A school-based education programme to reduce salt intake in children and their families
Lead Research Organisation:
Queen Mary University of London
Department Name: Wolfson Institute
Abstract
Cardiovascular disease (i.e. strokes, heart attacks and heart failure) is the leading cause of death and disability worldwide. Raised blood pressure is a major cause of cardiovascular disease, accounting for 62% of strokes and 49% of heart attacks. Dietary salt intake is the major factor that increases blood pressure and is largely responsible for the rise in blood pressure with age.
Although cardiovascular events occur most frequently after the age of 40 years and the prevalence of hypertension is very low in children, the origins of hypertension and cardiovascular disease occur in childhood. Accordingly, the greatest long-term potential to reduce these conditions is to initiate prevention activities in youth. Such a public heath strategy aimed at preventing or slowing the progression of rising blood pressure altogether would have enormous benefits.
Previous studies have demonstrated that salt intake plays an important role in regulating blood pressure in children. A lower salt diet in children could prevent the development of hypertension and cardiovascular disease later in life.
Despite the evidence above, there is no reliable data on how much salt children are eating now and no strategy on how to keep children on a low salt intake.
We propose to carry out a cross-sectional study to determine the current salt intake in children by using the gold standard method, i.e. measuring 24-h urinary sodium. Furthermore, we will carry out a randomised trial to determine whether an education programme targeted at school children can lower salt intake in children and their families.
Our study will be carried out in China which is the largest low- and middle-income country in the world. The successful completion of our study will be the start of a national salt reduction programme which will reduce salt intake both in children and in adults. Furthermore, our salt reduction programme could be adopted by many other low- and middle-income countries. A modest reduction in salt intake across the whole population will lower population blood pressure and prevent many thousands of strokes, heart attacks and heart failure each year, and also lead to major cost-savings to individuals, their families and the health services.
Although cardiovascular events occur most frequently after the age of 40 years and the prevalence of hypertension is very low in children, the origins of hypertension and cardiovascular disease occur in childhood. Accordingly, the greatest long-term potential to reduce these conditions is to initiate prevention activities in youth. Such a public heath strategy aimed at preventing or slowing the progression of rising blood pressure altogether would have enormous benefits.
Previous studies have demonstrated that salt intake plays an important role in regulating blood pressure in children. A lower salt diet in children could prevent the development of hypertension and cardiovascular disease later in life.
Despite the evidence above, there is no reliable data on how much salt children are eating now and no strategy on how to keep children on a low salt intake.
We propose to carry out a cross-sectional study to determine the current salt intake in children by using the gold standard method, i.e. measuring 24-h urinary sodium. Furthermore, we will carry out a randomised trial to determine whether an education programme targeted at school children can lower salt intake in children and their families.
Our study will be carried out in China which is the largest low- and middle-income country in the world. The successful completion of our study will be the start of a national salt reduction programme which will reduce salt intake both in children and in adults. Furthermore, our salt reduction programme could be adopted by many other low- and middle-income countries. A modest reduction in salt intake across the whole population will lower population blood pressure and prevent many thousands of strokes, heart attacks and heart failure each year, and also lead to major cost-savings to individuals, their families and the health services.
Technical Summary
The first phase of our proposal is to carry out a cross-sectional study in 400 primary school children with age of 7 to 11 years, to assess salt intake by measuring 24h urinary sodium excretion. We will also measure blood pressure (BP), height, weight, hip and waist circumference using a standard protocol.
The second phase is to carry out a cluster randomised controlled trial in 240 children aged 10-11 years. After baseline assessments including 24h urine, BP and anthropometry, schools will be randomly allocated to either the control or intervention group. Additionally, both parents and grandparents of the participating children will be invited to take part in the study.
Intervention group: Our target is to lower salt intake by 20% for both children and their families. The intervention will be delivered to school children who will be empowered to persuade their parents and grandparents to reduce the amount of salt used during food preparation. The intervention consists of two components, i.e. classroom and family.
Control group: All children, their parents and grandparents in the control group will have the same measurements as those in the intervention group, but no salt awareness education will be given.
Duration and follow-up: The duration will be one school term, i.e. 5 months. All measurements made at baseline will be repeated at mid-term and again at the end of the trial. The biochemist who performs the measurements of urinary electrolytes will not be told which group the participant is allocated. The use of automatic BP device will minimise observer bias with BP measurement.
