山东省全民食盐加碘防治碘缺乏病措施现状评价

目的　监测山东省居民户食用盐现状以评价全民食盐加碘防治碘缺乏病措施。方法　采用横断面调查方法 ,在随机抽取的乡 (镇 )和村庄采集居民户食用盐样本进行碘含量检测。结果　调查了 97个县 (市、区 )、85 7个乡 (镇 )的 2 742 3个居民户 ,采集并检测食用盐 2 742 3份。加碘盐 2 6189份占 95 .5 % ,合格碘盐 2 4996份占 91.2 % ,非碘盐 12 3 4份占 4.5 % ;人口加权后的全省碘盐覆盖率为 95 .9%、碘盐合格率 94.9%、合格碘盐食用率 91.1%、非碘盐率 4.1%。81.4% (79/97)县 (市、区 )的碘盐覆盖率≥ 95 % ,88.7% (86/97)县 (市、区 )的碘盐覆盖率≥ 90 % ;76.3 % (74/97)县 (市、区 )的合格碘盐食用率≥ 90 % ;11.3 % (11/97)县 (市、区 )的非碘盐率 >10 %。非碘盐问题主要存在于沿海产盐地区。结论　山东省落实全民食盐加碘措施良好 ,居民户碘盐覆盖率在省级水平上已达到消除碘缺乏病目标 ,但在市级和县级水平还未达到标准。应加强综合性干预措施以期在县级水平实现目标。     

2002年浙江省居民户食用盐现状调查结果分析

目的　掌握浙江省居民用户食用盐碘含量水平现状以评价碘缺乏病防治进程。方法　采用横断面调查方法 ,随机抽查并定量检测居民户食用盐样本。结果　调查 3 3个县 (市、区 )的 2 64 0户居民 ,全定量检测食盐 2 64 0份。盐碘含量均值为 2 8.78± 9.14mg/Kg ,中位数为 2 9.5mg/Kg ,范围为 ( 0～ 96.1)mg/Kg。加碘盐 2 5 15份占 95 .2 7% ,合格碘盐2 40 9份占 91.2 5 % ,非碘盐 12 5份占 4.73 %。碘盐覆盖率 95 .2 7% ,人口加权合格碘盐食用率为 94.0 8%。结论　浙江省居民户碘盐覆盖率和合格碘盐食用率总体上已经达到标准要求 ,但山区和海岛地区存在非碘盐 ,应强化综合干预措施和健康促进来提高合格碘盐食用率。     

2002年山东省居民户盐碘水平监测结果分析

目的评估山东省食盐加碘的落实情况及居民户碘盐食用情况.方法采用分层整体抽样法采集3040份居民户盐样进行盐碘定量检测.结果 3 040份盐样碘含量为(27.8±10.4)mg/kg.非碘盐214份,占7.0%,不合格碘盐191份,占6.3%,合格碘盐2.635份,占86.7%.碘盐覆盖率为94.1%,合格碘盐食用率为87.0%.结论居民户合格碘盐食用率有很大提高,合格碘盐食用率已基本达到阶段性目标的要求.但仍有7%为非碘盐和6.3%不合格碘盐.且不合格碘盐的组成结构发生了变化,＞50 mg/kg的盐样所占的比重升高.应加强非碘盐打击力度,继续抓好以学龄儿童及家庭妇女为主的碘缺乏病宣传教育工作,提高群众的自我保健意识和参与意识,同时加强对盐业生产厂家的规范化管理.     

