A town level comprehensive intervention study to reduce salt intake in China: protocol for a cluster randomised...

Area of Science:

• Public Health
• Cardiovascular Disease Prevention
• Nutrition Science

Background:

• Salt intake in China (≈12 g/day) significantly exceeds WHO recommendations (5 g/day).
• Action on Salt China (ASC) launched in 2017 to address high salt consumption.
• This study evaluates a comprehensive intervention within the ASC program.

Purpose of the Study:

• To assess the acceptability, scalability, and effectiveness of a multi-component salt reduction intervention in a real-world setting in China.
• To evaluate the impact of the intervention on salt intake, blood pressure, and salt-related knowledge, attitude, and practice (KAP).

Main Methods:

• Cluster randomized controlled trial (RCT) design involving 2688 participants from 48 towns across 6 provinces.
• Intervention components include government engagement, health education, and targeted strategies for restaurants, home cooks, and schoolchildren.
• Data collection includes 24-hour urinary sodium excretion, blood pressure, and KAP surveys at baseline, 1-year, and 2-year follow-ups.

Main Results:

• Primary outcome: salt intake measured by 24-hour urinary sodium excretion after 1 year.
• Secondary outcomes: sustained reduction in salt intake, blood pressure changes, and KAP improvements at 1 and 2 years.
• Process evaluation and health economic analysis will also be conducted.

Conclusions:

• The study aims to provide evidence on the effectiveness of a comprehensive, real-world salt reduction strategy in China.
• Findings will inform public health policies and interventions to combat high salt intake and associated cardiovascular risks.