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Selected Category: noncommunicable diseases (NCDs)

Two Initiatives Worth Their Salt: Reducing Sodium Intake in Philadelphia and Shandong, China

Categories: cardiovascular disease, noncommunicable diseases (NCDs)

September 29 is World Heart Day.

September 29 is World Heart Day.

Background information

Barbara Bowman, Ph.D., Director, Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, CDC

Barbara Bowman, Ph.D., Director, Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, CDC

CDC’s 2013 Vital Signs publication reported that more than 200,000 deaths among Americans younger than age 75 are preventable. These deaths from heart disease and stroke, both primary contributors to cardiovascular disease (CVD), could be prevented through better lifestyle practices and better care. Heart disease and stroke are two of our nation’s leading causes of death, responsible for nearly 1 in 3 deaths in the US each year. Globally, hypertension accounts for almost one-half of heart attacks and strokes. In China alone, CVD caused an estimated 3.5 million deaths in 2008.

Excess sodium intake is a key risk factor for hypertension, and reducing sodium intake is a global and domestic public health priority. A 2007 study found that reducing average population sodium intake by 15% in 23 low- and middle-income countries (bearing 80% of the chronic disease burden) could prevent 8.5 million deaths over 10 years, at a cost of only $0.05 / person / year (see footnote #1). In China and in the US, average sodium consumption is in excess of recommendations (see footnote #2). Primary sources of sodium vary depending on the country: the primary sources of sodium in the US are packaged and restaurants foods, while in China it is salt added during cooking. Thus, efforts to reduce sodium consumption in each country focus on their respective primary contributors to sodium intake.

Shandong Province is the third most populous province in China with 96 million residents. Rates of hypertension and salt intake in adults are higher than the national average; Shandong Province is also one of the largest salt producers in China. To reduce the burden of hypertension, in 2011China’s National Health and Family Planning Commission (formerly the Ministry of Health) and Shandong provincial government, with technical assistance provided by US CDC, launched the first comprehensive salt reduction project in China: the Shandong Province & Ministry of Health Action on Salt and Hypertension (SMASH). The goal of SMASH is to: 1) reduce daily salt intake from 12.5 grams/day to 10 grams/day by 2015; and 2) improve hypertension control within the province.

In order to reduce salt intake, food labeling, reformulating local cuisine, distribution of scaled spoons for measurement of salt use in cooking, and food industry product reformulation are being broadly adopted. The initiative works with restaurants to develop sodium standards for Shandong cuisine, including, developing and conducting chef training and contests to provide lower salt menu items and recipes track salt usage, and disseminate educational resources. Restaurants that follow the lower salt requirement are designated a “Distinguished Restaurant”.

Philadelphia, also interested in reducing salt intake as part of its Get Healthy Philly initiative, launched the Philadelphia Healthy Chinese Take-out Initiative in 2012, a joint effort of the Philadelphia Chinese Restaurant Association, the Center for Asian Health of Temple University, the Asian Community Health Coalition and the Department of Health (DOH), to improve access to healthier food options. In an effort to control and prevent high blood pressure, the initiative aims to reduce the sodium content in Chinese take-out dishes by 10-15%. BetweenJuly, 2012 and April, 2013, 206 restaurants of more than 400 agreed to participate in the initiative. Philadelphia Healthy Chinese Take-out Initiative provided a series of free cooking trainings for owners and chefs on low salt cooking techniques. These included enhancing flavor with herbs and spices, using lower sodium ingredients such as reduced sodium soy sauce, modifying recipes to use ½ the amount of prepared sauce in dishes, and limiting distribution of soy sauce packets to customers. Marketing materials for owners and consumers to promote awareness of the initiative were also developed and distributed. DOH staff collected and analyzed samples of two popular dishes from 20 restaurants to assess changes in sodium content since the program began: preliminary results show an average of a 10% reduction in sodium content over the past two years.

