Reduction of Salt and Sugar Contents in Canteen Foods and Intakes By Students and Staff at a Malaysian Higher Education Institution: Protocol for a Mixed Methods Study.

backgroundUniversity 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 is imperative to understand the salt and sugar consumption levels of campus communities.

objectiveThis protocol describes the rationale and design of a 3-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 in Malaysia.

methodsFirst, the knowledge, attitudes, and practices (KAPs) and perception, barriers, and enablers (PBEs) of salt and sugar intake and reduction were assessed among students and staff (part 1 of the study). Second, the KAPs and PBEs of salt, oil, and sugar reduction were assessed among canteen staff (part 2 of the study). Third, a longitudinal interventional study was conducted by implementing a campus-wide executive order to reduce salt and sugar in all foods sold on campus (part 3 of the study). The salt and sugar contents of selected foods were measured at baseline and at 3 months and 6 months postreduction. Participants who eat frequently on campus were selected as the intervention group, while those who do not comprised the control group. All participants had their urine electrolytes and body compositions measured and recorded 24-hour dietary intakes for 2 weekdays and 1 weekend at baseline, 3 months, and 6 months after salt and sugar reduction.

resultsThe study protocols were approved by the institutional review board of Sunway University (SUREC 2024/029 and SUREC 2024/040). Recruitment for the cross-sectional studies began in May 2024, while that for the longitudinal intervention study began in June 2024. The 6-month intervention began in September 2024 immediately after the official launch of the campus-wide executive order to reduce salt and sugar. We targeted recruitment of 1000, 50, and 300 participants for parts 1, 2, and 3, respectively. We anticipate reduced dietary salt and sugar intakes by 30% and 50%, respectively (World Health Organization targets), and beneficial health effects on the participants.

conclusionsThe insights gained from this study will help to create a healthier food environment, benefitting individuals who regularly eat out, especially at the workplace.

trial registrationClinicalTrials.gov NCT06473038; https://clinicaltrials.gov/study/NCT06473038. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/69610.