High dietary sodium intake is linked to incident hypertension, stroke, heart failure and kidney disease. U.S. federal guidelines advocate daily sodium intake of less than 2,300 milligrams (mg) with further reduction to 1,500 mg in persons who are 51 and older and those of any age who are African American and/or have hypertension, diabetes, or chronic kidney disease. The estimated average sodium intake for Americans is 3,400 mg per day.
In recent years, consumption of pre-processed and restaurant foods has substantially increased, and more than 75% of sodium in the average U.S. diet now comes from these sources. The important gap is that most patients prescribed a low sodium diet either do not understand or have information about the sodium content of the foods they eat, and current IT approaches to reduce sodium intake focus solely on counting the amount of dietary sodium eaten. Therefore, there is a critical need to develop technologies that provide just-in-time information about low sodium choices in both grocery stores and restaurants with an overall goal to improve the ability to reduce dietary sodium intake.
LowSalt4Life is an app designed to provide education, assistance, and support to people who are trying to reduce their sodium intake. It includes actionable push messages to promote adherence to a low sodium diet, and was developed using information derived from focus groups. The goal is to demonstrate the effectiveness of the mobile application in reducing sodium intake in participants with hypertension.
The long-term goal is to develop successful strategies that are driven by adaptive technologies to support self-management in cardiovascular conditions. As part of the long-term goal, a mobile application will be developed that incorporates geofencing technology and provides just-in-time mobile push messages at the 2 main locations hypertensive individuals interact with processed and prepared foods, at a grocery store or eating at a restaurant. Geofencing technology allows the mobile application to be aware of the user’s location and provide location-specific messages, vital for the just-in-time nature of the intervention.
The central hypothesis is that a mobile application with geofencing based just-in-time push messages will help hypertensive patients reduce dietary sodium intake and feel more confident in following a low sodium diet. The rationale for this project, supported by the preliminary data, is that patients need immediate information about low sodium dietary options in the places they make most food choices - grocery stores or restaurants.
Aim 1: Establish a geofencing based adaptive notification message system for the mobile application using participant feedback to facilitate reducing dietary sodium intake.
Aim 2: Determine the effectiveness of the newly developed mobile application on dietary sodium intake and on confidence in following a low sodium diet.
Participants will be greater than 18 years of age and have a diagnosis of hypertension. They must be on antihypertensive therapy for at least 3 months, with stable antihypertensive therapy (medication type and dose) for at least 2 weeks. They must own and use an Apple iPhone and have a daily sodium intake of >2,300 mg, as estimated by a Food Frequency Questionnaire.