卫生研究

目的评价以减盐宣传教育和设置低盐菜品专柜(区)为主的减盐综合干预措施在食堂和饭店餐饮单位的减盐效果。方法 2015年8月,在山东省内济南、烟台、潍坊、莱芜、临沂和泰安共6个地市采用方便抽样的方法抽取36家餐饮单位(饭店和食堂各18家),随机分为干预A组、干预B组和对照组。干预A组以减盐宣传教育为主,主要包括对餐饮单位管理者、厨师和服务人员集中进行减盐相关知识培训,频次为每月一次;发放厨师专用控盐勺和限盐罐;餐厅减盐环境的布置等。干预B组在A组的基础上设置低盐菜品专柜(区)或推出低盐菜单,对照组不主动施加任何干预措施,干预期为6个月,厨师按照统一要求记录每餐低盐菜品销售量、食盐领取量及用餐人次数。干预前后对餐饮单位工作者进行问卷调查,比较干预前后饭店和食堂的减盐效果及控盐行为变化情况。结果干预后,干预A、B两组餐饮单位工作者盐与高血压各项相关知识知晓率和减盐行为均有较大提高(P<0.05),而对照组只有高血压诊断标准知晓率略有提高(P<0.05)。与干预A组相比,干预后B组主动采取减盐行为的提高值较大(P<0.05),使用定量盐勺和主动给顾客推荐低盐菜品比例的提高值分别是32.1%和24.2%,而干预A组的提高值分别是9.5%和8.5%,差异有统计学意义(χ²分别是51.72和30.01,P<0.05)。食堂的低盐菜品销售比例稳步上升,干预期末已达到16.8%,而饭店干预期末销售比例降到9.2%,二者差异有统计学意义(χ²=44.66,P<0.05)。结论减盐宣传干预能明显提高盐与高血压知识和态度,设置低盐菜品专柜(菜单)对改善减盐行为方面效果显著。减盐综合干预措施在单位食堂开展的效果要优于饭店,倡导餐饮单位开展减盐宣传干预和设置低盐菜品专柜等多样化的干预措施。

OBJECTIVE To evaluate the effects of comprehensive intervention measures mainly consisting of salt reduction health education and labeling less salt foods among catering units. METHODS The total of 36 catering units were selected randomly and divided into intervention group A, B and control group in August of 2015. Health education was initiated in the intervention group A, including the training of knowledge on salt reduction for managers, cooks and service personnel of catering units every month; distribution of special salt control spoon for cooks; the arrangement of environment of salt reduction in catering units. And health education and labeling less salt foods was provided to the intervention group B, The control group C did not actively provide any intervention. The cook records the quantity of low-salt dishes sold, salt collection and the number of persons per meal in according to the requirements. Questionnaire survey and physical examination were performed to evaluate the effects of comprehensive intervention measures among catering units in the three groups of staffs in the catering units in a baseline study and an evaluation survey six months after the intervention. RESULTS Compared with group C, the knowledge, attitude and behavior of salt reduction was significantly improved in intervention group A and B(P<0.05). The behavior towards salt reduction improved much better in group B than in group A(P<0.05), and using salt spoon when cooking and recommending less salt food to customer improved 32.1%(χ²=51.72, P<0.05)and 24.2%(χ²=30.01, P<0.05)separately. The proportion of sales of low salt dishes in the unit canteen has increased steadily, reaching 16.8% while the proportion of sales has dropped to 9.2% in the hotel by the end of the intervention period(χ²=44.66, P<0.05). CONCLUSION The level of knowledge of reducing salt was improved by health education, and labeling less salt foods can promote reducing salt related behavior. The effect of comprehensive intervention measures for salt reduction in unit canteen is better than in the hotel. It was suggested that comprehensive intervention measures mainly consisting of salt reduction health education and labeling less salt foods should be used together in the catering units.