Outcomes: The primary outcome is the difference between the intervention and control group in the change in 24-h urinary sodium from baseline to the end of follow-up. The secondary outcome is the difference between the two groups in the change in BP.
The second phase is to carry out a cluster randomised controlled trial in 240 children aged 10-11 years. After baseline assessments including 24h urine, BP and anthropometry, schools will be randomly allocated to either the control or intervention group. Additionally, both parents and grandparents of the participating children will be invited to take part in the study.
Intervention group: Our target is to lower salt intake by 20% for both children and their families. The intervention will be delivered to school children who will be empowered to persuade their parents and grandparents to reduce the amount of salt used during food preparation. The intervention consists of two components, i.e. classroom and family.
Control group: All children, their parents and grandparents in the control group will have the same measurements as those in the intervention group, but no salt awareness education will be given.
Duration and follow-up: The duration will be one school term, i.e. 5 months. All measurements made at baseline will be repeated at mid-term and again at the end of the trial. The biochemist who performs the measurements of urinary electrolytes will not be told which group the participant is allocated. The use of automatic BP device will minimise observer bias with BP measurement.
Outcomes: The primary outcome is the difference between the intervention and control group in the change in 24-h urinary sodium from baseline to the end of follow-up. The secondary outcome is the difference between the two groups in the change in BP.
Planned Impact
Humans only need a very small amount of salt from the diet, i.e. less than 1 g per day to maintain normal physiological function. However, the vast majority of the population including children eat far more salt than they need (on average most adult populations in the world eat 9-12 times that level). This high salt intake increases blood pressure and thereby increases the risk of cardiovascular disease such as stroke, heart attack and heart failure.
Our study will develop a new approach to reduce salt intake both in children and in adults. The immediate benefit from a reduction in salt intake is to lower blood pressure. For adults, this will have an immediate and significant benefit on reducing the risk of suffering a stroke, heart attack or heart failure. For children, a lower salt intake will prevent the development of hypertension and thereby cardiovascular disease later in life.
Because almost everyone eats far more salt than they require, almost everyone stands to benefit from a reduction in salt intake. From a population viewpoint, even a modest reduction in salt intake across the whole population will have a large impact on reducing the appalling burden of cardiovascular disease in the population.
Furthermore, it has also been demonstrated that a reduction in salt intake not only saves lives, but also saves money to individuals and the health service. To put the magnitude of the potential benefits in context, a paper in the Lancet demonstrates that a modest reduction in salt intake is more, or at the very least just, as cost-effective as tobacco control in terms of reducing cardiovascular disease - the leading cause of death and disability worldwide.
Our study will develop a new approach to reduce salt intake both in children and in adults. The immediate benefit from a reduction in salt intake is to lower blood pressure. For adults, this will have an immediate and significant benefit on reducing the risk of suffering a stroke, heart attack or heart failure. For children, a lower salt intake will prevent the development of hypertension and thereby cardiovascular disease later in life.
Because almost everyone eats far more salt than they require, almost everyone stands to benefit from a reduction in salt intake. From a population viewpoint, even a modest reduction in salt intake across the whole population will have a large impact on reducing the appalling burden of cardiovascular disease in the population.
Furthermore, it has also been demonstrated that a reduction in salt intake not only saves lives, but also saves money to individuals and the health service. To put the magnitude of the potential benefits in context, a paper in the Lancet demonstrates that a modest reduction in salt intake is more, or at the very least just, as cost-effective as tobacco control in terms of reducing cardiovascular disease - the leading cause of death and disability worldwide.
Publications
Campbell NRC
(2023)
2022 World Hypertension League, Resolve To Save Lives and International Society of Hypertension dietary sodium (salt) global call to action.
in Journal of human hypertension
Valero-Morales I
(2022)
24-hour sodium and potassium excretion in the Americas: a systematic review and meta-analysis.
in Revista panamericana de salud publica = Pan American journal of public health
He FJ
(2018)
Action on Salt China.
in Lancet (London, England)
Zhang P
(2023)
An mHealth-based school health education system designed to scale up salt reduction in China (EduSaltS): A development and preliminary implementation study.
in Frontiers in nutrition
He FJ
(2022)
App based education programme to reduce salt intake (AppSalt) in schoolchildren and their families in China: parallel, cluster randomised controlled trial.
in BMJ (Clinical research ed.)
