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BackgroundSalt intake in China is over twice the maximum recommendation of the World Health Organization. Unlike most developed countries where salt intake is mainly derived from prepackaged foods, around 80% of the salt consumed in China is added during cooking. ObjectiveAction on Salt China (ASC), initiated in 2017, aims to develop, implement, and evaluate a comprehensive and tailored salt reduction program for national scaling-up. MethodsASC consists of six programs working in synergy to increase salt awareness and to reduce the amount of salt used during cooking at home and in restaurants, as well as in processed foods. Since September 2018, two health campaigns on health education and processed foods have respectively started, in parallel with four open-label cluster randomized controlled trials (RCTs) in six provinces across China: (1) app-based intervention study (AIS), in which a mobile app is used to achieve and sustain salt reduction in school children and their families; (2) home cook-based intervention study (HIS), in which family cooks receive support in using less salt; (3) restaurant-based intervention study (RIS) targeting restaurant consumers, cooks, and managers; and (4) comprehensive intervention study (CIS), which is a real-world implementation and evaluation of all available interventions in the three other RCTs. To explore the barriers, facilitators, and effectiveness of delivering a comprehensive salt reduction intervention, these RCTs will last for 1 year (stage 1), followed by nationwide implementation (stage 2). In AIS, HIS, and CIS, the primary outcome of salt reduction will be evaluated by 24-hour urinary sodium excretion in 6030 participants, including 5436 adults and 594 school children around 8-9 years old. In RIS, the salt content of meals will be measured by laboratory food analysis of the 5 best-selling dishes from 192 restaurants. Secondary outcomes will include process evaluation; changes in knowledge, attitude, and practice on salt intake; and economic evaluation. ResultsAll RCTs have been approved by Queen Mary Research Ethics Committee and the Institutional Review Boards of leading institutes in China. The research started in June 2017 and is expected to be completed around March 2021. The baseline investigations of the four RCTs were completed in May 2019. ConclusionsThe ASC project is progressing smoothly. The intervention packages and tailored components will be promoted for salt reduction in China, and could be adopted by other countries. Trial RegistrationChinese Clinical Trial Registry. AIS: ChiCTR1800017553; https://tinyurl.com/vdr8rpr. HIS: ChiCTR1800016804; https://tinyurl.com/w8c7x3w. RIS: ChiCTR1800019694; https://tinyurl.com/uqkjgfw. CIS: ChiCTR1800018119; https://tinyurl.com/s3ajldw. International Registered Report Identifier (IRRID)DERR1-10.2196/15933

Objective To determine the contribution of pre-packaged foods to population sodium intake in China, and to propose sodium content targets for food subcategories used for the World Health Organization's (WHO's) global sodium benchmarks. Methods The impact of four different approaches to reducing the sodium content of pre-packaged foods on population sodium intake was estimated using data from national databases covering the nutrient content and ingredients of 51 803 food products and food consumption by 15 670 Chinese adults. We recategorized food products using a food categorization framework developed for WHO's global sodium benchmarks and adapted for China-specific foods. Findings Pre-packaged foods, including condiments, contributed 1302.5 mg/day of sodium intake per adult in 2021, accounting for 30.1% of population sodium intake in China. Setting maximum sodium content levels using a 90th-percentile target would reduce sodium intake from pre-packaged foods by 96.2 mg/day, corresponding to a 1.9% reduction in population intake. Using the 75th-percentile, a fixed 20% reduction and WHO benchmark targets would further reduce intake by 262.0 mg/day (5.2% population intake), 302.8 mg/day (6.0% population intake) and 701.2 mg/day per person (13.9% population intake), respectively. Maximum sodium content levels based on revised 20% reduction targets were proposed because they should result in substantial and acceptable reductions in sodium content for most food subcategories: overall sodium intake would decline by 305.0 mg/day per person, and population intake by 6.1%. Conclusion This study provides the scientific rationale for government policy on setting targets for food sodium content in China. Simultaneous action on discretionary salt use should also be taken. [Phrase omitted] Objectifs relatifs a la teneur en sodium des aliments preemballes en Chine: etude quantitative et proposition Objectif Determiner dans quelle mesure les denrees alimentaires preemballees contribuent a l'apport en sodium au sein de la population chinoise et proposer des objectifs pour en limiter la teneur parmi les sous-categories d'aliments reprises dans les criteres de reference mondiaux de l'Organisation mondiale de la Sante (OMS). Methodes Nous avons estime l'impact de quatre approches differentes visant a reduire la teneur en sodium des denrees alimentaires preemballees sur l'apport sode de la population