Modeling health gains and cost savings for ten dietary salt reduction targets

Abstract

BackgroundDietary salt reduction is included in the top five priority actions for non-communicable disease control internationally. We therefore aimed to identify health gain and cost impacts of achieving a national target for sodium reduction, along with component targets in different food groups.MethodsWe used an established dietary sodium intervention model to study 10 interventions to achieve sodium reduction targets. The 2011 New Zealand (NZ) adult population (2.3 million aged 35+ years) was simulated over the remainder of their lifetime in a Markov model with a 3 % discount rate.ResultsAchieving an overall 35 % reduction in dietary salt intake via implementation of mandatory maximum levels of sodium in packaged foods along with reduced sodium from fast foods/restaurant food and discretionary intake (the “full target”), was estimated to gain 235,000 QALYs over the lifetime of the cohort (95 % uncertainty interval [UI]: 176,000 to 298,000). For specific target components the range was from 122,000 QALYs gained (for the packaged foods target) down to the snack foods target (6100 QALYs; and representing a 34–48 % sodium reduction in such products).All ten target interventions studied were cost-saving, with the greatest costs saved for the mandatory “full target” at NZ$1260 million (US$820 million). There were relatively greater health gains per adult for men and for Māori (indigenous population).ConclusionsThis work provides modeling-level evidence that achieving dietary sodium reduction targets (including specific food category targets) could generate large health gains and cost savings for a national health sector. Demographic groups with the highest cardiovascular disease rates stand to gain most, assisting in reducing health inequalities between sex and ethnic groups.Electronic supplementary materialThe online version of this article (doi:10.1186/s12937-016-0161-1) contains supplementary material, which is available to authorized users.

Monitoring and implementation of salt reduction initiatives in Africa: A systematic review

“…Consistent with prior studies, 68,70‐72 modeling studies demonstrate that interventions for reducing dietary sodium have the potential to generate large health gains and also large cost savings for a health system. A modeling study that informed the development of the sodium legislation in South Africa estimated that a reduction of daily sodium intake of 0.85 g per person per day could avert 7400 cardiovascular deaths; 6400 of which would be due to reducing the sodium levels of bread alone 57 .…”

Effect of 25% Sodium Reduction on Sales of a Top‐Selling Bread in Remote Indigenous Australian Community Stores: A Controlled Intervention Trial

“…Using an alternative average energy intake of 8.5 MJ/day (as per the remote sample of the Australian Aboriginal and Torres Strait Islander Health Survey 2012–2013) [9], the projected sodium reduction would equal approximately 15% of the reduction needed to meet the WHO target. While a sodium reduction of 3.8% or 110 mg/day may seem small, it has the potential to be clinically significant at the population level [12,13,30]. Cobiac et al (2010) modelled the health benefits and cost-effectiveness of interventions to reduce sodium intake in the Australian adult population [30].…”

“…We calculated that 25% salt-reduction in bread has the capacity to reduce salt intake in remote Indigenous communities by 5%, or an average reduction of 140 mg sodium (0.4 g salt) per day [6]—a reduction that could be clinically significant at the population level [12,13,14]. However, to maintain commercial viability and to maximise the clinical impact, it is important that consumers continue to purchase the lower salt bread.…”

Salt Consumption and Health

“…Çoğunlukla bir devlet politikası olarak yürütülen zorunlu uygulamaların (örneğin; ekmeğin tuzunu azaltmak gibi) daha başarılı olduğu bildirilmektedir. 84 Türkiye'de önerilenin üç katı olan tuz tüketimi Sağlık Bakanlığı'nı harekete geçirmiş ve "Türkiye Aşırı Tuz Tüketiminin Azaltılması Programı" nın başlamasına neden olmuştur. Gıda, Tarım ve Hayvancılık Bakanlığı'nın da desteklediği bu program kapsamında, öncelikle ekmeklerin tuzu azaltılmış; daha sonra peynir, salça gibi işlenmiş besinlerin tuzunun azaltılması, toplu beslenme yapılan yerlerdeki menülerde gerektiği kadar tuz azaltımına gidilmesi, masalardan tuzluğun uzaklaştırılması gibi önlemler alınmıştır, alınmaya da devam etmektedir.…”