Sun Y
(2021)
App-Based Salt Reduction Intervention in School Children and Their Families (AppSalt) in China: Protocol for a Mixed Methods Process Evaluation.
in JMIR research protocols
Description | A case study to provide real-life examples from LMICs of how to take a life course approach at each critical life stage for reduction of future NCD risk |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Contribution to new or improved professional practice |
Impact | High salt intake is the major cause of raised blood pressure and thereby increases the risk of cardiovascular disease such as heart disease and stroke. Even a modest reduction in salt intake can lower blood pressure and the risk of cardiovascular disease. The School-based Education Programme to Reduce Salt was selected as a case study to demonstrate real-world application of behavioural change interventions tailored to children, with the aim of reducing the burden of non-communicable diseases (NCDs) in low- and middle-income countries. This study was recommended as a novel approach to target children and young people which will also influence behaviour in their adult family members. There is great potential to drive the adoption of this approach among policymakers, researchers, and implementers, thereby strengthening policy and programmes that target NCDs and improve global health equity. |
URL | https://globalncdsuk.org/2023/02/03/a-life-course-approach-to-ncds-new-report/ |
Description | Case study to highlight the importance of implementation research in working towards practice and policy solutions |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Contribution to new or improved professional practice |
Impact | The School-based Education Programme to Reduce Salt is recommended as a novel approach to lowering salt intake, focusing on children in primary school education and their families in China. The case study highlights the health benefits of reducing salt intake, presents the research evidence which helps drive the changes necessary to tackle NCDs, shows how the projects and approaches fit to the context of the problem in China. |
URL | https://gacd.org/our-impact/case-studies/reducing-salt-intake-through-a-school-based-education-progr... |
Description | A Pilot Study of the Hospital-based Education Programme to Reduce Salt Intake in Hypertensive Patients in China (HerSalt) |
Amount | £11,000 (GBP) |
Funding ID | 2022-HUST-QMUL-SPRF-09 |
Organisation | Queen Mary University of London |
Sector | Academic/University |
Country | United Kingdom |
Start | 03/2022 |
End | 12/2023 |
Description | Development of country support tools to promote salt action in SEAR member States |
Amount | £19,098 (GBP) |
Organisation | World Health Organization (WHO) |
Sector | Public |
Country | Global |
Start | 09/2020 |
End | 12/2020 |
Description | Establishing salt reduction targets in the EMRO region and implementing a salt reduction strategy in Malaysia |
Amount | £207,060 (GBP) |
Organisation | Vital Strategies |
Sector | Charity/Non Profit |
Country | United States |
Start | 11/2020 |
End | 02/2023 |
Description | Mapping salt reduction initiatives and development of a scorecard to track progress in salt reduction policies in the WHO South-East Asia Region |
Amount | £32,200 (GBP) |
Funding ID | 202868266 |
Organisation | World Health Organization (WHO) |
Sector | Public |
Country | Global |
Start | 04/2022 |
End | 09/2022 |
Description | School-based education programme to reduce salt: Scaling-up in China (EduSaltS) |
Amount | £2,512,787 (GBP) |
Funding ID | MR/T024399/1 |
Organisation | Medical Research Council (MRC) |
Sector | Public |
Country | United Kingdom |
Start | 12/2019 |
End | 12/2023 |
Description | GIC & Changzhi Medical College |
Organisation | Changzhi Medical College |
Country | China |
Sector | Academic/University |
PI Contribution | The George Institute's research team serve as the liaison between the project and Changzhi Medical College, the headquarters for the field team. |
Collaborator Contribution | Changzhi Medical College serves as the headquarters for the field team. The director of the Medical College is a key member of the study team. Changzhi Medical College is responsible for the implementation of the study protocol. |
Impact | We have collaborated on a paper PMID: 23864214 |
Start Year | 2011 |
Description | GIC & Changzhi Medical College |
Organisation | George Institute for Global Health |
Country | Australia |
Sector | Academic/University |
PI Contribution | The George Institute's research team serve as the liaison between the project and Changzhi Medical College, the headquarters for the field team. |
Collaborator Contribution | Changzhi Medical College serves as the headquarters for the field team. The director of the Medical College is a key member of the study team. Changzhi Medical College is responsible for the implementation of the study protocol. |
Impact | We have collaborated on a paper PMID: 23864214 |
Start Year | 2011 |
Description | GIC & PKU |
Organisation | George Institute for Global Health |
Country | Australia |
Sector | Academic/University |
PI Contribution | The George Institute researchers serve as the primary liaison between Peking University Health Science Center and the project. |
