A Town-Level Comprehensive Intervention Study to Reduce Salt Intake in China: Cluster Randomized Controlled Trial

Area of Science:

• Public Health
• Nutritional Science
• Cardiovascular Health

Background:

• High salt intake is a major risk factor for cardiovascular diseases globally.
• Comprehensive community-based interventions are explored to reduce population salt consumption.
• China faces a significant public health challenge due to high dietary salt intake.

Purpose of the Study:

• To evaluate the effectiveness of a town-level comprehensive intervention program on population salt intake.
• To assess the impact of the intervention on urinary sodium and potassium excretion.
• To examine changes in blood pressure, salt-related knowledge, and attitudes.

Main Methods:

• A parallel, cluster randomized controlled trial involving 48 towns across China.
• Baseline and one-year follow-up assessments included 24-hour urine collections, anthropometric measurements, and questionnaires.
• 2693 participants aged 18-75 years were recruited; 2335 provided valid follow-up data.

Main Results:

• No significant change in 24-hour urinary sodium excretion (salt intake) was observed between the intervention and control groups (p = 0.31).
• The intervention group showed a significant increase in 24-hour urinary potassium excretion (p = 0.004).
• Systolic blood pressure significantly decreased in the intervention group (p < 0.001), and salt reduction knowledge and attitudes improved (p < 0.05).

Conclusions:

• A one-year town-level intervention program did not significantly reduce population salt intake.
• The program demonstrated positive effects on potassium excretion, blood pressure reduction, and health knowledge/attitudes.
• Longer intervention periods and follow-up assessments are recommended to determine long-term effectiveness for salt reduction.