Modelling the impact of specific food policy options on coronary heart disease and stroke deaths in Ireland

Abstract

ObjectiveTo estimate the potential reduction in cardiovascular (CVD) mortality possible by decreasing salt, trans fat and saturated fat consumption, and by increasing fruit and vegetable (F/V) consumption in Irish adults aged 25–84 years for 2010.DesignModelling study using the validated IMPACT Food Policy Model across two scenarios. Sensitivity analysis was undertaken. First, a conservative scenario: reductions in dietary salt by 1 g/day, trans fat by 0.5% of energy intake, saturated fat by 1% energy intake and increasing F/V intake by 1 portion/day. Second, a more substantial but politically feasible scenario: reductions in dietary salt by 3 g/day, trans fat by 1% of energy intake, saturated fat by 3% of energy intake and increasing F/V intake by 3 portions/day.SettingRepublic of Ireland.OutcomesCoronary heart disease (CHD) and stroke deaths prevented.ResultsThe small, conservative changes in food policy could result in approximately 395 fewer cardiovascular deaths per year; approximately 190 (minimum 155, maximum 230) fewer CHD deaths in men, 50 (minimum 40, maximum 60) fewer CHD deaths in women, 95 (minimum 75, maximum 115) fewer stroke deaths in men, and 60 (minimum 45, maximum 70) fewer stroke deaths in women. Approximately 28%, 22%, 23% and 26% of the 395 fewer deaths could be attributable to decreased consumptions in trans fat, saturated fat, dietary salt and to increased F/V consumption, respectively. The 395 fewer deaths represent an overall 10% reduction in CVD mortality. Modelling the more substantial but feasible food policy options, we estimated that CVD mortality could be reduced by up to 1070 deaths/year, representing an overall 26% decline in CVD mortality.ConclusionsA considerable CVD burden is attributable to the excess consumption of saturated fat, trans fat, salt and insufficient fruit and vegetables. There are significant opportunities for Government and industry to reduce CVD mortality through effective, evidence-based food policies.

Public health economic evaluation of different European Union–level policy options aimed at reducing population dietary trans fat intake

“…Although our model applied a lifetime horizon (85 y) for calculating health effects and costs, others used shorter time horizons (15–18). The time horizon needs to be sufficiently long to reflect all important differences in costs or outcomes between the policy options under comparison (25).…”

“…Several health economic models suggest that reducing population iTFA intakes provides health benefits [i.e., reductions in cardiovascular disease or coronary artery disease (CAD)–related events and deaths as well as cost savings] (15–18). Restrepo and Rieger (19) estimated that the 2004 legal limit on iTFAs in Denmark has prevented ∼14.2 deaths · 100,000 persons −1 · y −1 .…”

Effects of reducing processed culinary ingredients and ultra-processed foods in the Brazilian diet: a cardiovascular modelling study

“…Modelling the effect of changing saturated fat, trans-fat, added sugar and salt consumption patterns We used the IMPACT Food Policy methodology (20,32,37) to estimate potential CVD mortality reduction if saturated fat, trans-fat, salt and added sugar from processed culinary ingredients and UPF were reduced in the Brazilian diet.…”

Adaptación española de las guías europeas de 2016 sobre prevención de la enfermedad cardiovascular en la práctica clínica

“…Por este motivo, las estrategias de prevención individuales para personas con riesgo alto o ECV establecida deben de complementarse con estrategias poblacionales que promuevan la adopción de estilos de vida saludables y la reducción de los factores de riesgo en la población (12) . Ambas estrategias son coste-efectivas, particularmente la legislación dirigida a disminuir el consumo de tabaco y el contenido de sal, azúcares y ácidos grasos de tipo trans en los alimentos, y los tratamientos para el control del colesterol y la presión arterial cuando se dirigen a personas con alto RCV (13,14,15,16,17,18,19) . Es importante señalar que el control poblacional de los principales factores de RCV es todavía muy bajo en España: 22,7% para la hipertensión arterial (HTA) (20) y 13,2% para el colesterol (21) .…”