2008年河北省居民户食用盐监测结果分析

目的 了解2008年河北省非高碘县碘盐和高碘县非碘盐的居民食用情况,为碘缺乏病防治工作提供科学依据.方法 根据<全国碘缺乏病监测方案(试行)>,在河北省以县(市、区)为单位,按照系统抽样和简单随机抽样原则抽取乡(镇)和行政村,在行政村按照简单随机抽样原则抽取居民户,取家中食用盐检测盐碘.用直接滴定法测定非高碘县居民户盐碘,半定量检测高碘县居民户盐碘.结果 在167个非高碘县(市、区)共抽取48 448份居民户食用盐,经过县级人口数加权后非碘盐率为4.73%,碘盐覆盖率为95.27%,碘盐合格率为96.13%,合格碘盐食用率为91.96%.碘盐覆盖率≥195%的县(市、区)占80.83%(135/167),碘盐合格率>90%的县(市、区)占92.81%(155/167),合格碘盐食用率>90%的县(市、区)占82.04%(137/167).在5个高碘县共抽取食用盐1466份,非碘盐1367份,非碘盐率为93.25%(1367/1466).结论 河北省非高碘地区的碘缺乏病防治工作基本达到国家要求,但部分非高碘县(市、区)碘盐覆盖率和合格碘盐食用率较低,应加大防治工作力度,而高碘地区应尽快落实停供碘盐政策.     

2005年甘肃省白银市居民户食用碘盐监测报告

目的了解甘肃省白银市居民食用加碘盐质量情况,以更好地控制本地区碘缺乏病。方法2005年对白银市3县2区防治碘缺乏病居民户食用盐进行督导检查和常规监测。结果督导检查3县2区食用盐400份,合格362份(非碘盐15份),合格率为94%,碘盐覆盖率为96.3%,合格碘盐食用率为90.5%;常规监测食用盐1440份,合格1329份,合格率为96.3%,合格碘盐食用率为92.3%,非碘盐60份,碘盐覆盖子率为95.8%。结论白银市居民食用盐总体质量及普及情况已达到以消除碘缺乏病要求,但个别县尚未达标。     

2004年山东省日照市居民户食用碘盐调查报告

目的了解山东省日照市阶段消除碘缺乏病(IDD)后居民户食用盐现状,评价IDD干预措施与效果可持续性机制。方法采取横断面抽样调查方法,随机抽查定量检测本居民户食用盐样本。结果调查3个区县27处乡镇864户居民,检测食用盐样864份。盐碘含量0 mg/kg~58.2mg/kg,均值(30.5±7.4)mg/kg,变异系数为24.3%,中位数29.7mg/kg;精制盐826份(95.6%),原盐38份(4.4%),其中碘盐859份(99.4%),合格碘盐817份(94.6%),非碘盐5份(0.6%);每个区县碘盐覆盖率均高于98%,合格碘盐食用率均高于90%。结论日照市居民合格碘盐食用率符合国家消除IDD标准要求,但对碘盐的监督、监测和宣传教育工作仍不能放松。     

2008～2010年新疆阿克苏地区居民户碘盐监测结果分析

目的全面掌握新疆阿克苏地区居民户合格碘盐普及情况,为适时采取针对性防治措施和科学调整干预策略提供依据。方法按照《全国碘缺乏病监测方案》中碘盐监测随机抽样方法执行,采用直接滴定法定量测定盐中碘含量。结果 2008～2010年全地区9个县（市）共对207个乡（镇）、828个行政村、7 896户居民户的食用盐抽样检测,共检测居民户食用盐7 896份,合格碘盐6 975份,不合格碘盐165份,非碘盐756份,合格碘盐食用率为88.33%,碘盐覆盖率为90.42%,非碘盐率为9.57%,盐碘均数31.2 mg/L。结论通过阿克苏地区各级政府和防治机构的共同努力,2010年全地区合格碘盐食用率、碘盐覆盖率均达到了国家基本消除碘缺乏病的目标。由于自然环境缺碘不会改变,消除碘缺乏病工作必须长期、有效地坚持下去。     

新疆生产建设兵团2011年碘盐监测结果分析

目的了解新疆生产建设兵团(简称兵团)居民食用盐碘含量状况,为制定消除碘缺乏病防治策略提供科学依据。方法根据国家相关监测方案的要求,采用随机抽样调查和重点抽样调查方法对兵团14个师居民碘盐食用情况进行监测分析。结果随机抽取14个师的115个团场,共检测盐样4 128份,盐碘含量均值为(32.42±5.66)mg/kg,中位数为32.30mg/kg,合格盐样4 048份,不合格碘盐27份,非碘盐53份,碘盐覆盖率为98.72%,合格碘盐食用率为98.06%,非碘盐率为1.28%;同时,重点抽样32个团场检测盐样9 329份,非碘盐97份,非碘盐率1.04%,碘盐覆盖率98.96%。结论兵团居民户碘盐合格率总体上已经达到标准要求,但仍有部分南疆团场存在非碘盐,应加强综合干预措施和健康促进来提高合格碘盐食用率。     

