This study aimed to examine the usefulness of the self-monitoring of urinary salt excretion for educating individuals about the risk of excessive dietary salt intake. The subjects were 30 volunteers (15 men and 15 women) not consuming anti-hypertensive medication. The subjects measured urinary salt excretion at home for 4 weeks using a self-monitoring device. Blood pressure (BP), anthropometric variables and nutritional variables (by a dietary-habits questionnaire) were measured before and after the measurement of urinary salt excretion. Statistical analyses were performed, including paired t-tests, Chi-square test, Pearson’s product moment correlation coefficient and multiple linear regression analysis. In all subjects, the average urinary salt excretion over 4 weeks was 8.05±1.61 g/day and the range (maximum-minimum value) was 5.58±2.15 g/day. Salt excretion decreased significantly in weeks 3 and 4 (P<0.05 and P<0.01, respectively). Diastolic BP decreased from 77.7±14.3 (at baseline) to 74.3±13.3 after 4 weeks (P<0.05), while systolic BP and anthropometric variables remained unchanged. Nutrition surveys indicated that energy intake was correlated with salt intake both before and after the measurements; changes in both variables during the observation period were correlated (r=0.40, P<0.05). The percentage of subjects who were aware of the restriction in dietary salt intake increased from 47 to 90%. In conclusion, daily monitoring of the amount of urinary salt excretion using a self-monitoring device appears to be an effective educational tool for improving the quality of life of healthy adults.

Objective: As Nepalese pregnant women vary widely in literacy levels and cultural backgrounds and are reluctant to make decisions about their health, general interventions are insufficient to improve maternal anemia. This study aimed to assess the effectiveness of “face-to-face health education using educational material created using pictures, photos, and nomograms” in reducing anemia and improving health literacy. Methods: A total of 156 Nepalese pregnant women with hemoglobin (Hb) levels below 11.0 g/dl were divided into three groups: the education group received three sessions of face-to-face health education using art-based material unaffected by literacy skills; the distribution group received material used in the education group; and the control group underwent general perinatal checkups. Hb levels and health literacy scores were assessed at baseline early pregnancy (8–12 weeks) and late pregnancy (36–40 weeks). A Nepalese version of the 14-item Health Literacy Scale (HLS-14) was developed to assess health literacy. Results: The post-intervention three-group comparison showed a statistically significant difference (P < 0.042) in mean Hb levels after the intervention. Dunnett’s test showed a statistically significant difference (P < 0.044) between the education and control groups but no significant difference between the distribution and control groups (P = 0.972). No significant differences in health literacy (total scores and subscales) were observed among the three groups before the intervention in the Kruskal-Wallis test and after the intervention (although there was a trend towards improvement). Total health literacy scores before and after the intervention were statistically significantly different for the total group and all three groups (P<0.001). Only the education group showed statistically significant differences in functional (P<0.012), communication (P<0.004), and critical (P<0.014) literacy subscale scores. Conclusion: Continuous face-to-face health education using literacy material significantly reduced anemia and improved health literacy among Nepalese pregnant women. Trial registration: UMIN Clinical Trials Registry (UMIN-CTR), URL: https://www.umin.ac.jp/ctr/ (Registration number: UMIN000049603).

The anemia rate among pregnant Nepalese women remains high and has not significantly declined over the past 20 years. Thassess the effectiveness of a nutritional intervention program for reducing anemia in pregnant women. We conducted an intervention study among pregnant women visiting Western Regional Hospital in Pokhara, Nepal, from March 2019 to March 2020. We involved 138 participants in this study and divided them into three groups- education, distribution, and control. Hemoglobin levels were evaluated before and after the intervention. This study revealed that the mean hemoglobin values after the intervention were 11.65 ± 0.59 mg/dL in the education group, 11.15 ± 1.08 mg/dL in the distribution group, and 11.14 ± 1.19 mg/dL in the control group. The changes in hemoglobin levels were 1.40 ± 0.84 mg/dL in the education group, 0.96 ± 1.21 mg/dL in the distribution group, and 0.87 ± 1.11 mg/dL in the control group. The difference in the change in hemoglobin levels among the three groups was statistically significant. In conclusion, anemia during pregnancy can be effectively reduced through individual nutritional counseling using visual educational materials. Therefore, there is an urgent need to develop a national standard model of a nutritional education protocol for maternal women combined with training programs for maternal healthcare workers to upgrade their nutrition counseling skills.