The research involved Queen Mary University of London, the George Institute for Global Health at Peking University Health Science Center and Changzhi Medical College.
The controlled trial conducted in 28 primary schools in Changzhi, northern China, indicated participating childrens’, parents’ and grandparents’ salt consumption was cut by a quarter across a school term (3.5 months). This resulted in a significant fall in systolic blood pressure in adults.
The study, also known as School-EduSalt (School Based Education Programme to Reduce Salt), included almost 280 children, aged about 10 years old. More than 550 adult family members, with an average age of 44, also took part.
During the study, children were taught about the dangers of eating salt and how to reduce it using the schools’ usual health education lessons. They then delivered the message to the whole family. In particular, children needed to persuade the person who did the cooking to reduce the amount of salt used at home.
Salt intake was measured at the beginning and the end of the study, each involving two consecutive 24-hour urine collections.
14 schools implemented the education plan and 14 were used for control purposes.
The average baseline salt intake for the children was 7g/day, while for the adults it was 11.7g/day, above the World Health Organisation’s 10g recommended threshold.
Fall in blood pressure
The education initiative led to children cutting their salt intake by 1.9 g/day (or a third of a teaspoon) in children and adults reducing their salt consumption by 2.9 g/day (half a teaspoon). The reduction was accompanied by a fall in systolic blood pressure of 2.3 mmHg in adults.
“The study provides a novel, feasible, effective and important approach to reducing salt intake in the population where most of the salt in the diet is added by consumers,” said Dr Feng He, the study’s principal investigator, senior research fellow at the Wolfson Institute, Queen Mary University of London.
“As the salt reduction education was delivered to children using the schools’ usual health education lessons, it could be easily incorporated into the national school curriculum. A nationwide implementation will lead to a major reduction in salt intake in the Chinese population and therefore a reduction in strokes and heart attacks.”
Professor Graham MacGregor, co-principal investigator of the study, chairman of World Action on Salt and Health (WASH) and Professor of cardiovascular medicine at the Wolfson Institute, Queen Mary University of London, said:“This study has achieved a reduction in salt intake of a quarter.
“Such a big reduction in salt intake could prevent approximately 400,000 stroke and heart attack events in China, half of which would be fatal.
“Universal primary education is a common goal in most national education policies, school children in other countries should also be taught about the harmful effects of salt on health. Conveying salt reduction message to children has the potential to set habits and attitudes that will persist throughout adulthood.”
Source: British Medical Journal
Published online, doi:http://www.bmj.com/cgi/doi/10.1136/bmj.h770
“School based education programme to reduce salt intake in children and their families (School-EduSalt): cluster randomised controlled trial”
Authors: F. He, Y. Wu, X-X Feng, J. Ma, Y. Ma, H. Wang, J. Zhang, J. Yuan, C-P Lin, C. Nowson, G. MacGregor