Accepted for/Published in: JMIR Research Protocols
Date Submitted: Dec 3, 2024
Date Accepted: May 16, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Reduction of Salt and Sugar Contents in Canteen Foods, and Intakes among Students and Staff at a Malaysian Higher Education Institution: Protocol for a Mixed Methods Study
ABSTRACT
Background:
University students and staff members, especially those who frequently eat out and spend considerable time on campus, form a crucial demographic facing challenges related to high salt and sugar intake in out-of-home food. Recognizing the high prevalence of eating out among these populations, it becomes imperative to understand the salt and sugar consumption of campus communities.
Objective:
This protocol describes the rationale and design of a three-part cross-sectional and longitudinal interventional study to reduce salt and sugar contents in canteen foods, and intakes among students and staff at Sunway University and Sunway College, Malaysia.
Methods:
First, the knowledge, attitudes, and practices (KAP) and perception, barriers, and enablers (PBE) of salt and sugar intake and reduction will be assessed among students and staff. Second, the KAP and PBE of salt, oil, and sugar reduction will be assessed among canteen staff. Third, a longitudinal interventional study will be conducted, by implementing a campus-wide executive order reduction of salt and sugar in all foods sold on campus. The sodium and sugar contents of selected foods will be measured at baseline, 3 months, and 6 months. Participants who eat frequently on campus will be selected as the intervention group, while those who do not will be the control group. All participants will have their urine electrolytes and body compositions measured, and record 24-hour dietary intakes for two weekdays and one weekend - at baseline, 3 months, and 6 months after salt and sugar reduction.
Results:
The study protocols have been approved by the institutional review board of Sunway University (Ref. nos: SUREC 2024/029 and SUREC 2024/040). Recruitment for the Part 1 and Part 2 cross-sectional studies began in May 2024, while Part 3 longitudinal intervention study began in September 2024 immediately after the official launch of the campus-wide executive order. We plan to recruit 1000, 50 and 300 (150 each arm) for Parts 1, 2, and 3, respectively. This study will anticipate a reduced dietary sodium and sugar intake by 30% and 50%, respectively (WHO targets) and will have beneficial health effects on the participants.
Conclusions:
The insights gained from this study will help to create a healthier food environment, benefitting individuals who regularly eat out regularly, especially at the workplace. Clinical Trial: This study has been registered at https://clinicaltrials.gov/study/NCT06473038.
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