Collaborator Contribution | Peking University Health Science Center provided the expertise in child and adolescent health to develop the salt reduction curriculum. They will also serve as the liaison between the study team and public health officials, as well as policy makers, to translate the research outputs into policy. |
Impact | The education materials, posters, curricula and message deliver strategies were developed by this partnership. This collaboration has resulted in a paper PMID: 23864214. |
Start Year | 2011 |
Description | GIC & PKU |
Organisation | Peking University |
Department | Institute of Child and Adolescent Health |
Country | China |
Sector | Academic/University |
PI Contribution | The George Institute researchers serve as the primary liaison between Peking University Health Science Center and the project. |
Collaborator Contribution | Peking University Health Science Center provided the expertise in child and adolescent health to develop the salt reduction curriculum. They will also serve as the liaison between the study team and public health officials, as well as policy makers, to translate the research outputs into policy. |
Impact | The education materials, posters, curricula and message deliver strategies were developed by this partnership. This collaboration has resulted in a paper PMID: 23864214. |
Start Year | 2011 |
Description | GIC & UM |
Organisation | George Institute for Global Health |
Country | Australia |
Sector | Academic/University |
PI Contribution | This research has provided an opportunity for global health research training and experience for a Fogarty Global Health Fellow. |
Collaborator Contribution | This partnership has provided support for a research team member in the international coordinator, qualitative evaluation and informatics role. |
Impact | The partnership has resulted in the development of the evaluation on field studies and software components of the intervention . |
Start Year | 2012 |
Description | GIC & UM |
Organisation | University of Michigan |
Department | Global REACH |
Country | United States |
Sector | Academic/University |
PI Contribution | This research has provided an opportunity for global health research training and experience for a Fogarty Global Health Fellow. |
Collaborator Contribution | This partnership has provided support for a research team member in the international coordinator, qualitative evaluation and informatics role. |
Impact | The partnership has resulted in the development of the evaluation on field studies and software components of the intervention . |
Start Year | 2012 |
Description | QMUL & GIC |
Organisation | George Institute for Global Health |
Country | Australia |
Sector | Academic/University |
PI Contribution | Queen Mary University of London (QMUL) and the George Institute China (GIC) collaborated on the initial proposal for this project. Dr Feng He (PI) and Professor Graham MacGregor (Co-PI) represent QMUL and Professor Yangfeng Wu (Co-PI) represents GIC. Researchers from QMUL contribute extensive experience in salt reduction research. |
Collaborator Contribution | The George Institute China serves as the primary liaison to the field team and field site. |
Impact | This collaboration has resulted in a paper PMID: 23864214. |
Start Year | 2011 |
Description | QMUL & GIC |
Organisation | Queen Mary University of London |
Department | Wolfson Institute of Preventive Medicine |
Country | United Kingdom |
Sector | Public |
PI Contribution | Queen Mary University of London (QMUL) and the George Institute China (GIC) collaborated on the initial proposal for this project. Dr Feng He (PI) and Professor Graham MacGregor (Co-PI) represent QMUL and Professor Yangfeng Wu (Co-PI) represents GIC. Researchers from QMUL contribute extensive experience in salt reduction research. |
Collaborator Contribution | The George Institute China serves as the primary liaison to the field team and field site. |
Impact | This collaboration has resulted in a paper PMID: 23864214. |
Start Year | 2011 |
Description | A keynote speech in the 42nd World Health Forum (Shizuoka) |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | Prof Graham MacGregor gave a keynote speech about The Importance of Reducing Salt Intake to Prevent Strokes and Heart Failure at the 42nd World Health Forum (2021, Shizuoka) supported by UNESCO and Ministry of Health, Labour and Welfare, Japan |
Year(s) Of Engagement Activity | 2021 |
Description | A presentation in an International e-Seminar organised by Universiti Putra Malaysia, Malaysia |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | On 29 June 2021, Prof Feng He gave a presentation in the International e-Seminar "FMHS UPM's Silver Jubilee: Education & Research Excellence in Diversity", which was organised by Universiti Putra Malaysia, Malaysia. The topic of Prof He's presentation was "Current Successful Experience of Worldwide Salt Reduction Programmes" . |
Year(s) Of Engagement Activity | 2021 |
URL | https://medic.upm.edu.my/upload/dokumen/20210621211704e-SEMINAR_FMHS_UPM_POSTER__v7.pdf |
