Format

Send to

Choose Destination
PLoS One. 2016 Dec 9;11(12):e0166620. doi: 10.1371/journal.pone.0166620. eCollection 2016.

The Effects of a Community-Based Sodium Reduction Program in Rural China - A Cluster-Randomized Trial.

Li N1,2,3, Yan LL1,4, Niu W5, Yao C6, Feng X7, Zhang J8, Shi J9, Zhang Y10, Zhang R11, Hao Z1, Chu H1,5, Zhang J1, Li X1, Pan J6, Li Z7, Sun J8, Zhou B9, Zhao Y10, Yu Y11, Engelgau M12, Labarthe D4, Ma J13, MacMahon S2,3, Elliott P14, Wu Y1,5,6, Neal B2,3,14,15.

Author information

1
The George Institute for Global Health at Peking University Health Science Center, Beijing, China.
2
The George Institute for Global Health, Sydney, Australia.
3
Sydney Medical School, the University of Sydney, Sydney, Australia.
4
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America.
5
School of Public Health, Peking University Health Science Center, Beijing, China.
6
Peking University Clinical Research Institute, Beijing, China.
7
Changzhi Medical College, Changzhi, Shanxi, China.
8
Hebei Province Center for Disease Prevention and Control, Shijiazhuang, Hebei, China.
9
First Hospital of China Medical University, Shenyang, Liaoning, China.
10
Ningxia Medical University, Yinchuan, Ningxia, China.
11
Xi'an Jiaotong University, Xi'an, Shaanxi, China.
12
United States Centers for Disease Control and Prevention, Beijing, China.
13
Chinese Center for Disease Control and Prevention, Beijing, China.
14
Imperial College London, United Kingdom.
15
Royal Prince Alfred Hospital, Sydney.

Abstract

BACKGROUND:

Average sodium intake and stroke mortality in northern China are both among the highest in the world. An effective, low-cost strategy to reduce sodium intake in this population is urgently needed.

OBJECTIVE:

We sought to determine the effects of a community-based sodium reduction program on salt consumption in rural northern China.

DESIGN:

This study was a cluster-randomized trial done over 18 months in 120 townships (one village from each township) from five provinces. Sixty control villages were compared to 60 intervention villages that were given access to a reduced-sodium, added-potassium salt substitute in conjunction with a community-based health education program focusing on sodium reduction. The primary outcome was the difference in 24-hour urinary sodium excretion between randomized groups.

RESULTS:

Among 1,903 people with valid 24-hour urine collections, mean urinary sodium excretion in intervention compared with control villages was reduced by 5.5% (-14mmol/day, 95% confidence interval -26 to -1; p = 0.03), potassium excretion was increased by 16% (+7mmol/day, +4 to +10; p<0.001), and sodium to potassium ratio declined by 15% (-0.9, -1.2 to -0.5; p<0.001). Mean blood pressure differences were -1.1 mm Hg systolic (-3.3 to +1.1; p = 0.33) and -0.7 mm Hg diastolic (-2.2 to +0.8, p = 0.35) and the difference in the proportion with hypertension was -1.3% (-5.1 to 2.5, p = 0.56).

CONCLUSION:

There were clear differences in population sodium and potassium intake between villages that were most likely a consequence of increased use of salt substitute. The absence of effects on blood pressure reflects the moderate changes in sodium and potassium intake achieved.

TRIAL REGISTRATION:

Clinicaltrials.gov identifier: NCT01259700.

PMID:
27935977
PMCID:
PMC5147834
DOI:
10.1371/journal.pone.0166620
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Public Library of Science Icon for PubMed Central
Loading ...
Support Center