Excessive salt intake kills over 1.6 million people globally each year, and this UK-China research unit is exporting Britain’s proven salt-reduction strategy to five Chinese provinces where average consumption reaches 12–14 grams per day—more than double the WHO’s recommended limit. The problem is stark: China has no comprehensive salt-reduction programme, and nearly half its population lives in rural areas with high salt intake and limited health information. The poorest 55 million people survive on less than US$1 per day, making them most vulnerable to the cardiovascular diseases that salt drives. The UK’s own salt-reduction programme, led by the group behind this unit, cut national intake substantially by working with food manufacturers, restaurants, and home cooking. China lacks that coordinated approach. If successful, the unit will build a multidisciplinary team targeting the three main salt sources—home-cooked food, pre-packaged products, and restaurant meals—across Xinjiang, Gansu, Shaanxi, Jilin, and Heilongjiang. Local and central government involvement should speed translation of research into policy. The potential impact is a measurable drop in China’s hypertension and stroke burden, particularly among its rural poor, and a replicable model for other developing countries still struggling to meet the WHO’s 30% salt-reduction target by 2025.
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Global Health is a key area of focus at QMUL, supported by our internationally recognised medical research (we are ranked among the top 5 Medical Schools in the UK for Clinical Medicine and Population Health, 2014 REF); strong clinical expertise through our partnership with Barts Health NHS Trust; strong interdisciplinary teams across QMUL in Life Sciences (QMUL is ranked 9th among UK multi-disciplinary universities and a track record of productive international collaborations). Global Health is a key strand of QMUL’s Life Sciences Initiative (LSI), a multidisciplinary endeavour involving all three of our Faculties. QMUL is a leading health research school with extensive global health experience. Excessive salt intake is linked to over 1.6 million deaths globally each year, about 80% of which occur in developing countries[1]. WHO requires member states to reduce salt by 30% by 2025[2]. Average salt intake in China is high at 12-14 g/d[3]. Salt reduction will have enormous health benefits. The success of the UK’s salt reduction programme[4] was largely attributable to the work of CASH[5]. Following the success of CASH, WASH (World Action on Salt and Health)[6] was set up in 2005 with a mission of reducing salt globally. WASH has helped many countries develop a salt reduction strategy. CASH and WASH brought together broad expertise in nutrition and health (23 experts in UK and over 540 members from 100 countries) which will provide strong support to ASC. QMUL will provide scientific, infrastructure, personnel, financial and administrative support with an in-kind of £227,437. CASH and The George Institute for Global Health China (TGI China) have had many years’ collaboration in NCDs prevention. TGI China is a leading health research institute benefiting from strong links with health authorities in China, especially those related to salt reduction. This application will strengthen our collaboration with TGI China and further expand our partnership in China to health authorities including Chinese Center for Health Education (CCHE), China National Centre for Food Safety Risk Assessment (CFSA) and three departments/institutes from Chinese Centre for Disease Control and Prevention (China CDC) including Division of Health and NCD Control and Community Health (NCD Division), National Centre for Chronic and Non-communicable Disease Control and Prevention (NCD centre) and National Institute for Nutrition and Health (NINH), which have all agreed to be involved. Lifestyle intervention is a priority of the Chinese government, however, there is lack of a comprehensive salt reduction programme. Almost half of the Chinese live in rural areas where many are poor with very high salt intake and limited access to health information. By 2015, there were 592 poverty-stricken counties with more than 55 million living on less than US$1/day. This application is highly relevant to China’s agenda on health and development. Exporting our experience and expertise will help China strengthen their current effort and capacity in salt reduction. Building relationships with key stakeholders in China to produce champions for the cause of salt reduction will assist in sustainability. To benefit the poorer people and maximise the value for money, we will target 5 provinces (Xinjiang, Gansu, Shaanxi, Jilin, Heilongjiang) with high salt intake, large population (>20 million each) and lower GDP. A multidisciplinary team will be formed with engagement from health authorities, research institutes, universities, NGOs, food industry and other social sectors from both UK and China to develop specific research programmes to target the main contributors of salt (food prepared at home, pre-packaged and restaurant food)[7, 8]. Each programme will be led by a delegated participating team who have the expertise and authority in the specific area. Local and central governments will be involved to ensure swift translation of practice to policies. Progr
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