| Objective:In order to obtain a method for estimating dietary sodium intake by province;to estimate provincial dietary sodium intake;and to analyze the provincial burden of gastric cancer morbidity and mortality attributable to overconsumption of dietary sodium among Chinese adults.Methods:Data on dietary sodium consumption of this study from the China National Nutrition and Health Surveillance(CNNHS)2010-2012,the CNNHS 2010-2012 was carried out on multi-stage stratified cluster sampling method with proportional to the population,a total of 150 site was selected in this study.Three consecutive days of 24 hours recalls in combination with household condiments weighing method to collect complete dietary record information of 48826 adults.The dietary sodium intake of subjects was calculated according to the Chinese Food Composition Table by age groups and sex.Regression Kriging Method(RK),Inverse Distance Weighting(IDW),Ordinary Kriging(OK)and Collaborative Kriging Method(CK)were used to estimate the dietary sodium intake of each site,Root-Mean-Square-Error(RMSE)and Mean-Absolute Error(MAE)were used to compare the interpolation accuracy of different estimation methods.The method with the highest estimation accuracy was selected to estimate the dietary sodium intake of all site,and the dietary sodium estimates of each province were calculated according to the population weight.Data on the case and death of gastric cancer were collected from the 2018 China Cancer Registry Annual Report,which collected gastric cancer data from 388 monitoring sites in 2015.According to the number of cases and deaths in each monitoring site as well as the morbidity and mortality in each age group at each monitoring site,the morbidity and mortality at each monitoring site were calculated according to the morbidity,mortality and age and gender at each monitoring site.The number of gastric cancer cases and deaths,morbidity and mortality of each province were calculated based on the gastric cancer incidence,mortality and population weight of each province.The disease burden of gastric cancer due to high sodium diet was calculated based on the RR value of gastric cancer and overconsumption of dietary sodium,as well as the morbidity and mortality of gastric cancer.ArcGIS 10.7 was used to estimate dietary sodium intake,and SAS 9.4 was used to analyze and calculate the consumption of dietary sodium,gastric cancer morbidity and mortality,and the PAF of gastric cancer due to overconsumption of dietary sodium.Results:1.Comparing the accuracy of different estimation methods of dietary sodium intake:The accuracy of estimation of dietary sodium intake by IDW,OK,CK and RK was compared with the measured dietary sodium intake,the RMSE of the four estimation methods were 0.72,0.66,0.65 and 0.62,and the MAE were 0.54,0.53,0.52 and 0.50,respectively.The RMSE and MAE of RK method were the lowest,and the estimated dietary sodium intake of RK method were closer to the measured dietary sodium intake.2.Dietary sodium intake among Chinese in 2010:The dietary sodium consumption of Chinese was 5172mg/d according to the CNNHS 2010-2012.The RK method was used to estimate the dietary sodium consumption of all site in China,the estimated dietary sodium intake was 5201 mg/d,which was only 29mg/d higher than the measured sodium consumption.The provinces with high dietary sodium consumption were mainly Xinjiang,Hebei,Tianjin,Shangdong,Qinghai and Tibet,dietary sodium consumption in Guangxi,Guangdong,Guizhou and other places of is low,the spatial distribution of dietary sodium intake showed a decreasing trend from north to south.Among the 31 inland provinces,the province with the lowest measured dietary sodium consumption was Guizhou,with 3647mg/d;the province with the highest measured dietary sodium intake was Xinjiang,with 6431mg/d;the measured dietary sodium for men was 5314mg/d,for women was 5208mg/d.The measured dietary sodium intake of Chinese male aged 50-54 years was the highest,and the measured dietary sodium intake of Chinese female aged 55-59 years was the highest,which was 5660mg/d and 5353mg/d,respectively.Among the 31 provinces,Guizhou Province had the lowest estimated intake of 4204mg/d,while Tibet had the highest estimated intake of 6453mg/d,and male and female had an estimated intake of 5307mg/d and 5011mg/d,respectively.The estimated dietary sodium intake of Chinese male and female aged 50-54 years was the highest,which was 5689mg/d and 5289mg/d,respectively.3.The morbidity and mortality of gastric cancer in