2005年山西尧都区乡村居民户盐碘定量检测结果分析

目的分析2005年山西省临汾市尧都区乡村居民户碘盐食用情况,为可持续性消除碘缺乏病提供科学依据。方法按随机抽样法对9个乡村居民用户盐碘含量进行监测。结果281份乡村居民户碘盐合格率为97.5%,盐碘均值为29.35 mg/kg、标准差为4.40 mg/kg,碘盐覆盖率为100%,合格碘盐食用率为97.5%。结论尧都区乡村居民食用盐的含碘合格率达到了国家标准。     

2005～2006年黔东南州碘盐监测结果分析

目的了解黔东南州碘盐质量,为今后碘缺乏病防治工作提供科学依据。方法按照《全国碘盐监测方案》对黔东南州16县(市)碘盐采用直接滴定法(GB/T13025.7-1999)进行检测。结果2005~2006年共检测9 213份居民户食盐,碘盐合格率为96.85%,碘盐覆盖率为99.36%,合格碘盐食用率为96.30%,非碘盐检出率为0.56%,盐碘均数为32.35 mg/kg。同时检测盐库碘盐1 944份,合格率为94.39%,均数为34.09 mg/kg。结论黔东南州除从江县外,其余15县(市)的居民户合格碘盐食用率达到了国家消除IDD的控制标准,但多数县(市)碘盐质量有待提高。     

对我国5城市消费者关于普及食盐加碘政策的认知调查

目的了解消费者对普及食盐加碘(USI)政策及相关问题的认识,为碘缺乏病(IDD)防治工作提供参考。方法采用拦截访问和问卷调查相结合的方式,对我国5城市(北京、合肥、杭州、广州、武汉)共计4 797名消费者进行调查。以Epidata3.1软件录入并核对数据,SPSS 13.0软件完成统计分析。结果 95.2%的被调查者认为USI政策正确或基本正确;62.3%的消费者知晓食盐加碘是为了预防碘缺乏病;56.4%的消费者会主动选择购买碘盐;72.0%消费者希望超市同时供应碘盐和非碘盐。结论绝大多数被调查者肯定USI政策的成就和重大意义,但调查人群对碘相关知识认识不足。应结合目前正在实施盐碘浓度的调整,进一步加大相关知识的宣传力度,增强与公众间的风险沟通,按照因地制宜,分类指导,科学补碘的原则,保证人群碘营养处于适宜水平,既纠正人群碘缺乏、又避免碘过量的风险。     

Monitoring and implementation of salt reduction initiatives in Africa: A systematic review

This systematic review aims to document salt consumption patterns and the implementation status and potential impact of salt reduction initiatives in Africa, from studies published between January 2009 and November 2019. Studies were sourced using MEDLINE, Embase, Cochrane Library electronic databases, and gray literature. Of the 887 records retrieved, 38 studies conducted in 18 African countries were included. Twelve studies measured population salt intake, 11 examined salt level in foods, 11 assessed consumer knowledge, attitudes, and behaviors, 1 study evaluated a behavior change intervention, and 3 studies modeled potential health gains and cost savings of salt reduction interventions. The population salt intake studies determined by 24‐hour urine collections showed that the mean (SD) salt intake in African adults ranged from 6.8 (2.2) g to 11.3 (5.4) g/d. Salt levels in foods were generally high, and consumer knowledge was fairly high but did not seem to translate into salt lowering behaviors. Modeling studies showed that interventions for reducing dietary sodium would generate large health gains and cost savings for the health system. Despite this evidence, adoption of population salt reduction strategies in Africa has been slow, and dietary consumption of sodium remains high. Only South Africa adopted legislation in 2016 to reduce population salt intake, but success of this intervention has not yet been fully evaluated. Thus, rigorous evaluation of the salt reduction legislation in South Africa and initiation of salt reduction programs in other African countries will be vital to achieving the targeted 30% reduction in salt intake by 2025.     

