Health literacy has been recognized as a significant social determinant of health, defined as the ability to access, understand, appraise, and apply health-related information across healthcare, disease prevention, and health promotion. This systematic review aims to understand the relationship between health literacy, blood pressure, and dietary salt intake. A web-based search of PubMed, Web of Science, CINAHL, ProQuest, Scopus, Cochrane Library, and Prospero was performed using specified search/MESH terms and keywords. Two reviewers independently performed the data extraction and analysis, cross-checked, reviewed, and resolved any discrepancies by the third reviewer. Twenty out of twenty-two studies met the inclusion criteria and were rated as good quality papers and used in the final analysis. Higher health literacy had shown to have better blood pressure or hypertension knowledge. However, the relationship between health literacy with dietary salt intake has shown mixed and inconsistent findings. Studies looking into the main four domains of health literacy are still limited. More research exploring the links between health literacy, blood pressure, and dietary salt intake in the community is warranted. Using appropriate and consistent health literacy tools to evaluate the effectiveness of salt reduction as health promotion programs is required.
Excessive salt or sodium intake is strongly linked to increased blood pressure, which is a major risk factor for cardiovascular diseases. This study aimed to qualitatively explore the views of key stakeholders on salt intake reduction and barriers and facilitators to reducing salt intake in Malaysian schools. The stakeholders in this study were school administrators, food operators, and consumers. Their views were determined using in-depth interviews and focus group discussions, and data collected were analyzed using inductive thematic analysis. Salient barriers identified in this study were a lack of knowledge pertaining to salt intake reduction and foods sold outside the school. Meanwhile, key facilitators of salt reduction included few strategies such as public health campaigns, priority toward salt reduction policies, and school-based education programs, alongside support from other relevant stakeholders. Overall, the barriers and facilitators signal the need for implementing salt reduction programs and the collaborative efforts of different stakeholders.