Description | A series of presentations at 14th Asian Congress of Nutrition |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Professors Puhong Zhang and Dr. Yuan Li were invited to give presentations at the 14th Asian Congress of Nutrition in September 2023 in Chengdu. They delivered four presentations on topics related to salt reduction, including "Deepening salt reduction in China: suggested strategies," research on salt reduction in pre-packaged foods, and low-sodium salt substitutes. |
Year(s) Of Engagement Activity | 2023 |
URL | https://www.cast.org.cn/xw/KXYW/art/2023/art_96c2f7770d1342f6ab251222383eaaf7.html |
Description | A talk in a WHO SERO webinar organised by the WHO SEAR Office |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Policymakers/politicians |
Results and Impact | Prof Feng He gave a talk about "Scaling up population salt reduction in South-East Asia Region (SEAR)" in a WHO SERO webinar organised by the WHO SEAR office, 11th March 2021. |
Year(s) Of Engagement Activity | 2021 |
Description | An article published in The Conversation |
Form Of Engagement Activity | A magazine, newsletter or online publication |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Media (as a channel to the public) |
Results and Impact | Professor Feng He wrote an article for The Conversation (a network of not-for-profit media outlets) titled "There is no great salt debate: we should be consuming less". This article described a recent study published in Hypertension, which demonstrated a direct linear relationship between salt intake and mortality, i.e. the lower the salt intake, the lower the risk of deaths. A reduction in salt intake across the whole population, even by a small amount, will have an enormous benefit on health. This Conversation article was the top reads of the month (August 2019), with 28,850 reads. Following the publication of the Conversation article, The Independent published an article with a title of "Even small reductions in nation's salt intake result in enormous health benefits". Furthermore, the Conversation article was translated from English into Indonesian and then published in The Conversation Indonesia, which is part of the Australia-based The Conversation Media Group global network. |
Year(s) Of Engagement Activity | 2019 |
URL | https://theconversation.com/there-is-no-great-salt-debate-we-should-be-consuming-less-120874 |
Description | Contributed to the best practice collection on health education and health promotion organized by CCHE |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | EduSaltS partners contributed to the collection of best practices on health education and health promotion organized by CCHE for the 2023 Health Promotion National Conference. The intervention and pilot experiences of EduSaltS received significant recognition from CCHE. Professor Puhong Zhang delivered a presentation at the conference, further highlighting the impactful contributions of EduSaltS. |
Year(s) Of Engagement Activity | 2023 |
Description | Dissemination of health education materials, including EduSaltS outputs through social media and website |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Media (as a channel to the public) |
Results and Impact | Health education messages and materials, alongside the research outputs of EduSaltS, have been continuously disseminated and communicated through social media channels and the project website from 2022 to 2024. Particularly during significant events like World Salt Awareness Week, World Hypertension Day, China's Salt Awareness Week (September 15th), and China's Schoolchildren's Nutrition Day (May 20th), these educational resources and project findings were prominently showcased on various social media platforms and websites, which has facilitated extensive outreach of the salt reduction message, effectively reaching millions of individuals across China. |
Year(s) Of Engagement Activity | 2022,2023,2024 |
URL | https://mp.weixin.qq.com/s?__biz=MzU2Mzg0MjMwMA==&mid=2247485801&idx=1&sn=285871eeb5654b2d702cff4497... |
Description | Engagement with policy makers |
Form Of Engagement Activity | A magazine, newsletter or online publication |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | A book that provides detailed description of the school-based education programme to reduce salt was sent to 20 members of the National Committee of the Chinese People's Political Consultative Conference who have interests in salt and health. Policies to promote salt reduction and salt substitute are expected to be proposed through the committee. |
Year(s) Of Engagement Activity | 2016 |
Description | Expanding School-EduSalt to other Low- and Middle-Income Countries. |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Other audiences |
Results and Impact | School-EduSalt is being adapted for reducing salt intake in Malawi. High blood pressure is a growing problem in sub-Saharan Africa, including low-income countries like Malawi, in part driven by high salt intake across all sub-groups of the population. The Malawi Epidemiology and Intervention Research Unit, together with the Malawi Ministry of Health NCD Department and the School Health and Nutrition programme, are carrying out a salt reduction study in urban and rural Malawi modelled on the successful EduSalt trial in China. The project is being funded by the UK MRC. The study, if successful, will have major public health implications in terms of reducing blood pressure and cardiovascular disease in Malawi. Professor Feng He and Professor Graham MacGregor had a Skype meeting and a face-to-face meeting with the researchers of the Malawi team to share experience and expertise. |
