Reducing daily salt intake in China by 1 g could prevent almost 9 million cardiovascular events by 2030: a modelling study

Tan, Monique; He, Feng J; Morris, Joan K.; MacGregor, Graham A.

doi:10.1136/bmjnph-2021-000408

Cited by 19 publications

(14 citation statements)

References 35 publications

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“…According to the latest dietary survey, the salt added by individuals during cooking was 9.3 g/d, accounting for 70–75% of the total salt intake [ 12 , 41 ]. It was estimated that reducing daily salt intake in China just 1 g could prevent almost 9 million cardiovascular events and save 4 million lives by 2030 [ 42 ]. Fully aware of the harm that high-salt diets cause and the benefits of salt reduction, the Chinese government has issued a series of policies [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Salt-Related Knowledge, Attitudes, and Behaviors and Their Relationship with 24-Hour Urinary Sodium Excretion in Chinese Adults

Fan

Li²,

Li³

et al. 2022

Nutrients

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Salt intake in China is very high, which increases the risk of hypertension and cardiovascular disease. This study aimed to assess the levels of salt-related knowledge, attitudes, and behaviors (KABs) and the factors that influence them and to explore the relationship between the scores of salt-related KAB and 24-h urinary sodium excretion. In 2018, we collected data from 5453 individuals aged 18–75 years from six provinces in China. A face-to-face survey was carried out, focusing on the KAB related to salt reduction. All participants were asked to collect one 24-h urine sample. Of the 5453 participants, 5352 completed urine collection. The mean score for overall KAB was 31.27 (SD = 9.18), which was composed of three elements: knowledge 4.80 (SD = 5.14), attitude 9.33 (SD = 3.93), and behavior 17.14 (SD = 4.43). The average 24-h urinary sodium excretion was 187.70 (SD = 77.48) mmol, which was equivalent to a urinary sodium excretion of 4.32 (SD = 1.78) g/d. We found that salt-related knowledge, attitude, behavior, and overall KAB scores were all inversely associated with 24-h urinary sodium excretion. For every one-point increase in the KAB score, the 24-h urinary sodium excretion decreased by 0.851 mmol (95% CI: −1.095, −0.602). We also found that location (rural/urban), sex, age, and education are associated with salt-related KAB scores. These results suggest that large-scale health education is needed to reduce salt intake in the Chinese population. In particular, efforts should be focused on reaching those who live in rural areas with low educational levels and older people.

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Section: Discussionmentioning

confidence: 99%

Salt-Related Knowledge, Attitudes, and Behaviors and Their Relationship with 24-Hour Urinary Sodium Excretion in Chinese Adults

Fan

Li²,

Li³

et al. 2022

Nutrients

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“…These potential benefits may be even more pronounced internationally [44]. Tan et al [45] conducted a modelling study to assess salt reduction's impact on CVD in China, through its effects on BP. Their findings indicate that even a 1 g/day reduction in salt intake in China, sustained until 2030, would prevent an average of 9 million CVD events and an average of 4 million deaths [45].…”

Section: Effect Of Sodium Restriction On Blood Pressure In Randomized...mentioning

confidence: 99%

Salt restriction for treatment of hypertension – current state and future directions

Nolan,

McEvoy

2023

Current Opinion in Cardiology

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Purpose of review Given the adverse effects of excess dietary sodium chloride (also known as table salt) on blood pressure (BP) and cardiovascular disease (CVD), restriction of dietary sodium is recommended by numerous guidelines. The strictest of these recommend no more than 1.5 g/day of dietary sodium among hypertensive persons. However, average dietary sodium intake in the population is closer to 5 g/day and there is debate about whether too much sodium restriction may be associated with increased CVD risk. Herein, we aim to provide a balanced update on this topic. Recent findings In 2021, the Salt Substitute and Stroke Study (SSaSS) demonstrated a significant reduction in BP, CVD, and death among Chinese adults randomized to a low sodium salt-substitute supplemented with potassium. This trial largely puts to rest any remaining debate about the benefits of dietary sodium restriction among persons with excess baseline intake (dietary sodium intake fell from approximately 5 down to 4 g/day in the active arm of SSaSS). However, whether achieving and maintaining a dietary sodium of less than1.5 g/day is feasible in real-world settings and whether this low an intake is harmful remain open questions. Summary Aiming for sodium intakes of 2--3 g/day in the general population and as low as 2 g/day in persons with hypertension or CVD seems most reasonable, but there is some uncertainty around lower targets.

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“…5 In China, the average consumption of sodium is about 4.3 g per day, which is among the highest in the world. 6 The World Health Organization (WHO) introduced a "strong recommendation" to set the upper limit of sodium intake at 2.0 g per day, and WHO Member States have committed to reducing the global population's salt intake by 30% by 2025. 7 Therefore, reducing sodium intake has become an urgent public health need in all countries.…”

Section: ■ Introductionmentioning

confidence: 99%

“…The recommended daily value of sodium in the USA is set at 2.3 g, but only 10% of the population meets this recommendation . In China, the average consumption of sodium is about 4.3 g per day, which is among the highest in the world . The World Health Organization (WHO) introduced a “strong recommendation” to set the upper limit of sodium intake at 2.0 g per day, and WHO Member States have committed to reducing the global population’s salt intake by 30% by 2025 .…”

Section: Introductionmentioning

confidence: 99%

Preparation of Saltiness-Enhancing Enzymatic Hydrolyzed Pea Protein and Identification of the Functional Small Peptides of Salt Reduction

Xue

Song

Zhou

et al. 2023

J. Agric. Food Chem.

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According to the correlation of saltiness determined by electronic tongue and perceived NaCl concentration, favorable enzymatic hydrolysis parameters were achieved to prepare the saltiness enhancing mixture peptides from pea protein. Six peptide fractions (F1, F2, F3, F4, F5, and F6) were isolated using Sephadex G-10 gel filtration. Among them, fraction F4 (0.1%) exhibited the highest saltiness (5.90 ± 0.03). The amino acid sequences of five main peptides identified by time-of-flight mass spectrometry were Tyr-Trp (367.40 Da), Gly-Glu-His-Glu (470.43 Da), Glu-Arg-Phe-Gly-Pro (604.65 Da), Gly-Ala-Gly-Lys (331.37 Da), and Pro-Gly-Ala-Gly-Asn (414.41 Da). Tyr-Trp (0.01%) in 0.4% NaCl solution had a 20% saltiness-enhancement compared with 0.4% NaCl solution. More salivary aldosterone was secreted after tasting hydrolysate or Tyr-Trp solutions via enzyme-linked immunosorbent assay, reflecting the improvement of human sensitivity to saltiness. Thereby, the saltiness-enhancing effect was confirmed for the small peptides from hydrolyzed pea protein and the main contributor was further identified.

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Reducing daily salt intake in China by 1 g could prevent almost 9 million cardiovascular events by 2030: a modelling study

Cited by 19 publications

References 35 publications

Salt-Related Knowledge, Attitudes, and Behaviors and Their Relationship with 24-Hour Urinary Sodium Excretion in Chinese Adults

Salt-Related Knowledge, Attitudes, and Behaviors and Their Relationship with 24-Hour Urinary Sodium Excretion in Chinese Adults

Salt restriction for treatment of hypertension – current state and future directions

Preparation of Saltiness-Enhancing Enzymatic Hydrolyzed Pea Protein and Identification of the Functional Small Peptides of Salt Reduction

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