each province:The number of gastric cancer cases in China was 269644,the number of male cases was 187328,and the number of female cases was 82316.The age group with the largest number of cases was 65-69 years old,and Henan Province had the highest number of cases of gastric cancer among the 31 provinces,the morbidity of gastric cancer was 26.87/100000,among which the morbidity of male gastric cancer was 37.02/100000 and that of female gastric cancer was 16.54/100000.The age group with the highest morbidity was the age group≥80 years old,and the province with the highest morbidity was Gansu Province.The total number of gastric cancer deaths in 31 provinces was 195455,including 134782 men and 60674 women.The number of gastric cancer deaths increased gradually with age,from 253 in the 20-24 years old group to 37013 in the≥80 years old group.The mortality of gastric cancer patients in the whole population was 19.48/100000,among which the mortality of male gastric cancer patients was 26.24/100000 and that of female gastric cancer patients was 12.19/100000.The mortality of gastric cancer increased with age,from 0.20/100000 in the 20-24 years old group to 176.80/100000 in the≥80 years old group.Among the 31 provinces,Gansu Province had the highest mortality of gastric cancer(51.26/100000),among which the mortality of male was as high as 75.85/100000,and that of female was 26.23/100000.4.Population attribution proportion of gastric cancer morbidity and mortality with overconsumption of dietary sodium:Among Chinese gastric cancer patients,29.94%were attributed to overconsumption of dietary sodium,and the PAF of male gastric cancer patients attributed to overconsumption of dietary sodium was 30.81%,and that of female was 27.95%.Among all the provinces,Guizhou has the lowest population attribution proportion of overconsumption of dietary sodium to gastric cancer,with the PAF of 22.21%,22.96%for men and 21.17%for women,followed by Guangxi(23.74%),24.13%for men and 22.96%for women,respectively.The overconsumption of dietary sodium in Tibet had the highest proportion of population attribution for gastric cancer(36.54%),38.38%in male and 33.92%in female,respectively.In the cases of gastric cancer death,Guizhou Province also had the lowest population attribution proportion of overconsumption of dietary sodium to gastric cancer death,with population attribution proportion of 21.71%,and the Tibet had the highest population attribution proportion of overconsumption of dietary sodium to gastric cancer death,with a population attribution proportion of 34.80%.5.Gastric cancer morbidity and mortality attributable to overconsumption of dietary sodium:The morbidity of gastric cancer attributable to overconsumption of dietary sodium in Chinese was 8.04/100000,including 11.41/100000 in male and 4.62/100000 in female.The mortality of gastric cancer attributable to overconsumption of dietary sodium was 5.64/100000 in Chinese,among which the mortality was 7.92/1’00000 in male and 3.32/100000 in female.For both male and female,gastric cancer morbidity and mortality due to overconsumption of dietary sodium increased with age.The morbidity of gastric cancer attributed to overconsumption of dietary sodium was the lowest(2.51%)in Guangdong,and the highest(24.85%)in Gansu.The lowest mortality attributed to overconsumption of dietary sodium was found in Tibet(0.29%)and the highest in Gansu(14.51%).Conclusion:RK is suitable for estimating dietary sodium intake in areas where no dietary survey has been conducted,dietary sodium intake of Chinese far exceeds the recommended amount,and the intake gradually decreases from north to south.The dietary sodium intake in Tibet was the highest(6453mg/d),and that in Guizhou was the lowest(3627mg/d).The morbidity of gastric cancer increased first and then decreased with age,and the areas with high morbidity and mortality were mainly in Gansu,Henan and Sichuan provinces.The higher risk of gastric cancer and gastric cancer deaths in our population is attributed to the high sodium diet.The risk of gastric cancer and death of Chinese is attributed to a high proportion of overconsumption of dietary sodium.The proportion of population attribution of overconsumption of dietary sodium to gastric cancer morbidity and mortality is different in provinces.The proportion of population attribution of overconsumption of dietary sodium to gastric cancer morbidity and mortality increases with the increase of dietary sodium intake. |
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