Zeng Yiping, Xu Zeshui, Rao Yu
Department of Management Science and Engineering Business School, Sichuan University Chengdu China.
Department of Bioengineering Food Science and Bioengineering School, Xihua University Chengdu China.
Health Sci Rep. 2022 Mar 7;5(2):e540. doi: 10.1002/hsr2.540. eCollection 2022 Mar.
Interventions that significantly reduce dietary sodium intake are anticipated to decrease gastric cancer (GCa) burden. However, the optimal restriction strategies remain unknown at present. This study aims to understand where and to what extent policies modifying sodium consumption change the distribution of GCa burden, and the effects of potential salt reduction strategies in China.
The synthetic population in this microscopic simulation study is close to reality. We incorporated estimates of dietary patterns and GCa risk into the model of excess salt consumption. These estimates and simulated population were obtained from the China Health and Nutrition Survey, Global Burden of Disease Project, and the sixth census of China's National Bureau of Statistics, respectively.
In the no intervention scenario, we estimated that disease burdens due to excess sodium intake would be at 472.9 million disability-adjusted life years (DALYs) nationally between 2010 and 2030 (95% credible interval [CrI]: 371.1-567.7). The GCa burden caused by high sodium is projected to have a disproportionate impact on the central and southern provinces of China (9.2 and 4.5 million DALYs, respectively). Implementing a cooking salt substitute strategy would be expected to avoid a larger portion of GCa burden (about 67.2%, 95% CrI: 66.8%-67.6%) than the salt-restriction spoon program (about 16.7%, 95% CrI: 16.1%-17.4%).
Dietary salt reduction policy is very powerfully effective in reducing the GCa burden overall. It is expected that proposed salt substitutes are more effective than traditional salt-restriction spoons to avoid increased inequality.
预期显著降低膳食钠摄入量的干预措施将减轻胃癌（GCa）负担。然而，目前最佳的限制策略尚不清楚。本研究旨在了解改变钠消费的政策在何处以及在多大程度上改变了GCa负担的分布，以及中国潜在减盐策略的效果。
本微观模拟研究中的合成人群接近现实。我们将饮食模式和GCa风险估计纳入过量盐消费模型。这些估计和模拟人群分别来自中国健康与营养调查、全球疾病负担项目和中国国家统计局第六次人口普查。
在无干预情景下，我们估计2010年至2030年期间全国因过量钠摄入导致的疾病负担将达到4.729亿伤残调整生命年（DALYs）（95%可信区间[CrI]：3.711 - 5.677亿）。高钠导致的GCa负担预计对中国中部和南部省份影响较大（分别为920万和450万DALYs）。实施烹饪盐替代策略预计比限盐勺计划能避免更大比例的GCa负担（约67.2%，95% CrI：66.8% - 67.6%），而限盐勺计划约为16.7%（95% CrI：16.1% - 17.4%）。
膳食减盐政策在总体上减轻GCa负担方面非常有效。预计提议的盐替代品比传统限盐勺更有效，可避免不平等加剧。
