Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK.
Rev Panam Salud Publica. 2012 Oct;32(4):293-300. doi: 10.1590/s1020-49892012001000008.
There is compelling evidence that dietary salt intake is the major cause of raised blood pressure (BP) and that a reduction in salt intake from the current level of ≈ 9 - 12 g/day in most countries to the recommended level of < 5 g/day lowers BP. A further reduction to 3 - 4 g/day has a greater effect and there needs to be ongoing consideration of lower targets for population salt intake. Cohort studies and outcome trials have demonstrated that a lower salt intake is related to a reduced risk of cardiovascular disease. Salt reduction is one of the most cost-effective measures to improve public health worldwide. In the Americas, a salt intake of > 9 g/day is highly prevalent. Sources of salt in the diet vary hugely among countries; in developed countries, 75% of salt comes from processed foods, whereas in developing countries such as parts of Brazil, 70% comes from salt added during cooking or at the table. To reduce population salt intake, the food industry needs to implement a gradual and sustained reduction in the amount of salt added to foods in developed countries. In developing countries, a public health campaign plays a more important role in encouraging consumers to use less salt coupled with widespread replacement of salt with substitutes that are low in sodium and high in potassium. Numerous countries in the Americas have started salt reduction programs. The challenge now is to engage other countries. A reduction in population salt intake will result in a major improvement in public health along with major health-related cost savings.
有确凿证据表明，膳食盐摄入量是导致血压升高的主要原因，而将盐摄入量从大多数国家目前的 9-12 克/天降至推荐量<5 克/天，可降低血压。进一步将盐摄入量减少至 3-4 克/天，效果会更大，需要持续考虑降低人群盐摄入量的目标。队列研究和结局试验表明，低盐摄入与心血管疾病风险降低有关。减少盐摄入是改善全球公共卫生最具成本效益的措施之一。在美洲，盐摄入量>9 克/天的情况非常普遍。饮食中的盐来源在各国差异巨大；在发达国家，75%的盐来自加工食品，而在发展中国家，如巴西的部分地区，70%的盐来自烹饪或餐桌上添加的盐。为了降低人群盐摄入量，食品行业需要在发达国家逐步持续减少食物中的盐添加量。在发展中国家，公共卫生运动在鼓励消费者减少盐的使用方面发挥着更重要的作用，同时广泛用低钠高钾的替代品替代盐。美洲的许多国家已经启动了减盐计划。现在的挑战是让其他国家也参与进来。降低人群盐摄入量将极大地改善公共卫生，并带来相关的重大健康成本节约。