After learning about US sodium reduction efforts via CDC’s Salt e-Update, SMASH officials have been working with Philadelphia Healthy Chinese Take-out Initiative to share information on their respective sodium reduction initiatives. Shandong shared CDC sodium fact sheets translated to Chinese with Philly, which assisted Philly in communicating with participating restaurant operators who only speak Chinese. Philly has provided Shandong with program insights and experience on monitoring and evaluation as well as program scope. Continued discussions will allow both communities to better communicate and share enhanced recipes, cooking techniques, and chef training materials with restaurants to reduce sodium in their menus. Expanded dialogue will also allow both projects to share lessons learned and fine tune efforts around training restaurants to reduce sodium, conducting public education campaigns focused on sodium reduction, and collecting baseline survey data to help inform targeted strategies for sodium reduction.

While the US continues to make progress in achieving our national CVD goals for sodium intake, there remains great opportunity to achieve more. Active engagement with global partners not only provides the unique opportunity to share our expertise and knowledge but to also leverage existing global efforts to enhance our knowledge and improve domestic approaches. SMASH and Philly’s Healthy Chinese Take-out Initiative share similar goals and approaches and are leveraging resources and experiences to enhance their respective programs.

To learn more:

  • CDC Division for Heart Disease and Stroke Prevention
    The mission of the Division for Heart Disease and Stroke Prevention (DHDSP) is to provide public health leadership to improve cardiovascular health for all, reduce the burden, and eliminate disparities associated with heart disease and stroke.
  • Sodium
    Most of the sodium we consume is in the form of salt, and the vast majority of sodium we consume is in processed and restaurant foods. Too much sodium can increase your blood pressure and your risk for a heart attack and stroke. Heart disease and stroke is the leading cause of death in the US.
  • Sodium Reduction Toolkit: A Global Opportunity to Reduce Population-Level Sodium Intake
    The toolkit is designed to provide international and national government agencies and public health organizations with a brief overview, tools, and information for developing and implementing sodium reduction programs, policies, and initiatives aimed at lowering sodium intake. The toolkit offers seven self-guided modules, each about 30 minutes to complete. (Chinese modules are currently hosted on a Chinese site through US CDC China office.)
  • High Blood Pressure
    High blood pressure is a common and dangerous condition. Having high blood pressure means the pressure of the blood in your blood vessels is higher than it should be. But you can take steps to control your blood pressure and lower your risk of heart disease and stroke.
  • The Shandong Province and Ministry of Health Action on Salt and Hypertension (SMASH)
  • Healthy Chinese Takeout Initiative

A Call for Action: Responding to the Tobacco Epidemic and the Price of Cigarettes

Categories: cancer, cardiovascular disease, noncommunicable diseases (NCDs), tobacco

Woman smoking tobacco

“Raising taxes to increase the price of tobacco products is the most effective means to reduce tobacco use and encourage smokers to quit.” – WHO Report on the Global Tobacco Epidemic, 2013

Samira Asma, DDS, MPH - Chief, CDC Global Tobacco Control Branch

Samira Asma, DDS, MPH - Chief, CDC Global Tobacco Control Branch

Real People, Real Stories

Mehmet Nuhoğlu started smoking when he was in middle school at the age of 12 after hearing that real men smoke. Little did he know that 45 years later his two pack a day addiction would lead to a heart attack and then cancer. “I never thought it would happen to me. I still can’t believe it,” he says.

Featured in national ads similar to the US Tips campaign, Mehmet was one of the real-life people featured in Turkey’s anti-tobacco mass media campaign that was launched in the later part of 2011. He tells of his experience with cigarettes and what daily smoking ended up costing him- his voice and his health. Now speaking with the help of an electrolarynx (a device that helps users who have lost their voice box produce clearer speech), he confesses that he regrets smoking.

March 10-16 Is World Salt Awareness Week

Categories: cardiovascular disease, noncommunicable diseases (NCDs)

 

This blog was originally posted on CNN.com on January 23, 2014.

 

Grocery store

Almost two years ago, Philadelphia launched its Healthy Chinese Take-out Initiative with the goal of reducing sodium content by 10% to 15%.

