JMIR Publications

ABSTRACT

Background:

Salt intake in China is high, over twice the maximum WHO recommendation. Unlike in most developed countries where salt intake mainly comes from pre-packaged food, the salt consumed in China is mainly (around 80%) added during cooking. Compelling evidence has shown that a lower salt intake is associated with a reduced risk of cardiovascular disease (CVD) and total mortality. Salt reduction is one of the most cost-effective measures to prevent hypertension and CVD.

Objective:

Action on Salt China (ASC) aims to develop, implement and evaluate a comprehensive and tailored salt reduction programme, for national scaling-up in China.

Methods:

ASC consists of six programmes working in synergy to increase salt awareness and to reduce the amount of salt used during cooking at home and in restaurants, as well as in processed foods.

Results:

Since September 2018 in six provinces across China, two health campaigns on health education and processed foods, respectively have started, in parallel with four cluster randomised controlled trials (RCTs): (1) Application-based Intervention Study (AIS), where a mobile application is used to achieve and sustain salt reduction in schoolchildren and their families; (2) Housewife-based Intervention study (HIS), where family chefs receive support in using less salt in home cooking; (3) Restaurant-based Intervention Study (RIS), targeting restaurants consumers, cooks, and managers; and (4) Comprehensive Intervention Study (CIS), which is a real-world implementation and evaluation of all available interventions in the three other RCTs.

Conclusions:

As a unit, the six programmes of ASC will provide a set of novel approaches to reduce salt intake in China. The expected outputs of ASC include: (1) several evidence-based intervention packages addressing major sources of salt intake; (2) evidence-based salt reduction strategies and experience on policy advocacy and scaling-up in different regions and populations; and (3) study reports and publications to highlight the gaps, needs, barriers and facilitators, and strategies in salt reduction among different populations. Clinical Trial: Registered on Chinese Clinical Trial Registry. AIS: ChiCTR1800017553; HIS: ChiCTR1800016804; RIS: ChiCTR1800019694; CIS: ChiCTR1800018119.