Year(s) Of Engagement Activity | 2018,2019 |
Description | Health communication through china.com.cn |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | EduSaltS partners have collaborated with china.com.cn, one of the most influential and official media partner to cover the news on salt reduction, including school-based salt reduction practices throughout the years. This collaborative partnership will continue in 2024. |
Year(s) Of Engagement Activity | 2023,2024 |
URL | https://t.m.china.com.cn/convert/c_rMNCD9TW.html |
Description | Health education popularization and publicity on salt reduction |
Form Of Engagement Activity | A broadcast e.g. TV/radio/film/podcast (other than news/press) |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Media (as a channel to the public) |
Results and Impact | The health education materials, ranging from salt reduction health education manuals to public service advertisements, sitcoms, animation courses, and children's picture books, developed by the project team, were consistently showcased on the WeChat official account of the China Health Education Center. This initiative played a pivotal role in widely disseminating the concept of "less salt, healthier living" and aiding the general public in acquiring salt reduction knowledge and skills. |
Year(s) Of Engagement Activity | 2023 |
URL | https://mp.weixin.qq.com/s/-gFZ969zdr7eTnTH_K2Q1w |
Description | Luzhou International Cardiology Conference |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Dr. Feng He was an invited Keynote speaker at Luzhou International Cardiology Conference July 2017. Approximately 700 people attended the conference. The attendees were a mix of academics, health professionals, government officials, representatives from non-government organisations, and students. Dr. He gave a presentation on salt, blood pressure and cardiovascular disease. She also took the opportunity to present the School-EduSalt programme, calling for widespread implementation across China. The presentation received very positive feedback. |
Year(s) Of Engagement Activity | 2017 |
Description | Media release about BMJ published the findings from the app-based education programme to reduce salt intake in schoolchildren and their families |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Media (as a channel to the public) |
Results and Impact | "LifeTimes" newspaper and WeChat Official Account "Salt and Health" reported the news that the primary findings from the app-based education programme to reduce salt intake in schoolchildren and their families were published in BMJ. The news highlighted the great potential to reduce population salt intake and promote other healthy habits using school settings and Child-to-Parent Approach. If the study is scaled up nationwide, it will effectively promote the national salt reduction action, thereby reducing population salt intake in China and reducing the risk of stroke and heart disease. (https://mp.weixin.qq.com/s/Mvq8UWDGe4blIuKkkQckXg) |
Year(s) Of Engagement Activity | 2022 |
URL | https://www.lifetimes.cn/article/47KrmOiByRB |
Description | NIHR Global Health Research Unit Action on Salt China (ASC) Launch |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | Following the success of the school-based education programme to reduce salt (School-EduSalt) in northern China, Dr Feng He and Professor Graham MacGregor have secured an NIHR grant to further the salt reduction programme in China. In collaboration with Professor Puhong Zhang at the George Institute China, they have set up an NIHR Global Health Research Unit Action on Salt China (ASC). ASC will carry out various research and public health programmes with an aim of reducing salt intake by 15% by 2021 in China. ASC has established partnerships with several Chinese health authorities including Chinese Centre for Disease Control and Prevention (China CDC), Chinese Centre for Health Education (CCHE) and China National Centre for Food Safety Risk Assessment (CFSA). ASC organised a Launch event in Beijing on 11th October 2017. The event was very successful in generating the momentum of salt reduction in China. The key message has reached a wide range of the population through press release and media coverage. Importantly, the event was attended by several senior officials from central and provincial government, e.g. Mr. Qunan Mao, Director-General of Department of Communication and Health Promotion at the National Health and Family Planning Commission (former Ministry of Health), Mr. Changning Li, Director-General of Chinese Center for Health Education, Professor Xinhua Li, Party Committee Secretary of China CDC, Professor Weixing Yan, Vice Director-General of China National Center for Food Safety Risk Assessment. There were also representatives from non-governmental organisations, WHO China office, British Embassy in Beijing, Academic Associations, the food industry, etc. All have expressed strong support for salt reduction and their willingness to collaborate and cooperate with ASC on this important course which will not only benefit the Chinese people, but also contribute to global health development. ASC will continue to engage policy makers and other stakeholders to ensure research findings can be translated into public health policies, leading to a sustainable impact. |
