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Introduction
Noncommunicable diseases (NCDs) are a growing source of concern and a challenge to public health. Before the surge of deaths from COVID-19, these diseases accounted for 7 of 10 deaths globally, exceeding deaths from all infectious diseases combined (1). The Global Burden of Disease study of 2017 showed that the leading contributors to NCD-related morbidity and mortality were cardiovascular diseases such as high blood pressure, stroke, coronary heart disease, and heart failure (2). Of these, high blood pressure is one of the most significant (3).
High blood pressure develops from complex and interrelated factors, including those related to modifiable behavior and lifestyle (4). A key modifiable risk factor for NCDS is high sodium intake (4). The World Health Organization (WHO) recommends a daily sodium consumption of less than 2 grams (or <5 g salt/d). If adhered to, this recommendation would prevent an estimated 2.5 million deaths from NCDs worldwide (3). Dietary sodium comes from 3 distinct sources: packaged foods, food prepared outside the home (eg, restaurants), and additional discretionary sources (adding salt to foods prepared at home during cooking or eating) (4). However, sources of dietary sodium intake differ among populations. An understanding of cultural variation in diet and dietary practices that affect sodium intake has important implications for public health practice (4).
Dietary Sodium Intake Among Nigerians in the US
The source of dietary sodium intake for most Americans is packaged, processed, store-bought, and restaurant foods; hence, these are the focus of population-level sodium reduction interventions (5). However, the source of dietary sodium among Nigerians in the US differs from that of Americans. Nigerians maintain their traditional diet and dietary practices while navigating new cultural spaces and seldom consume packaged or processed foods (6).
Despite the presence of multiple ethnicities in Nigeria, the typical traditional diet across ethnic groups comprises mainly the pairing of carbohydrate-based meals with soup or sauce (7) prepared by adding both salt and bouillon seasoning to enhance the flavor (8). This practice of using both salt and bouillon seasoning in meal preparation (8) has also been observed in metropolitan Atlanta among a sample of Nigerian women, the primary food-preparers for their households (9). This indicates that this salt intake practice persists among Nigerians in the US. Considering that the...