2009年全国随机抽样碘盐监测结果分析

目的准确、及时、连续掌握全国碘盐普及状况及重点地区的非碘盐冲销情况。方法监测方法参见卫生部2007年颁布的《全国碘缺乏病监测方案（试行）》。碘盐检测采用GB/T 13025.7-1999中直接滴定法,川盐、强化盐和不确定的非碘盐采用仲裁法定量测定。合格碘盐判定标准为（35±15）mg/kg（20～50 mg/kg）;非碘盐判定标准为〈5 mg/kg。结果全国居民碘盐覆盖率为98.42%,合格碘盐食用率为96.40%。在省级水平,全国只有西藏的居民碘盐覆盖率〈90%;合格碘盐食用率低于90%的有西藏和海南2省（区）。在县级水平,全国有2 760个县（市、区、旗）和新疆生产建设兵团师碘盐覆盖率≥90%,有56个县（市、区、旗）碘盐覆盖率〈80%。全国有95.41%的县（市、区、旗）和新疆生产建设兵团师居民合格碘盐食用率达到了90%以上。结论国家重视、目标明确、措施有效是我国碘盐覆盖水平稳步提高的主要原因。碘盐覆盖率较低的县仍然相对集中在西藏、新疆、海南等未实现消除碘缺乏病的省（区）。巩固防治成果,缩小地区之间防治水平上的差距是今后消除碘缺乏病的主要工作。     

Compliance with Long-Term Dietary Salt Restriction in Hypertensive Outpatients

Eighty hypertensive outpatients were recruited for a dietary salt restriction program to examine long-term compliance. Twenty-four-hour urine samples were collected repeatedly (7.9±2.6 times, mean±s.d.) during a follow-up period of 6.4±1.7 years. After initial urine collection, nutritional education was carried out by dietitians to reduce dietary salt intake to 8 g/day or less. After every urine collection, the subjects were given advice by doctors on salt restriction, if necessary. The mean 24–hour urinary salt excretion (U-NaCl) and the mean urinary salt/creatinine ratio (U-NaCl/U-Cr) varied considerably both among and within individuals. U-NaCl/U-Cr, but not U-NaCl, in females was significantly higher than that in males, and in middle-aged subjects than in young subjects. U-NaCl and U-NaCl/U-Cr tended to decrease in the summer. In spite of the repeated educational effort, neither U-NaCl nor U-NaCl/U-Cr was different in the first control samples from that in the last samples. When 57 subjects were divided into three groups according to the urinary salt excretion level, U-NaCl was consistently higher during a follow-up period in the high-salt excretion group than in the mid-salt excretion group, while U-NaCl in the low-salt excretion group was initially lower than, but finally similar to, that in the mid-salt excretion group. These results suggest that: (1) multiple 24–hour urine samplings are required to assess urinary salt excretion in individuals; (2) the influence of age and sex should be taken into account in interpreting U-NaCl/U-Cr; and (3) it seems difficult to achieve long-term dietary salt restriction as a non-pharmacologic treatment of hypertension in an outpatient clinic.     

Impact of self‐monitoring of salt intake by salt meter in hypertensive patients: A randomized controlled trial (SMAL‐SALT)

