中国高血压和心脑血管事件预防的高钾低钠饮食战略

Implementation of a high potassium/low sodium diet to prevent hypertension,and cardiovascular and cerebrovascular events in China

减少高血压和心脑血管事件是我国当前面临的一项紧迫而艰巨的任务.政府需要增加慢性病预防的财政投入,大力宣传饮食钾钠平衡的健康意义,提倡高钾低钠饮食;建立《中国减盐与健康》专项基金和专家指导委员及相关机构,加快大规模高钾低钠盐人群干预试验和高钾低钠盐及相关产品的研发和应用,为减少高血压和心脑血管事件提供科学依据和安全、实效、经济的技术干预手段.为此,一方面要向欧盟学习成功的减盐经验,与食品工业及相关部门协调完善食品标签特别要标注食品中Na＋,K＋,Mg＋＋,Ca＋＋的含量及能量值,并将我国占盐摄入30的加工食品用盐每年减少5;另一方面需根据我国严重高钠低钾饮食的国情特点实施低钠高钾饮食战略性干预,要重点向占盐摄入70的餐饮业及家庭烹任者大力宣传减盐补钾的健康意义,提倡国民选用市场已有的富钾低钠盐（70NaCl＋30KCl,Na/K=1.8：1）,大力支持和逐步推广正在研发的高钾低钠盐（NaCl/KCl=1：1,Na/K=0.8：1）以及有待研发和推广的富钾低钠酱油、咸菜等相关调味品.争取在＂十二五＂期间（2011~2015年）使人均食盐（NaCl）的日摄入量减少3g或钠的日摄入量减少50mmol,钾的日摄入量增加2g或50mmol,使尿Na/K下降50,接近2.预计削减3g食盐/天可降低人群收缩压3mmHg（1mmHg=1.333×102Pa）和舒张压1.8mmHg,可减少13的脑卒中和10的缺血性心脏病突发事件.这对落实科技健康行动计划,改善我国人群健康,减轻社会负担,提高我国卫生健康科研水平及发展相关产业都具有重要意义.

It is urgent for China to develop strategies and approaches to reduce the incidence of hypertension,and of cardiovascular and cerebrovascular events.To provide scientific evidence and to establish safe,effective and economic interventions for these disorders,the Government needs to（1） increase financial investment for the prevention of chronic diseases,to publicize the health benefits of maintaining an appropriate dietary potassium/sodium balance,and to recommend a high potassium/low sodium diet;and（2） establish a specific foundation for ＂China Salt Reduction and Health＂,an Expert Steering Committee,and a relevant agency to speed up large-scale intervention studies in China,as well as the development and application of high potassium/low sodium salt diets and related products.To this end,China needs to learn from the European Union regarding its approaches used to reduce salt intake and to coordinate with the food industries and related sectors to improve food labeling of Na＋,K＋,Mg＋＋ and Ca＋＋ contents,as well as the energy content.It is also important to reduce salt content by 5 per year in processed foods,which account for 30 of the total salt intake in China.In addition,China needs to develop a strategy to encourage individuals to follow a low sodium/high potassium diet by focusing on the serious health effects of high sodium/low potassium diets.It is important to target people who prepare food in restaurants and at home,as these places account for 70 of the total salt intake in China,to encourage the switch from high sodium salts to a low sodium salt（70 NaCl＋30 KCl）,and ultimately transfer to low sodium/high potassium salt（NaCl：KCl=1：1）,low sodium/high potassium soy sauce and other related condiments.During the 12th Five-Year Plan period（2011-2015）,the goal is to reduce salt intake by 3 g（50 mmol Na＋） per day and increase potassium intake by 2 g（50 mmol） per day,on average.This will reduce the urinary Na/K ratio by 50,towards 2.Reducing the daily salt intake by 3 g has been estimated to lower systolic blood pressure by 3 mmHg,diastolic blood pressure by 1.8 mmHg,and reduce the incidences of stroke and heart attack by 13 and 10,respectively,in China.These changes will significantly help to improve the health of the population,reduce the social burden of ill health,encourage scientific research,and lead to the development of health-related industries.