The Effects of a Community-Based Sodium Reduction Program in Rural China - A Cluster-Randomized Trial.
The Effects of a Community-Based Sodium Reduction Program in Rural China - A Cluster-Randomized Trial.
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DOI：
10.1371/journal.pone.0166620
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Neal B
中科院分区：
文献类型：
--
作者：
Li N;Yan LL;Niu W;Yao C;Feng X;Zhang J;Shi J;Zhang Y;Zhang R;Hao Z;Chu H;Zhang J;Li X;Pan J;Li Z;Sun J;Zhou B;Zhao Y;Yu Y;Engelgau M;Labarthe D;Ma J;MacMahon S;Elliott P;Wu Y;Neal B
中国北部地区的平均钠摄入量和中风死亡率均位居世界前列。迫切需要一种有效、低成本的策略来减少这一人群的钠摄入量。我们试图确定以社区为基础的减钠计划对中国北部农村居民食盐消费的影响。本研究是一项为期18个月的整群随机试验，在5个省的120个乡镇(每个乡镇1个村)进行。将60个对照村庄与60个干预村庄进行比较，这些村庄在接受以减少钠为重点的社区健康教育计划的同时，获得了低钠、添加钾盐的替代品。主要结果是随机组之间24小时尿钠排泄量的差异。在1,903名24小时有效尿液采集者中，与对照村相比，干预村的平均尿钠排泄量减少了5.5%(-14 mmol/天，95%可信区间-26至-1；p=0.03)，钾排泄量增加了16%(+7 mmol/天，+4至+10；p<；0.001)，钠钾比下降了15%(-0.9p<；0.001)。平均血压差为-1.1 mm Hg收缩压(-3.3~+1.1；p=0.33)和-0.7 mm Hg舒张压(-2.2~+0.8，p=0.35)，合并高血压的比例为-1.3%(-5.1~2.5，p=0.56)。不同村庄之间的人口钠和钾摄入量存在明显差异，这很可能是盐替代品使用量增加的结果。对血压没有影响反映了钠和钾摄入量的适度变化。ClinicalTrials.gov标识符：NCT01259700。
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. We sought to determine the effects of a community-based sodium reduction program on salt consumption in rural northern China. 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. 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). 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. Clinicaltrials.gov identifier: NCT01259700.
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