Salt intake over reference level would result in elevated blood pressure (BP) and long‐term morbidity. Salt meter is a device used to detect sodium content in daily food. This study aimed to evaluate the efficacy of salt‐meter addition to dietary education. The authors conducted a randomized‐controlled trial in hypertensive patients with uncontrolled BP (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg). Patients were randomized to receive salt meter plus dietary education (group A) or education only (group B), and followed up for 8 weeks. The primary endpoint was change in 24‐h urinary sodium excretion. Changes in BP, salt taste sensitivity, cardio‐ankle vascular index (CAVI) were also analyzed. There were total number of 90 patients who had complete follow‐up, 45 in each group. Mean age was 62.9 years and 53% were females. Mean baseline 24‐h urine sodium was 151.6 mmol/24 h and mean SBP and DBP were 152.8 and 83.4 mmHg, respectively. Baseline characteristics were similar between two groups. At 8 weeks, mean change in urine sodium were –31.83 mmol/24 h and 0.36 mmol/24 h in group A and group B, respectively (p = .006). Mean decrease in BP were SBP, 14.44 versus 8.22 mmHg (p = .030), and DBP 5.53 versus 1.93 mmHg (p = .032). The salt sensitivity was improved more in group A. There was no different between change in CAVI. From this study, salt meter in conjunction with dietary education, for self‐monitoring of salt intake is superior to education alone in hypertensive patients, and provided better blood pressure control. Salt meter should be considered in uncontrolled hypertensive patients.     

Assessing the Policy Landscape for Salt Reduction in South-East Asian and Latin American Countries – An Initiative Towards Developing an Easily Accessible,Integrated, Searchable Online Repository

Background:High dietary salt intake is an avoidable cause of hypertension and associated cardiovascular diseases (CVDs). Thus, salt reduction is recommended as one of the most cost-effective interventions for CVD prevention and for achieving the World Health Organization’s (WHO) 25% reduction in premature non-communicable disease (NCD) mortality by 2025. However, current and comprehensive information about national salt reduction policies and related actions across different regions are difficult to access and impede progress and monitoring.Objectives:As an initial step to developing an online repository of salt reduction policies and related actions, and to track nation-wise progress towards the WHO’s 25 by 25 goal, we aimed to identify and assess salt reduction policies and actions in select countries from two of the top five most populous regions of the world- the South-East Asia and Latin America.Methods:We conducted a literature review to identify national and regional salt reduction policies in the selected South-East Asian and Latin American countries, from January 1990–August 2020, available in English and Spanish. We also contacted selected WHO country offices (South-East Asian region) or relevant national authorities (Latin America) to gain access to unpublished documents.Results:In both regions, we found only a few dedicated stand-alone salt reduction policies: Bhutan, Sri-Lanka and Thailand from South East Asia and Costa Rica from Latin America. Available polices were either embedded in other national health/nutritional policy documents/overall NCD policies or were unpublished and had to be accessed via personal communication.Conclusions:Salt reduction policies are limited and often embedded with other policies which may impede their implementation and utility for tracking national and international progress towards the global salt reduction target associated with the 25 by 25 goal. Developing an online repository could help countries address this gap and assist researchers/policymakers to monitor national progress towards achieving the salt reduction target.     

简化碘盐监测方案在碘盐普及地区的应用探讨

目的对目前碘盐覆盖率较高,普及碘盐的地区,探讨碘盐监测方案的简化办法。方法选取碘盐覆盖率和合格碘盐食用率均达标的吉林省的20个县(市),同时按照现行方案和简化方案开展碘盐监测。对两方案的结果进行比较,分析简化方案的可行性。结果20个县(市)2种方案监测结果间差异均不显著。结论简化方案具有较好的可操作性,在高碘盐覆盖率地区,其监测结果与现行方案间差异不显著。因此,对于全国大部分达标地区,简化方案具有良好的推广意义。     

2002年全国居民户层次盐碘监测结果分析

目的 评估全国基本实现消除碘缺乏病阶段目标后的居民户层次盐碘水平。方法 从31个省(区、市)按一定比例随机抽取一定数量的盐样进行检测，根据各省上报的盐碘定量测定结果，利用EPI INFO6．0软件进行资料汇总分析。结果 全国有26个省的加碘盐覆盖率在90％以上，有16个省的合格碘盐食用率在90％以上。结论 适当降低加碘浓度，提高加碘盐合格率，杜绝非碘盐冲击，加强碘盐监测工作，确保居民食用合格碘盐，科学地防治碘缺乏病。