CDC Director Dr. Tom Frieden

CDC Director Dr. Tom Frieden

The city’s Public Health Department worked with 206 restaurants, first evaluating their menus for sodium content and then helping them choose ingredients and develop recipes with less sodium. One way found to reduce sodium was for restaurants to cut the use of commercially prepared sauces and instead make their own.

After nine months, the initiative analyzed two popular dishes from 20 participating restaurants to see what changed. The result? A 20% reduction in sodium, more than the project’s goal.

It’s one thing to choose how much salt to add to your food when you eat. It’s another to live with decisions made by those who prepare your food before it makes it to the table.

Global Burden of Mental Illness

Categories: mental health, noncommunicable diseases (NCDs)

Barbara Lopes Cardozo, MD, MPH, CDC Division of Global Health Protection

Barbara Lopes Cardozo, MD, MPH, CDC Division of Global Health Protection

“Total health” includes both physical and mental health. The Surgeon General’s landmark report on mental health in 1999 raised awareness about the inter-connectedness of mind and body, of physical and mental health. That reality has been validated ever since. However, mental health and addressing mental health-related problems are often under-emphasized.

CDC recognizes that the mental health of individuals in the community is a vital component of public health and that public health cannot be adequately addressed without also addressing mental health. Therefore, CDC is working on the public health issues related to mental health.

Improving Disease Surveillance and Outbreak Response in the Latin American and Caribbean Region through the Field Epidemiology Training Program

Categories: global health security, health systems strengthening, infectious disease, noncommunicable diseases (NCDs)

 

FETP residents taking water sample to test for cholera (2013)

FETP residents taking water sample to test for cholera (2013)

Dr. Victor Caceres, CDC Field Epidemiology Training Program Branch

Dr. Victor Caceres, CDC Field Epidemiology Training Program Branch

With increased global travel, everyone is more vulnerable to emerging and reemerging public health threats. This vulnerability is why every country needs a team of highly trained epidemiologists that can detect and rapidly respond to outbreaks and is why CDC is committed to working with countries to establish and support Field Epidemiology Training Programs (FETPs) all over the world including the Latin American and Caribbean (LAC) region.

For the last three years, CDC has been working with the Dominican Republic’s Ministry of Health (MoH), in collaboration with the University of Puerto Rico, to strengthen basic and intermediate-level training capacity for epidemiologists and laboratory personnel as part of the three-tiered “pyramid” training model developed and implemented by countries in Central America. 

Increasing Community and Stakeholder Knowledge, Awareness, and Acceptability of Cervical Cancer in Kenya

Categories: cancer, noncommunicable diseases (NCDs), women's/maternal health

Children in Kibera, Nairobi, Kenya

Children in Kibera, Nairobi, Kenya (Photo courtesy of Natasha Buchanan, CDC)

This year, in recognition of World Cancer Day, CDC’s Division of Cancer Prevention and Control (DCPC) is raising awareness about the impact of cancer around the world and CDC’s efforts to reduce the global burden. DCPC’s global activities include cancer prevention and control projects in Colombia, Brazil, Bolivia, Trinidad and Tobago, Tanzania, Kenya, Zambia, Botswana, India, Thailand, and Vietnam.

Natasha Buchanan, PhD, CDC Division of Cancer Prevention and Control

Natasha Buchanan, PhD, CDC Division of Cancer Prevention and Control

Many of these global projects are focused on helping to reduce the burden of cancer in developing regions, where more than half of the annual 14 million new cancer cases and 8 million cancer deaths occur. Among women worldwide, cervical cancer is the fourth most common cancer and the fourth leading cause of cancer-related death, but in less developed regions, the burden is much higher.

Eighty-five percent of cervical cancer deaths occur in developing countries where cervical cancer screening programs are incomplete or nonexistent. Because most women with cervical cancer in developing countries are 50 years old or younger, cervical cancer is the largest cause of years of life lost due to cancer in the developing world.