en utilisant les informations issues de bases de donnees nationales sur la teneur en nutriments et les ingredients de 51 803 produits alimentaires ainsi que la consommation en nourriture de 15 670 adultes chinois. Nous avons reclasse les produits alimentaires a l'aide d'un systeme de categorisation des aliments developpe dans le cadre des criteres de reference mondiaux de l'OMS et adapte aux habitudes alimentaires du pays. Resultats Les denrees alimentaires preemballees, y compris les condiments, representaient un apport sode de 1302,5 mg/jour par adulte en 2021, ce qui equivaut a 30,1% de l'apport en sodium au sein de la population chinoise. Etablir un objectif fonde sur le 90e percentile afin de definir une teneur maximale en sodium permettrait de reduire l'apport sode des denrees alimentaires preemballees de 96,2 mg/jour, ce qui correspond a une diminution de 1,9% de l'apport dans la population. Utiliser le 75e percentile, une reduction fixe de 20% et les criteres de reference mondiaux de l'OMS ferait encore baisser l'apport de 262,0 mg/jour (5,2% de l'apport dans la population), 302,8 mg/jour (6,0% de l'apport dans la population) et 701,2 mg/jour par personne (13,9% de l'apport dans la population) respectivement. Enfin, une teneur maximale en sodium inspiree des nouveaux objectifs de 20% de reduction a ete proposee car elle devrait entrainer un recul considerable et acceptable de la teneur en sodium pour la plupart des sous-categories d'aliments: l'apport sode global diminuerait de 305,0 mg/jour par personne et l'apport dans la population de 6,1%. Conclusion Cette etude fournit les arguments scientifiques necessaires a la mise en reuvre d'une politique gouvernementale qui definirait des objectifs relatifs a la teneur en sodium des denrees alimentaires en Chine. Des actions concomitantes en matiere d'utilisation du sel de table et de cuisine devraient egalement etre entreprises. Objetivos sobre el contenido de sodio de los alimentos preenvasados, China: estudio cuantitativo y propuesta Objetivo Determinar como los alimentos preenvasados propician la ingesta de sodio en la poblacion China, y proponer objetivos centrados en el contenido de sodio de las subcategorias alimenticias utilizadas en las referencias mundiales de sodio de la Organizacion Mundial de la Salud (OMS). Metodos Se evaluo la repercusion de cuatro enfoques diferentes destinados a reducir el contenido de sodio de los alimentos preenvasados en la ingesta de sodio poblacional. Para ello, se utilizo informacion de las bases de datos nacionales acerca del contenido en nutrientes y los ingredientes de 51 803 productos alimenticios, asi como sobre el consumo de alimentos de 15 670 chinos adultos. Restablecimos las categorias de los productos alimenticios utilizando un esquema de clasificacion alimenticia desarrollado para englobar las referencias mundiales de sodio de la OMS, adaptado a alimentos especificos de China. Resultados Los alimentos preenvasados, incluidos los condimentos, representaban 1302,5 mg/dia de la ingesta de sodio por adulto en 2021, lo que suponia un 30,1% de la ingesta de sodio de la poblacion China. Establecer niveles maximos de contenido en sodio utilizando como objetivo un percentil 90 reduciria la ingesta de sodio de los alimentos preenvasados en 96,2 mg/dia, lo que corresponde a una reduccion del 1,9% en la ingesta poblacional. Utilizando el percentil 75, una reduccion fija del 20% y los objetivos de referencia de la OMS se seguiria reduciendo la ingesta en 262,0 mg/dia (5,2% de la ingesta poblacional), 302,8 mg/dia (6,0% de la ingesta poblacional) y 701,2 mg/dia por persona (13,9% de la ingesta poblacional) respectivamente. Se propusieron niveles maximos de contenido en sodio basados en objetivos revisados relativos a una reduccion del 20%, lo que supondria una disminucion significativa y adecuada del contenido de sodio de la mayoria de subcategorias alimenticias: la ingesta global de sodio disminuiria en 305,0 mg/dia por persona, y la ingesta poblacional se reduciria en un 6,1%. Conclusion El presente estudio ofrece fundamentos cientificos relevantes para la politica gubernamental, acerca del establecimiento de objetivos centrados en el contenido de sodio alimenticio de productos de China. Asimismo, se deberian adoptar medidas simultaneas relativas al consumo de sal opcional., Introduction Sodium is an essential nutrient for which humans have a physiological need of as little as 200 to 500 mg/day. (1,2) The primary dietary contributor is the salt (i.e. [...]

Autism spectrum disorders (ASDs) are a group of neurodevelopmental-related disorders with a high genetic risk. Recently, chromatin remodeling factors have been found to be related to ASDs. "SMARCA4" is such a catalytic subunit of the chromatin-remodeling complex. In this report, we identified seven novel missense variants in the "SMARCA4" gene from eight pediatric patients. All eight patients had moderate to severe intellectual disability, and seven showed autistic/likely autistic features. Compared with the patients reported in the literature, our patients were less likely to show craniofacial or finger/toe anomalies. Our findings further supported that "SMARCA4" is associated with ASDs. We suggest that individuals with the abovementioned phenotypes should consider genetic testing.