Year(s) Of Engagement Activity | 2017 |
Description | Presentation on salt reduction and sharing experience in a webinar organised by Malaysian collaborators |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Prof Feng He presented evidence for salt reduction and shared experience from the UK and China, in a webinar organised by Malaysian collaborators. The webinar was attended by more than 700 people including policymakers, academics, students and the public. |
Year(s) Of Engagement Activity | 2022 |
Description | Press release for paper published in BMJ |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Media (as a channel to the public) |
Results and Impact | Upon publication of the BMJ paper, both WASH (World Action on Salt and Health) and The George Institute issued press releases which were picked up by many media outlets, generating wide media coverage in the UK, China and many other countries. Therefore, this research has had a wide reach, and has been disseminated to a large proportion of the general population. |
Year(s) Of Engagement Activity | 2015 |
URL | http://www.actiononsalt.org.uk/news/Salt%20in%20the%20news/2015/150750.html |
Description | Press release on China's school-based salt reduction model recognized by GACD |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | The WeChat Official Account - Salt and Health reported the news that China's school-based salt reduction model has been recognized by GACD as one of the best practices that help to drive the changes necessary to tackle NCDs. The case study showed how the projects and approaches fit into the context of China to lower blood pressure and reduce the risk of cardiovascular disease through salt reduction in school settings. |
Year(s) Of Engagement Activity | 2022 |
URL | https://mp.weixin.qq.com/s/P74ew-P6i23h5lV_9fS1hQ |
Description | Prof Feng He gave a Special Lecture about salt reduction at 22nd IUNS-ICN Tokyo, Japan |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Prof Feng He attended the 22nd International Congress of Nutrition (ICN) in Japan in Dec 2022. The aim of the conference is to promote the exchange of knowledge in Nutritional Sciences. Prof He gave a special lecture on Salt and Health in the session on Public Health Nutrition and Environment. She presented the evidence on salt and health, shared the salt reduction experience from the UK and China, and called for action that every country must develop a coherent, workable salt reduction plan and implement the plan to reduce the population salt intake to <5 g/d. Good feedback was received. A team in Japan leading the research on reducing sodium while enhancing taste desirability is very interested in the lecture and expressed their interest to explore the opportunity for further collaboration. |
Year(s) Of Engagement Activity | 2022 |
URL | https://icn22.org/program_lecture02.html |
Description | Prof Feng He gave a presentation about the UK's salt reduction experience at 22nd IUNS-ICN Tokyo, Japan |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Prof Feng He attended the 22nd International Congress of Nutrition (ICN) in Japan in Dec 2022. In the session of Public Health Nutrition and Environment, Prof He was invited to give a talk at the Symposium: Prevention of cardiovascular disease by population approach focusing on nutrition and diet in Europe, America and Japan. Prof He took this opportunity to show the UK salt reduction strategy, how to monitor the salt level and the impacts on public health achieved. |
Year(s) Of Engagement Activity | 2022 |
URL | https://confit.atlas.jp/guide/event/icn2022/subject/SY_T6_18-03/category?cryptoId= |
Description | Researchers contributed to BBC StoryWorks Facing Forward series: The cultural sensitivities of salt reduction. |
Form Of Engagement Activity | A broadcast e.g. TV/radio/film/podcast (other than news/press) |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | The research team contributed to BBC StoryWorks Facing Forward series, hosted by the NCD Alliance: The cultural sensitivities of salt reduction, which was launched during Global Week for NCDs on 28 September 2021. Produced by BBC StoryWorks Commercial Productions and presented by the NCD Alliance, this major new series integrates the stories of people who are living with NCDs across the globe, with those of organisations, communities, and individuals who are leading the way to prevent and control NCDs. One of the research team members contributed a short documentary-style audio piece to talk about the use of smartphone-based program to infuse salt reduction messages into students and their families. This audio piece reached a wide audience range and reflected the importance of reducing salt intake, how the projects and approaches fit to the context and how to adapt the programme further for harder-to-reach rural students. |
