Limits...
Eliminating artificial trans fatty acids in Argentina: estimated effects on the burden of coronary heart disease and costs.

Rubinstein A, Elorriaga N, Garay OU, Poggio R, Caporale J, Matta MG, Augustovski F, Pichon-Riviere A, Mozaffarian D - Bull. World Health Organ. (2015)

Bottom Line: We built a policy model including baseline intake of TFA, the oils and fats used to replace artificial TFAs, the clinical effect of reducing artificial TFAs and the costs and DALYs saved due to averted CHD events.Even under the most conservative scenario, reduction of TFA intake had a substantial effect on public health.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Institute for Clinical Effectiveness and Health Policy (IECS), Ravignani 2024, Buenos Aires, C1414CPV, Argentina .

ABSTRACT

Objective: To estimate the impact of Argentine policies to reduce trans fatty acids (TFA) on coronary heart disease (CHD), disability-adjusted life years (DALYs) and associated health-care costs.

Methods: We estimated the baseline intake of TFA before 2004 to be 1.5% of total energy intake. We built a policy model including baseline intake of TFA, the oils and fats used to replace artificial TFAs, the clinical effect of reducing artificial TFAs and the costs and DALYs saved due to averted CHD events. To calculate the percentage of reduction of CHD, we calculated CHD risks on a population-based sample before and after implementation. The effect of the policies was modelled in three ways, based on projected changes: (i) in plasma lipid profiles; (ii) in lipid and inflammatory biomarkers; and (iii) the results of prospective cohort studies. We also estimated the present economic value of DALYs and associated health-care costs of coronary heart disease averted.

Findings: We estimated that projected changes in lipid profile would avert 301 deaths, 1066 acute CHD events, 5237 DALYs and 17 million United States dollars (US$) in health-care costs annually. Based on the adverse effects of TFA intake reported in prospective cohort studies, 1517 deaths, 5373 acute CHD events, 26 394 DALYs and US$ 87 million would be averted annually.

Conclusion: Even under the most conservative scenario, reduction of TFA intake had a substantial effect on public health. These findings will help inform decision-makers in Argentina and other countries on the potential public health and economic impact of this policy.

No MeSH data available.


Related in: MedlinePlus

Trans fatty acids regulations in Argentina, 2004–2015
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4581646&req=5

Figure 1: Trans fatty acids regulations in Argentina, 2004–2015

Mentions: In Argentina, before 2004, artificial TFAs were present in most sweet or salty solid snack foods, such as biscuits.10 Between 2004 and 2014, Argentina implemented several policies to reduce artificial TFAs. After 2004, the industry voluntarily reformulated foods by replacing approximately 40% of TFAs from partially hydrogenated vegetable oils, mainly with TFA-free sunflower oil with high-oleic acid content.11 Regulations enforcing mandatory labelling of artificial TFAs in food were introduced in 2006.12 With support from the Pan American Health Organization,13,14 the Argentine Ministry of Health negotiated with industry to eliminate artificial TFAs. The country’s food code was amended,15 such that, by the end of 2014, industrially-produced TFAs in food should not exceed 2% of total fats in vegetable oils and margarines and 5% of total fats in other foods (Fig. 1).16


Eliminating artificial trans fatty acids in Argentina: estimated effects on the burden of coronary heart disease and costs.

Rubinstein A, Elorriaga N, Garay OU, Poggio R, Caporale J, Matta MG, Augustovski F, Pichon-Riviere A, Mozaffarian D - Bull. World Health Organ. (2015)

Trans fatty acids regulations in Argentina, 2004–2015
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4581646&req=5

Figure 1: Trans fatty acids regulations in Argentina, 2004–2015
Mentions: In Argentina, before 2004, artificial TFAs were present in most sweet or salty solid snack foods, such as biscuits.10 Between 2004 and 2014, Argentina implemented several policies to reduce artificial TFAs. After 2004, the industry voluntarily reformulated foods by replacing approximately 40% of TFAs from partially hydrogenated vegetable oils, mainly with TFA-free sunflower oil with high-oleic acid content.11 Regulations enforcing mandatory labelling of artificial TFAs in food were introduced in 2006.12 With support from the Pan American Health Organization,13,14 the Argentine Ministry of Health negotiated with industry to eliminate artificial TFAs. The country’s food code was amended,15 such that, by the end of 2014, industrially-produced TFAs in food should not exceed 2% of total fats in vegetable oils and margarines and 5% of total fats in other foods (Fig. 1).16

Bottom Line: We built a policy model including baseline intake of TFA, the oils and fats used to replace artificial TFAs, the clinical effect of reducing artificial TFAs and the costs and DALYs saved due to averted CHD events.Even under the most conservative scenario, reduction of TFA intake had a substantial effect on public health.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Institute for Clinical Effectiveness and Health Policy (IECS), Ravignani 2024, Buenos Aires, C1414CPV, Argentina .

ABSTRACT

Objective: To estimate the impact of Argentine policies to reduce trans fatty acids (TFA) on coronary heart disease (CHD), disability-adjusted life years (DALYs) and associated health-care costs.

Methods: We estimated the baseline intake of TFA before 2004 to be 1.5% of total energy intake. We built a policy model including baseline intake of TFA, the oils and fats used to replace artificial TFAs, the clinical effect of reducing artificial TFAs and the costs and DALYs saved due to averted CHD events. To calculate the percentage of reduction of CHD, we calculated CHD risks on a population-based sample before and after implementation. The effect of the policies was modelled in three ways, based on projected changes: (i) in plasma lipid profiles; (ii) in lipid and inflammatory biomarkers; and (iii) the results of prospective cohort studies. We also estimated the present economic value of DALYs and associated health-care costs of coronary heart disease averted.

Findings: We estimated that projected changes in lipid profile would avert 301 deaths, 1066 acute CHD events, 5237 DALYs and 17 million United States dollars (US$) in health-care costs annually. Based on the adverse effects of TFA intake reported in prospective cohort studies, 1517 deaths, 5373 acute CHD events, 26 394 DALYs and US$ 87 million would be averted annually.

Conclusion: Even under the most conservative scenario, reduction of TFA intake had a substantial effect on public health. These findings will help inform decision-makers in Argentina and other countries on the potential public health and economic impact of this policy.

No MeSH data available.


Related in: MedlinePlus