2018-改变吃盐的习惯（英文版）-1mb

SHAKE Technical Package for Salt Reduction Summary

Core Content

The SHAKE Technical Package is a comprehensive set of policies and interventions designed to help countries reduce population salt intake, which is a major risk factor for cardiovascular diseases and hypertension. It aims to achieve a 30% relative reduction in average salt consumption by 2025, as part of the Global Action Plan for the Prevention and Control of Noncommunicable Diseases (NCDs) 2013–2020. This reduction is essential to meet the global goal of a 25% decrease in premature mortality from NCDs by 2025.

Salt consumption is primarily driven by processed foods and frequent use in cooking or at the table. Excessive sodium intake (over 2g per day, equivalent to 5g of salt) increases the risk of heart disease and stroke, with high blood pressure being the most common health risk associated with high salt intake.

Main Views

• Salt reduction is a critical public health action to decrease the burden of NCDs, especially in low- and middle-income countries where the risk of death from high blood pressure is more than double that in high-income countries.
• The SHAKE package provides a set of evidence-based, cost-effective strategies to reduce salt consumption across the population.
• Political commitment and leadership are essential for the successful implementation of salt reduction programmes.
• Multisectoral collaboration and stakeholder engagement are vital for effective programme design, implementation, and evaluation.
• Surveillance and data collection are fundamental to understanding current salt consumption patterns and evaluating the impact of interventions.

Key Information

1. The SHAKE Vision

• The vision is to reduce average salt intake to less than 5g per day for adults and even less for children.
• This will lead to significant improvements in public health and reduce the strain on healthcare systems.

2. The SHAKE Package Components

3. Interventions in the SHAKE Package

• S1: Measure and Monitor Population Salt Consumption Patterns
  Collect data on population salt intake, knowledge, attitudes, and behaviors related to salt. Use population surveys like WHO STEPwise or USAID DHS.

• S2: Measure and Monitor the Sodium Content of Food
  Use shop and restaurant surveys or direct chemical analysis to monitor sodium levels in food. Data should be published regularly to track changes and encourage reformulation.

• S3: Monitor and Evaluate the Impact of the Salt Reduction Programme
  Evaluate the effectiveness of interventions through repeated population surveys and monitoring of sodium levels in food.

• H1: Set Target Levels for Salt in Foods and Meals and Promote Reformulation
  Establish target levels for salt content and work with the food industry to reformulate products to reduce sodium.

• A1: Adopt Interpretive Front-of-Pack Nutrition Labelling Systems
  Implement clear, easy-to-understand labelling to help consumers make informed choices.

• A2: Combat Misleading Marketing of High-Salt Foods
  Use strategies to reduce the marketing of high-salt foods, especially those that may mislead consumers about their health impact.

• K1: Implement Integrated Education and Communication Strategies
  Raise awareness about the health risks of high salt intake and promote behavior change through education and communication.

• E1: Implement Multicomponent Salt Reduction Strategies in Settings
  Integrate salt reduction into community settings like schools, workplaces, and hospitals to promote healthier eating habits.

4. Elements of a Successful Salt Reduction Programme

• Political Commitment: Necessary for long-term implementation and resource allocation.
• Programme Leadership and Governance: Requires high-level government involvement and adequate support staff and budget.
• Advocacy: Important for maintaining political and development agenda focus, ensuring sustainability.
• Partnerships: Multi-stakeholder collaboration across government, NGOs, industry, and academia.
• Integration with Iodine Deficiency Elimination Programmes: Ensures that reducing salt does not negatively impact efforts to eliminate iodine deficiency.

5. Implementation Considerations

• Countries should not wait for complete data before taking action.
• Surveillance systems should be established to measure, monitor, and evaluate salt consumption patterns.
• Baseline data from surveys help identify key sources of salt in the diet and guide targeted interventions.
• Regular updates on sodium levels in food are necessary to track progress and encourage reformulation.

6. Case Study: Mongolia

• Mongolia's Ministry of Health initiated a national salt reduction strategy in 2011.
• A two-week consultation and training programme was organized, involving intersectoral working parties and factory visits.
• A baseline survey of 1040 residents (25–64 years) revealed that average salt intake was 11.06g per day, more than double WHO recommendations.
• Main sources of salt included salted tea, sausage, smoked meat, pickled vegetables, bread, and chips.
• Pilot initiatives included reducing salt in factory meals and bread, with pre- and post-intervention monitoring using 24-hour urine samples.

Conclusion

The SHAKE Technical Package is a crucial tool for governments to develop and implement effective salt reduction strategies. It emphasizes the importance of surveillance, industry engagement, education, and setting the right environment for healthy eating. With proper implementation, it has the potential to significantly reduce the global burden of NCDs and improve public health outcomes.