Scaling up a school-based salt reduction program: EduSaltS is launched in Beijing

On 12 December 2019, the Chinese Center for Health Education (CCHE), the George Institute for Global Health Research (China) and Queen Mary University of London, jointly launched the "School-based Education Program to Reduce Salt", called EduSaltS, in Beijing. Over the next four years, the project will scale up of model of salt reduction across three cities (Beijing, Zhenjiang, and Shijiazhuang), to engage children to influence themselves and their families on how to reduce salt intake. Over 50 people, including project leaders from three project provinces (cities), and representatives of the British Embassy in China and World Health Organization, as well as experts and scholars in related fields, attended the launch meeting.

Li Yinghua, the Chinese representative of the EduSaltS project and CCHE researcher delivered the opening speech. She cited the State Council's Opinions on the Implementation of Healthy China Action Plan (issued by the State Council of China in 2019) which emphasizes the importance of salt reduction among primary and secondary school students, and how these activities have been integrated through three national health plans: health education for the public, recommendations for rational diet, and health promotion in primary and secondary schools. She said that EduSaltS well reflects the determination and cooperation of departments at all levels to raise public awareness, improve people’s health, and implement the Healthy China Action Plan.

Professor Craig Anderson, Executive Director of The George Institute China, congratulated the project on this exciting phase of the official launch. He emphaized the great challenge of scientific and medical research today is on achieving impact on policy and ultimately to enhance the health of populations through evidence-based interventions that are well implemented. “EdusaltS is one of the best examples that I know of in the world that is addressing this challenge by scaling up an effective salt reduction strategy to cover broad range of Chinese people, so that their health behaviours and conditions can be effectively improved.”

Dr Sarah Jevons, Head of Health and Life Sciences, China Prosperity Program at the British Embassy in China, shared the experiences of the UK government on a series of salt reduction measures implemented in that country. Through extensive collaboration with food industry to establish agreed salt reduction targets for pre-packaged foods, the average salt intake has been a great success in the UK, decreasing by 15% between 2003 and 2011. This is the equivalent of a reduction from 9.5g to 8.1gm per person per day, which equates to a large reductions in the rates of hypertension and cardiovascular deaths. The ongoing of Action on Salt China (ASC) project, from which EduSaltS has been developed, provides a solid foundation for similar success to be achieved for salt reduction in China.

Professor Zhang Xinhua, of the WHO China office, and President of the World Hypertension League, noted that salt reduction is an important work of WHO and is critical to achieving the goal of global chronic disease prevention and control, as well as the UN’s Sustainable Development Goals (SDG). "EduSaltS brings together the world's top experts and organisations in the field of salt reduction: World Action on Salt and Health (WASH) and The George Institute for Global Health. It assures strong allies in both academic and political area who collectively have the experience to bring about profound changes to the people of China and around the world."

In her speech, Professor He Fengjun, the British representative of the project from Queen Mary University of London, pointed out that China is among the countries with the highest salt intakes, with the average adult consuming more than 10 grams per person per day, of which 70-80% comes from household cooking. In 2013, the school-based salt reduction study conducted in Changzhi city, Shanxi Province, proved that after a semester of health intervention, the average salt intake of a child decreased by 2 grams, while the average for adults (family members) was reduced by 3 grams. "EduSaltS" explores a practical mechanism to scale up such intervention model. According to projected estimates, a nationwide promotion of such an intervention could prevent some 200,000 cardiovascular deaths per year, and of course bring about economic gains from reduced medical expenses.

Professor Zhang Puhong, Co-Lead of EduSaltS and Deputy Director of The George Institute China, introduced details of the project where some 1.7 million people die from conditions related to high salt intake each year. The pathway to reduce salt intake primarily from school children then to their families is an innovative attempt, which requires the participation of schools, students and parents. “EduSaltS will built upon previous research using a combination of online and offline innovative methods that include: a WeChat program and mobile APP technology to publish standardised, enjoyable and short health courses for children and their parents to learn and practice to achieve the goal of ‘salt reduction for the whole family’."

In the later discussion session, Dr. Li Yuan, Director of the Nutrition and Lifestyle department of The George Institute China, and Li Yinghua, CCHE Researcher, introduced specific strategies and plans for EduSaltS. Experts from Peking University, Fuwai Hospital, and the Changzhi Medical College, then provided professional comments and representatives of the health and education departments who will participate in the three project provinces outlined practical views and suggestions on how to conduct the study with regard to local conditions.

The EduSaltS project is funded by the British Medical Research Council (MRC) and the Global Alliance for Chronic Diseases (GACD) for a period of four years.