Year(s) Of Engagement Activity | 2021 |
URL | https://ncdalliance.org/facing-forward/content/cultural-sensitivities-salt-reduction |
Description | Salt reduction conference organised by China CDC |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Other audiences |
Results and Impact | Professor Feng He was an invited speaker at the salt reduction conference organised by China CDC in September 2018, Beijing. Over 50 people attended the conference. The attendees were a mix of academics, health professionals, government officials, representatives from non-government organisations, and students. Professor He gave a presentation on salt, blood pressure and cardiovascular disease. She also took the opportunity to present the School-EduSalt programme, calling for widespread implementation across China. The presentation received very positive feedback. |
Year(s) Of Engagement Activity | 2018 |
Description | Salt reduction in Malawi |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | The school-based education programme (School-EduSalt) is being adapted for reducing salt intake in Malawi. A project entitled "NoToNa: Tackling cardiovascular risk in the adolescent life-course through a schools' salt-reduction intervention in sub-Saharan Africa" is being carried out by a research team from London School of Hygiene & Tropical Medicine (LSHTM) and Malawi Epidemiology and Intervention Research Unit (MEIRU), together with the Malawi Ministry of Health NCD Department and the School Health and Nutrition programme. The "NoToNa" study is funded by MRC/DFID/NIHR Adolescent Health Grant Ref: MR/R022186/1. Professor Feng He is an independent Trial Steering Committee (TSC) member for the "NoToNa" study in Malawi and attended the first TSC meeting to discuss study protocol, analysis plan, study progress, and to share experience and expertise. The study, if successful, will have major public health implications in terms of reducing blood pressure and cardiovascular disease in Malawi. |
Year(s) Of Engagement Activity | 2020 |
Description | School-EduSalt was included in the impact Brochure for RCUK funded programmes in China |
Form Of Engagement Activity | A magazine, newsletter or online publication |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | The School-EduSalt programme, as a case study, was included in the impact Brochure for RCUK funded programmes in China - "Shaping the Future: UK-China Collaborative Research" and received lots of positive feedback. |
Year(s) Of Engagement Activity | 2015 |
URL | http://www.rcuk.ac.uk/international/offices/china/chinanews/150727/ |
Description | Schoolchildren participated the Children's Art Competition organized by WHL to celebrate WHD in 2020, 2021, 2022 and 2023 |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Schools |
Results and Impact | A total of 106 schoolchildren, who have participated in the salt reduction interventions in EduSaltS program, took part in the annual Children's Art Competition organized by the World Hypertension League (WHL) to celebrate World Hypertension Day (WHD) from 2020 to 2023. These students created artworks, such as paintings, aligned with each year's WHD theme, focusing on promoting healthy lifestyles, hypertension control and prevention, including salt reduction, among other topics. This initiative significantly enhanced community participation and engagement, especially among children and their family members, in the communication and dissemination of health education messages. |
Year(s) Of Engagement Activity | 2020,2021,2022,2023 |
URL | https://www.whleague.org/index.php?preview=1&option=com_dropfiles&format=&task=frontfile.download&ca... |
Description | World Salt Awareness Week 2015 |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Media (as a channel to the public) |
Results and Impact | The study was published coinciding with the World Salt Awareness Week 2015, the theme of which was "Salt and Children". The Week highlighted the importance of reducing salt intake in children. Over 30 countries took part in the salt awareness week. Many countries expressed interest in the School-EduSalt programme. |
Year(s) Of Engagement Activity | 2015 |
URL | http://www.worldactiononsalt.com/awarenessweek/World%20Salt%20Awareness%20Week%202015/142120.html |
Description | print media support health communication for EduSaltS program |
Form Of Engagement Activity | A magazine, newsletter or online publication |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | Traditional media partners, such as Lifetime Magazine«????», China Food News«?????», Health News«???», etc. which are popular print media specialized in communicating and disseminating health information to both the general public and health professionals. Over the years, they have consistently covered EduSaltS achievements and research outputs. With millions of regular readers, their reach extends even to rural and remote regions of China, resulting in significant social impact. |
Year(s) Of Engagement Activity | 2023 |
URL | https://hebei.hebnews.cn/2023-05/30/content_9010496.htm |