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赞成:在人群中减少盐的摄入量:这真的是公共卫生的重点吗?

Pro: Reducing salt intake at population level: is it really a public health priority?

机构信息

Division of Health Sciences (Mental Health & Wellbeing), Warwick Medical School, University of Warwick, WHO Collaborating Centre, Coventry, UK.

出版信息

Nephrol Dial Transplant. 2016 Sep;31(9):1392-6. doi: 10.1093/ndt/gfw279. Epub 2016 Aug 3.

Abstract

A reduction in salt intake reduces blood pressure, stroke and other cardiovascular events, including chronic kidney disease, by as much as 23% (i.e. 1.25 million deaths worldwide). It is effective in both genders, any age, ethnic group, and in high-, medium- and low-income countries. Population salt reduction programmes are both feasible and effective (preventive imperative). Salt reduction programmes are cost-saving in all settings (high-, middle- and low-income countries) (economic imperative). Public health policies are powerful, rapid, equitable and cost-saving (political imperative). The important shift in public health has not occurred without obstinate opposition from organizations concerned primarily with the profits deriving from population high salt intake and less with public health benefits. A key component of the denial strategy is misinformation (with 'pseudo' controversies). In general, poor science has been used to create uncertainty and to support inaction. This paper summarizes the evidence in favour of a global salt reduction strategy and analyses the peddling of well-worn myths behind the false controversies.

摘要

减少盐的摄入量可降低血压、中风和其他心血管事件的风险,包括慢性肾脏病,降幅高达 23%(即全球减少 125 万人死亡)。无论性别、年龄、种族和高、中、低收入国家,这种效果都存在。人群减盐计划既切实可行又有效(具有预防必要性)。在所有环境下(高、中、低收入国家),减盐计划都可节省成本(具有经济必要性)。公共卫生政策具有强大、快速、公平和节省成本的特点(具有政治必要性)。如果没有主要关注人口高盐摄入带来的利润、而较少关注公共卫生益处的组织的顽固反对,公共卫生领域的重要转变就不会发生。否认策略的一个关键组成部分是错误信息(伴随着“伪”争议)。总的来说,较差的科学被用于制造不确定性和支持无所作为。本文总结了支持全球减盐战略的证据,并分析了在虚假争议背后兜售陈旧谬论的行为。

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