Potential of trans fats policies to reduce socioeconomic inequalities in mortality from coronary heart disease in England: Cost effectiveness modelling study

Kirk Allen, Jonathan Pearson-Stuttard, William Hooton, Peter Diggle, Simon Capewell, Martin O'Flaherty

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: To determine health and equity benefits and cost effectiveness of policies to reduce or eliminate trans fatty acids from processed foods, compared with consumption remaining at most recent levels in England. DESIGN: Epidemiological modelling study. SETTING: Data from National Diet and Nutrition Survey, Low Income Diet and Nutrition Survey, Office of National Statistics, and health economic data from other published studies. PARTICIPANTS: Adults aged.25, stratified by fifths of socioeconomic circumstance. INTERVENTIONS: Total ban on trans fatty acids in processed foods; improved labelling of trans fatty acids; bans on trans fatty acids in restaurants and takeaways. MAIN OUTCOMEMEASURES: Deaths from coronary heart disease prevented or postponed; life years gained; quality adjusted life years gained. Policy costs to government and industry; policy savings from reductions in direct healthcare, informal care, and productivity loss. RESULTS: A total ban on trans fatty acids in processed foods might prevent or postpone about 7200 deaths (2.6%) from coronary heart disease from 2015-20 and reduce inequality in mortality from coronary heart disease by about 3000 deaths (15%). Policies to improve labelling or simply remove trans fatty acids from restaurants/fast food could save between 1800 (0.7%) and 3500 (1.3%) deaths from coronary heart disease and reduce inequalities by 600 (3%) to 1500 (7%) deaths, thus making them at best half as effective. A total ban would have the greatest net cost savings of about £265m (€361m, $415m) excluding reformulation costs, or £64m if substantial reformulation costs are incurred outside the normal cycle. Conclusions A regulatory policy to eliminate trans fatty acids from processed foods in England would be the most effective and equitable policy option. Intermediate policies would also be beneficial. Simply continuing to rely on industry to voluntary reformulate products, however, could have negative health and economic outcomes.

Original languageEnglish (US)
Article numberh4583
JournalBMJ (Online)
Volume351
DOIs
StatePublished - Sep 15 2015
Externally publishedYes

Fingerprint

Trans Fatty Acids
England
Cost-Benefit Analysis
Coronary Disease
Fats
Mortality
Diet Surveys
Food
Restaurants
Nutrition Surveys
Costs and Cost Analysis
Industry
Economics
Fast Foods
Quality-Adjusted Life Years
Cost Savings
Health
Insurance Benefits
Health Care Costs
Epidemiologic Studies

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Potential of trans fats policies to reduce socioeconomic inequalities in mortality from coronary heart disease in England : Cost effectiveness modelling study. / Allen, Kirk; Pearson-Stuttard, Jonathan; Hooton, William; Diggle, Peter; Capewell, Simon; O'Flaherty, Martin.

In: BMJ (Online), Vol. 351, h4583, 15.09.2015.

Research output: Contribution to journalArticle

Allen, Kirk ; Pearson-Stuttard, Jonathan ; Hooton, William ; Diggle, Peter ; Capewell, Simon ; O'Flaherty, Martin. / Potential of trans fats policies to reduce socioeconomic inequalities in mortality from coronary heart disease in England : Cost effectiveness modelling study. In: BMJ (Online). 2015 ; Vol. 351.
@article{4a498e8c717c4652899db0cc51c39eab,
title = "Potential of trans fats policies to reduce socioeconomic inequalities in mortality from coronary heart disease in England: Cost effectiveness modelling study",
abstract = "OBJECTIVES: To determine health and equity benefits and cost effectiveness of policies to reduce or eliminate trans fatty acids from processed foods, compared with consumption remaining at most recent levels in England. DESIGN: Epidemiological modelling study. SETTING: Data from National Diet and Nutrition Survey, Low Income Diet and Nutrition Survey, Office of National Statistics, and health economic data from other published studies. PARTICIPANTS: Adults aged.25, stratified by fifths of socioeconomic circumstance. INTERVENTIONS: Total ban on trans fatty acids in processed foods; improved labelling of trans fatty acids; bans on trans fatty acids in restaurants and takeaways. MAIN OUTCOMEMEASURES: Deaths from coronary heart disease prevented or postponed; life years gained; quality adjusted life years gained. Policy costs to government and industry; policy savings from reductions in direct healthcare, informal care, and productivity loss. RESULTS: A total ban on trans fatty acids in processed foods might prevent or postpone about 7200 deaths (2.6{\%}) from coronary heart disease from 2015-20 and reduce inequality in mortality from coronary heart disease by about 3000 deaths (15{\%}). Policies to improve labelling or simply remove trans fatty acids from restaurants/fast food could save between 1800 (0.7{\%}) and 3500 (1.3{\%}) deaths from coronary heart disease and reduce inequalities by 600 (3{\%}) to 1500 (7{\%}) deaths, thus making them at best half as effective. A total ban would have the greatest net cost savings of about £265m (€361m, $415m) excluding reformulation costs, or £64m if substantial reformulation costs are incurred outside the normal cycle. Conclusions A regulatory policy to eliminate trans fatty acids from processed foods in England would be the most effective and equitable policy option. Intermediate policies would also be beneficial. Simply continuing to rely on industry to voluntary reformulate products, however, could have negative health and economic outcomes.",
author = "Kirk Allen and Jonathan Pearson-Stuttard and William Hooton and Peter Diggle and Simon Capewell and Martin O'Flaherty",
year = "2015",
month = "9",
day = "15",
doi = "10.1136/bmj.h4583",
language = "English (US)",
volume = "351",
journal = "British Medical Journal",
issn = "0959-8146",
publisher = "BMJ Publishing Group",

