Yuewen Sun : Family-wide Salt Reduction Movement Starting with Children

Yuewen Sun is a research assistant under the Nutrition and Lifestyle Program. Let us hear her thoughts about preventing non-communicable diseases through the primary school salt reduction program.

How long have you been working at The George Institute?

I have been working here for almost a year since I joined George in August last year.

What is your professional background? Why did you decide to pursue global health research?

I obtained my bachelor’s degree majoring in preventive medicine from Wuhan University, then completed a master's degree in global health at Duke-Kunshan University.

I think global health considers population-wide impacts and implications in the creation of solutions. There are many common and serious diseases such as stroke, where after onset and even with treatment, it will still be difficult for patients to return to the physical state that they were in before disease occurrence, which is to say that their quality of life or their operational abilities in everyday life will certainly be somewhat lowered.

However, these diseases are often linked to the patients’ lifestyle or the primary interventions. If we can intervene before disease onset, it is likely to yield better results, and lower the cost of treatment. Therefore, I think global health is charming in this respect.

What research projects are you currently working on? How will they impact healthcare?

I am currently a research assistant of the Nutrition and Lifestyle Team, working on a sub-project of Action on Salt China – the primary school salt reduction project.

According to statistics, Chinese people are consuming a lot of salt, which may also be a major cause of disease burden. This means that if we are able to lower salt intake, it is likely that disease burden can be greatly reduced. However, it is very difficult to change people's eating habits. Therefore, we are exploring the possibility of changing the eating habits of an entire family through influencing children and changing their eating habits. Our point of entry is at a school, in a class of third grade pupils, exposing them to some courses through the use of our mobile phone application, to let them know that high consumption of salt is harmful to themselves and their family's health. We hope this enables them to realize that they should reduce their salt intake and also supervise their families to ensure that they reduce their salt intake as well – this is our overall idea.

Because our entire intervention process takes place over a year, the current intervention is at mid-stage and we have not seen the final result. However, if there is a good outcome for this project where we are able to achieve the pre-set goal, we hope that it can be promoted nation-wide or in primary school students within the provinces that have high salt intake.

Why did you think of using children as the point of entry for salt intake reduction?

We developed a health education kit series used professional knowledge, which includes some courses that were recorded into video clips. Then, we collaborated with the primary school teachers to let them translate the professional knowledge in the course content into a format and tone that the primary school students can better understand and absorb.

As children's diets are determined by their parents, we hope that the children will relay the knowledge they have learned to their parents and then supervise their parents to use less salt during the cooking process for the family. This is a reverse of the process where many projects have tried to intervene directly in adults, giving them direct health education, where they might say, "What you’re saying is right, but I can’t do it.".Therefore, we hope to use children as the point of entry, allowing children to influence their parents instead because Chinese families are very concerned about the growth and health of their children.

What is the significance of this early intervention?

Excessive salt intake will mainly give rise to hypertension, which in turn also leads to increased incidences of cardiovascular and cerebrovascular diseases. At present, other studies have shown that high salt intake is also correlated with gastric cancer as well as  osteoporosis and obesity. However, the clearest proven relationship currently is the one between salt and high blood pressure. And although not every parent has hypertension, some parents may have pre-hypertension or have a blood pressure that is within the normal range. In these states, high salt intake, though it has not led to hypertension yet, is still a risk factor. For those who are diagnosed with hypertension, they may get this knowledge from a doctor or nurse. However, there is still a significant proportion of the population who are still ignorant of such information. We are targeting both of these groups of people because for the hypertensive group of the population, they are generally 40-50 years or even older, and it is relatively difficult for them to change their eating habits. We hope to change this individual behavior into a family-wide behavior.

Why do you like working at the George Institute?

The Institute gives us more freedom to pursue our own research interests. For example, if you have a project of interest, you can apply for grants on your own. If the application is successful, you can then form a team to carry out the project. I also like the atmosphere of our small team where we can support each other, learn together and progress together.

In your opinion, what is the biggest challenge to global health today?

On one hand, there are not enough high-quality research for a number of existing public health issues within certain countries, which is to say that the existing problems have not been well studied.

On the other hand, there may be a gap between academia and the policy makers. For example, some studies, although it may involve high-quality research, cannot be well converted into policies. This may be because local governments have various considerations when formulating policies and it is just so that the benefits of the studies may not have fallen under the main considerations with regards to that particular policy.

In yet another aspect, I think communications is very important. Researchers need to find suitable ways to communicate study findings to policy makers.