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
Jones DW
(2022)
Potassium-Enriched Salt Substitution as a Population Strategy to Prevent Cardiovascular Disease.
in Hypertension (Dallas, Tex. : 1979)
Sun Y
(2022)
Process Evaluation of an Application-Based Salt Reduction Intervention in School Children and Their Families (AppSalt) in China: A Mixed-Methods Study.
in Frontiers in public health
Tan M
(2022)
Reducing daily salt intake in China by 1 g could prevent almost 9 million cardiovascular events by 2030: a modelling study
in BMJ Nutrition, Prevention & Health
He FJ
(2019)
Reducing population salt intake-An update on latest evidence and global action.
in Journal of clinical hypertension (Greenwich, Conn.)
Zhang P
(2020)
Reducing Salt Intake in China with "Action on Salt China" (ASC): Protocol for Campaigns and Randomized Controlled Trials.
in JMIR research protocols
He FJ
(2018)
Role of salt intake in prevention of cardiovascular disease: controversies and challenges.
in Nature reviews. Cardiology
Tan M
(2018)
Salt and cardiovascular disease in PURE: A large sample size cannot make up for erroneous estimations.
in Journal of the renin-angiotensin-aldosterone system : JRAAS
Tan M
(2019)
Salt content of sauces in the UK and China: cross-sectional surveys.
in BMJ open
Zhang P
(2018)
Salt reduction in China: from evidence to action
in The Lancet
He FJ
(2020)
Salt Reduction to Prevent Hypertension and Cardiovascular Disease: JACC State-of-the-Art Review.
in Journal of the American College of Cardiology
Burt HE
(2022)
Salt: the forgotten foe in UK public health policy.
in BMJ (Clinical research ed.)
He FJ
(2015)
School based education programme to reduce salt intake in children and their families (School-EduSalt): cluster randomised controlled trial.
in BMJ (Clinical research ed.)
Cheng YL
(2022)
Socioeconomic status and dietary sodium intake in children from 2008 to 2019 in the UK.
in Journal of hypertension
Du W
(2022)
Sodium Reduction in Restaurant Food: A Randomized Controlled Trial in China.
in Nutrients
Tan M
(2022)
Spot urinary sodium to monitor relative changes in population salt intake during the UK salt reduction programme.
in Journal of hypertension
Li Y
(2020)
Twenty-Four-Hour Urinary Sodium and Potassium Excretion and Their Associations With Blood Pressure Among Adults in China: Baseline Survey of Action on Salt China.
in Hypertension (Dallas, Tex. : 1979)
Tan M
(2019)
Twenty-Four-Hour Urinary Sodium and Potassium Excretion in China: A Systematic Review and Meta-Analysis.
in Journal of the American Heart Association
He FJ
(2019)
Urinary sodium excretion measures and health outcomes.
in Lancet (London, England)
| 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 | 04/2022 |
| 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 | 10/2020 |
| 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 | 05/2022 |
| 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 | 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 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 | Conference Presentation at George Think 2022 Event |
| 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 gave a talk about 'Translating evidence into practice for salt reduction - Experience from the UK" at the George Think Event on 20-22 July 2022. Prof He presented the UK salt reduction strategies and discussed the lessons learned from the UK salt reduction programmes. The event brought together more than 400 staff from across the George Institute for Global Health (TGI) globally to explore, reflect and develop new ideas and collaborative processes that can be transformed into real action to achieve the goal of improving the health of millions of people. Based on presentations and discussions, a wide range of recommendations have been developed for future action. |
| Year(s) Of Engagement Activity | 2022 |
| 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 | 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 | 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 |