jossey-Bass, 290–312.
42.
TangariAndrea Heintz, BurtonScot, HowlettElizabeth, ChoYoon-Na, and ThyroffAnastasia (2010), “Weighing In On Fast Food Consumption: The Effects of Meal and Calorie Disclosures on Consumer Fast Food Evaluations,”Journal of Consumer Affairs, 44(Fall), 431–62.
VasanRamachandran S., LarsonMartin G., LeipEric P., EvansJane C., O'DonnellChristopher J., KannelWilliam B. (2001), “Impact of High-Normal Blood Pressure on the Risk of Cardiovascular Disease,”New England Journal of Medicine, 345(18), 1291–97.
46.
ViswanathanMadhubalan, and HastakManoj (2002), “Role of Summary Information in Facilitating the Comprehension of Nutrition Information by Consumers,”Journal of Public Policy & Marketing, 21(Fall), 305–318.
47.
ViswanathanMadhubalan, and HastakManoj, and GauRoland (2009), “Understanding and Facilitating the Usage of Nutrition Labels by Low-Literate Consumers,”Journal of Public Policy & Marketing, 28(Fall), 135–45.
48.
WheltonPaul K., HeJiang, AppelLawrence J., CutlerJeffrey A., HavasStephen, KotchenTheodore A. (2002), “Primary Prevention of Hypertension: Clinical and Public Health Advisory from the National High Blood Pressure Education Program,”Journal of the American Medical Association, 288(15), 1882–88.