Working together to help strengthen Kenya’s capacity for birth defects prevention: A great collaborative start

Categories: child health, noncommunicable diseases (NCDs)

 

Working together to help strengthen Kenya’s capacity for birth defects prevention

 

Alejandro Azofeifa and Diana Valencia work to expand birth defects surveillance worldwide through Birth Defects COUNT, a CDC global initiative.

A Call for Assistance

Diana Valencia

Diana Valencia

Alejandro Azofeifa

Alejandro Azofeifa

In early 2012, Dr. Leland Albright, a pediatric neurosurgeon at Kijabe Hospital in Kijabe, Kenya, alerted CDC to what appeared to be a rising number of patients with some serious birth defects of the brain and spine called neural tube defects. He asked CDC to help pinpoint whether the prevalence was actually increasing or if there was simply an increased number of referrals to the hospital from throughout Kenya. Dr. Albright also questioned whether genetic, nutritional or social factors could be causing the increase.

The Value of CDC’s Work in Thailand

Categories: global disease detection, global health security, health systems strengthening, HIV/AIDS, infectious disease, noncommunicable diseases (NCDs), refugee health, tuberculosis (TB), violence and injury

 

Thai monk

 

When I became country director in 2013 the relationships between Thailand’s public health officials and CDC were already strong and well established.

Mitch Wolfe, MD MPH, Director, CDC-Thailand

Mitch Wolfe, MD MPH, Director, CDC-Thailand

That wasn’t surprising. CDC’s collaboration with the Ministry of Public Health, after all, began 30 years ago and the partnership has been prospering  – and expanding – ever since. And there is a strong history between the two countries – this year Thailand and the US are celebrating 180 years of Friendship.

The reasons are well established too. And numerous.

Last summer, while visiting family, I was asked by a U.S. border guard, “Why is America working abroad for public health?” I was happy to get this question, as it was an opportunity to deepen understanding for why CDC works abroad – to protect Americans from health threats, to build important relationships with strategic partners, and to learn lessons that can be expanded to other parts of the world.

CDC Launches New Noncommunicable Disease Training for Field Epidemiologists

Categories: noncommunicable diseases (NCDs)

Sharmily Roy, CDC Field Epidemiology Training Program (FETP)

Sharmily Roy, CDC Field Epidemiology Training Program (FETP)

Noncommunicable diseases (NCDs) are responsible for nearly 40 million deaths each year which represents almost three quarters of all deaths worldwide. These include deaths caused by injuries, such as motor vehicle injuries, and chronic diseases, such as cardiovascular disease, cancer, diabetes, and chronic respiratory diseases. Deaths due to NCDs are becoming more common in low- and middle-income countries, where the majority of NCD deaths occur and health systems are often not equipped to respond. The enormous social and economic toll of NCDs worldwide calls for an integrated strategic approach to reduce illnesses and deaths due to NCDs globally.

November 14 is World Diabetes Day

Categories: diabetes, noncommunicable diseases (NCDs)

 

Photo of people

Diabetes is the seventh leading cause of death in the United States, and there are 371 million people living with diabetes worldwide. Another 280 million are at high risk of developing the disease. By 2030, half a billion people are expected to be living with diabetes. (See About World Diabetes Day.)

Ann Albright, PhD, RD, Director, CDC Division of Diabetes Translation

Ann Albright, PhD, RD, Director, CDC Division of Diabetes Translation

The good news is that type 2 diabetes can be prevented or delayed. Making modest lifestyle changes today can help protect the future health of you and your family.

In addition to a variety of other diabetes awareness efforts, the Centers for Disease Control and Prevention’s (CDC) Division of Diabetes Translation (DDT) recognizes November 14 as World Diabetes Day. Through education and prevention, CDC supports this diabetes global awareness campaign.

What is diabetes?

Diabetes is a disease in which blood glucose levels are above normal. When you have diabetes, your body either doesn’t make enough insulin or can’t use its own insulin as well as it should. This causes glucose (sugar) to build up in your blood.  Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations.

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