Design and implementation of an intelligent monitoring system for household added salt consumption in China based on a real-world study: a randomized controlled trial

Jinli Xian,Zumin Shi,Mao Zeng,Zhengjie Cai,Rui Zhu,Yong Zhao,Abu S Abdullah

doi:10.1186/s13063-020-04295-1

Abstract

BackgroundA high intake of salt is a major risk factor for cardiovascular diseases. Despite decades of effort to reduce salt consumption, the salt intake in China is still considerably above the recommended level. Thus, this study aims to design and implement an intelligent household added salt monitoring system (SALTCHECKER) to monitor and control added salt consumption in Chinese households.MethodsA randomized controlled trial will be conducted among households to test the effect of a SALTCHECKER in Chongqing, China. The test modalities are the SALTCHECKER (with a smart salt checker and a salt-limiting WeChat mini programme) compared to a salt checker (with only a weighing function). The effectiveness of the system will be investigated by assessing the daily added salt intake of each household member and the salt consumption-related knowledge, attitude and practice (KAP) of the household’s main cook. Assessments will be performed at baseline and at 3 and 6 months.DiscussionThis study will be the first to explore the effect of the household added salt monitoring system on the reduction in salt intake in households. If the intelligent monitoring system is found to be effective in limiting household added salt consumption, it could provide scientific evidence on reducing salt consumption and preventing salt-related chronic diseases.Trial registrationChinese clinical trial registry (Primary registry in the World Health Organization registry network): ChiCTR1800018586. Date of registration: September 25, 2018.

Highlights

A high intake of salt is a major risk factor for cardiovascular diseases
Innovative interventions to reduce salt intake at the household level should be a priority in China
Aim This study aims to (1) develop an intelligent added salt monitoring system based on real-world study and (2) evaluate the effectiveness of the system in reducing the daily added salt intake of each household member and improving the salt consumption-related KAP of the household’s main cook

Summary

Introduction

A high intake of salt is a major risk factor for cardiovascular diseases. Despite decades of effort to reduce salt consumption, the salt intake in China is still considerably above the recommended level. Excessive dietary intake of sodium is associated with the increasing risk of hypertension and cardiovascular diseases [1]. The current average salt intake in Chinese adults (10.4 ± 0.2 g/d) is higher than the recommended level of the World Health Organization (5 g/d) and that of the Chinese Nutrition Society (6 g/d) [1,2,3]. Innovative interventions to reduce salt intake at the household level should be a priority in China. In China, evidence-based strategies to reduce salt intake are available [14,15,16,17,18,19]. The implementation of these strategies is limited [10, 14,15,16,17,18,19], mostly due to the high price of salt substitutes [20], inappropriate belief in salt-using experience and lack of awareness about the harms of excessive salt intake in residents, and the complex operation of the salt-limiting spoon [21]

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