}

TY - JOUR

T1 - Potential of trans fats policies to reduce socioeconomic inequalities in mortality from coronary heart disease in England

T2 - Cost effectiveness modelling study

AU - Allen, Kirk

AU - Pearson-Stuttard, Jonathan

AU - Hooton, William

AU - Diggle, Peter

AU - Capewell, Simon

AU - O'Flaherty, Martin

PY - 2015/9/15

Y1 - 2015/9/15

N2 - OBJECTIVES: To determine health and equity benefits and cost effectiveness of policies to reduce or eliminate trans fatty acids from processed foods, compared with consumption remaining at most recent levels in England. DESIGN: Epidemiological modelling study. SETTING: Data from National Diet and Nutrition Survey, Low Income Diet and Nutrition Survey, Office of National Statistics, and health economic data from other published studies. PARTICIPANTS: Adults aged.25, stratified by fifths of socioeconomic circumstance. INTERVENTIONS: Total ban on trans fatty acids in processed foods; improved labelling of trans fatty acids; bans on trans fatty acids in restaurants and takeaways. MAIN OUTCOMEMEASURES: Deaths from coronary heart disease prevented or postponed; life years gained; quality adjusted life years gained. Policy costs to government and industry; policy savings from reductions in direct healthcare, informal care, and productivity loss. RESULTS: A total ban on trans fatty acids in processed foods might prevent or postpone about 7200 deaths (2.6%) from coronary heart disease from 2015-20 and reduce inequality in mortality from coronary heart disease by about 3000 deaths (15%). Policies to improve labelling or simply remove trans fatty acids from restaurants/fast food could save between 1800 (0.7%) and 3500 (1.3%) deaths from coronary heart disease and reduce inequalities by 600 (3%) to 1500 (7%) deaths, thus making them at best half as effective. A total ban would have the greatest net cost savings of about £265m (€361m, $415m) excluding reformulation costs, or £64m if substantial reformulation costs are incurred outside the normal cycle. Conclusions A regulatory policy to eliminate trans fatty acids from processed foods in England would be the most effective and equitable policy option. Intermediate policies would also be beneficial. Simply continuing to rely on industry to voluntary reformulate products, however, could have negative health and economic outcomes.

AB - OBJECTIVES: To determine health and equity benefits and cost effectiveness of policies to reduce or eliminate trans fatty acids from processed foods, compared with consumption remaining at most recent levels in England. DESIGN: Epidemiological modelling study. SETTING: Data from National Diet and Nutrition Survey, Low Income Diet and Nutrition Survey, Office of National Statistics, and health economic data from other published studies. PARTICIPANTS: Adults aged.25, stratified by fifths of socioeconomic circumstance. INTERVENTIONS: Total ban on trans fatty acids in processed foods; improved labelling of trans fatty acids; bans on trans fatty acids in restaurants and takeaways. MAIN OUTCOMEMEASURES: Deaths from coronary heart disease prevented or postponed; life years gained; quality adjusted life years gained. Policy costs to government and industry; policy savings from reductions in direct healthcare, informal care, and productivity loss. RESULTS: A total ban on trans fatty acids in processed foods might prevent or postpone about 7200 deaths (2.6%) from coronary heart disease from 2015-20 and reduce inequality in mortality from coronary heart disease by about 3000 deaths (15%). Policies to improve labelling or simply remove trans fatty acids from restaurants/fast food could save between 1800 (0.7%) and 3500 (1.3%) deaths from coronary heart disease and reduce inequalities by 600 (3%) to 1500 (7%) deaths, thus making them at best half as effective. A total ban would have the greatest net cost savings of about £265m (€361m, $415m) excluding reformulation costs, or £64m if substantial reformulation costs are incurred outside the normal cycle. Conclusions A regulatory policy to eliminate trans fatty acids from processed foods in England would be the most effective and equitable policy option. Intermediate policies would also be beneficial. Simply continuing to rely on industry to voluntary reformulate products, however, could have negative health and economic outcomes.

UR - http://www.scopus.com/inward/record.url?scp=84946074978&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84946074978&partnerID=8YFLogxK

U2 - 10.1136/bmj.h4583

DO - 10.1136/bmj.h4583

M3 - Article

C2 - 26374614

AN - SCOPUS:84946074978

VL - 351

JO - British Medical Journal

JF - British Medical Journal

SN - 0959-8146

M1 - h4583

ER -