title: School based education programme to reduce salt intake in children and their families (School-EduSalt): cluster randomised controlled trial.
abstract: OBJECTIVE
  To determine whether an education programme targeted at schoolchildren could lower salt intake in children and their families.
  
  
  METHODS
  Cluster randomised controlled trial, with schools randomly assigned to either the intervention or control group.
  
  
  METHODS
  28 primary schools in urban Changzhi, northern China.
  
  
  METHODS
  279 children in grade 5 of primary school, with mean age of 10.1; 553 adult family members (mean age 43.8).
  
  
  METHODS
  Children in the intervention group were educated on the harmful effects of salt and how to reduce salt intake within the schools' usual health education lessons. Children then delivered the salt reduction message to their families. The intervention lasted for one school term (about 3.5 months).
  
  
  METHODS
  The primary outcome was the difference between the groups in the change in salt intake (as measured by 24 hour urinary sodium excretion) from baseline to the end of the trial. The secondary outcome was the difference between the two groups in the change in blood pressure.
  
  
  RESULTS
  At baseline, the mean salt intake in children was 7.3 (SE 0.3) g/day in the intervention group and 6.8 (SE 0.3) g/day in the control group. In adult family members the salt intakes were 12.6 (SE 0.4) and 11.3 (SE 0.4) g/day, respectively. During the study there was a reduction in salt intake in the intervention group, whereas in the control group salt intake increased. The mean effect on salt intake for intervention versus control group was -1.9 g/day (95% confidence interval -2.6 to -1.3 g/day; P<0.001) in children and -2.9 g/day (-3.7 to -2.2 g/day; P<0.001) in adults. The mean effect on systolic blood pressure was -0.8 mm Hg (-3.0 to 1.5 mm Hg; P=0.51) in children and -2.3 mm Hg (-4.5 to -0.04 mm Hg; P<0.05) in adults.
  
  
  CONCLUSIONS
  An education programme delivered to primary school children as part of the usual curriculum is effective in lowering salt intake in children and their families. This offers a novel and important approach to reducing salt intake in a population in which most of the salt in the diet is added by consumers.Trial registration ClinicalTrials.gov NCT01821144. .
authors: Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK f.he@qmul.ac.uk.
authors: Feng J
authors: FJ
authors: He
authors: George Institute for Global Health at Peking University Health Science Center, Beijing, China Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China Peking University Clinical Research Institute, Beijing, China.
authors: Yangfeng
authors: Y
authors: Wu
authors: Changzhi Medical College, Shanxi, China.
authors: Xiang-Xian
authors: XX
authors: Feng
authors: Institute of Child and Adolescent Health, Peking University Health Science Center, Beijing, China.
authors: Jun
authors: J
authors: Ma
authors: Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK George Institute for Global Health at Peking University Health Science Center, Beijing, China Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China.
authors: Yuan
authors: Y
authors: Ma
authors: Institute of Child and Adolescent Health, Peking University Health Science Center, Beijing, China.
authors: Haijun
authors: H
authors: Wang
authors: George Institute for Global Health at Peking University Health Science Center, Beijing, China.
authors: Jing
authors: J
authors: Zhang
authors: Changzhi Medical College, Shanxi, China.
authors: Jianhui
authors: J
authors: Yuan
authors: George Institute for Global Health at Peking University Health Science Center, Beijing, China University of Michigan Medical School, Ann Arbor, MI, USA.
authors: Ching-Ping
authors: CP
authors: Lin
authors: School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
authors: Caryl
authors: C
authors: Nowson
authors: Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors: Graham A
authors: GA
authors: MacGregor
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000517:prevention & control; D002648:Child; D002681:China; D004039:Diet, Sodium-Restricted; D006266:Health Education; D006801:Humans; D015397:Program Evaluation; D012307:Risk Factors; D012574:Schools; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage* / Q000009:adverse effects; D012982:Sodium, Dietary / Q000652:urine
chemical_list: D017673:Sodium Chloride, Dietary; D012982:Sodium, Dietary