The potential health impact and healthcare cost savings of different sodium reduction strategies in Canada.

Background: High dietary sodium is the main dietary risk factor for non-communicable diseases due to its impact on cardiovascular diseases, the leading cause of death globally. The objective of the study was to estimate the number of avoidable ischemic heart disease (IHD) and stroke incidence cases, and their associated healthcare cost and Quality-Adjusted Life Year (QALY) savings resulting from different sodium reduction strategies and recommendations in Canada.

Methods: We used the PRIMEtime model, a proportional multi-state lifetable model.

Population health, health equity and health system impacts of light vehicle electrification: a modelling study in Aotearoa/New Zealand.

Background: Electrification of the light vehicle fleet is a core component of decarbonisation policy globally. As transport is an important determinant of health, this process will likely impact a range of pathways to population health, outside of averted climate change.

Methods: A transport-health multistate lifetable model for Aotearoa/New Zealand was used to model changes in the vehicle fleet and transport behaviour patterns that could be expected as part of electrification in Aotearoa/New Zealand.

Estimated health effect, cost, and cost-effectiveness of mandating sodium benchmarks in Australia's packaged foods: a modelling study.

Background: Excess dietary sodium is a leading cause of death and disability globally. Because packaged foods are a major source of sodium in many countries, including Australia, mandatory limits for sodium might improve population health. We aimed to estimate the long-term health and economic effect of mandating such thresholds in Australia.

Estimated health benefits, costs, and cost-effectiveness of implementing WHO's sodium benchmarks for packaged foods in India: a modelling study.

Background: Excess dietary sodium intake has been associated with death and disability. WHO has released global sodium benchmarks for packaged foods to support countries to reduce population sodium intake. This study aimed to assess the potential health effect, costs, and cost effectiveness of implementing these WHO sodium benchmarks in India.

Policy approaches to decarbonising the transport sector in Aotearoa New Zealand: modelling equity, population health, and health-system effects.

Background: Health co-benefits are a key potential advantage of transport decarbonisation policy. However, health effects will occur in the context of existing transport-health inequities and decarbonisation policies will themselves affect inequities. This research examines the effects of national decarbonisation pathways for transport on population health, health inequity, and health-system costs in Aotearoa New Zealand.

Impact of the UK soft drinks industry levy on health and health inequalities in children and adolescents in England: An interrupted time series analysis and population health modelling study.

Background: The soft drinks industry levy (SDIL) in the United Kingdom has led to a significant reduction in household purchasing of sugar in drinks. In this study, we examined the potential medium- and long-term implications for health and health inequalities among children and adolescents in England.

Methods And Findings: We conducted a controlled interrupted time series analysis to measure the effects of the SDIL on the amount of sugar per household per week from soft drinks purchased, 19 months post implementation and by index of multiple deprivation (IMD) quintile in England.

Projected health and economic impacts of sugar-sweetened beverage taxation in Germany: A cross-validation modelling study.

Background: Taxes on sugar-sweetened beverages (SSBs) have been implemented globally to reduce the burden of cardiometabolic diseases by disincentivizing consumption through increased prices (e.g., 1 peso/litre tax in Mexico) or incentivizing industry reformulation to reduce SSB sugar content (e.

Vegans, vegetarians, fish-eaters and meat-eaters in the UK show discrepant environmental impacts.

Modelled dietary scenarios often fail to reflect true dietary practice and do not account for variation in the environmental burden of food due to sourcing and production methods. Here we link dietary data from a sample of 55,504 vegans, vegetarians, fish-eaters and meat-eaters with food-level data on greenhouse gas emissions, land use, water use, eutrophication risk and potential biodiversity loss from a review of 570 life-cycle assessments covering more than 38,000 farms in 119 countries. Our results include the variation in food production and sourcing that is observed in the review of life-cycle assessments.

Long-Term Effect of Weight Regain Following Behavioral Weight Management Programs on Cardiometabolic Disease Incidence and Risk: Systematic Review and Meta-Analysis.

Background: Behavioral weight management programs (BWMPs) enhance weight loss in the short term, but longer term cardiometabolic effects are uncertain as weight is commonly regained. We assessed the impact of weight regain after BWMPs on cardiovascular risk factors, diabetes, and cardiovascular disease.

Methods: Trial registries, 11 databases, and forward-citation searching (latest search, December 19) were used to identify articles published in English, from any geographical region.

Estimated Impact of Achieving the Australian National Sodium Reduction Targets on Blood Pressure, Chronic Kidney Disease Burden and Healthcare Costs: A Modelling Study.

Excess sodium intake raises blood pressure which increases the risk of chronic kidney disease (CKD). We aimed to estimate the impact of reduced sodium intake on future CKD burden in Australia. A multi-cohort proportional multistate lifetable model was developed to estimate the potential impact on CKD burden and health expenditure if the Australian Suggested Dietary Target (SDT) and the National Preventive Health Strategy 2021-2030 (NPHS) sodium target were achieved.

Weight regain after behavioural weight management programmes and its impact on quality of life and cost effectiveness: Evidence synthesis and health economic analyses.

Aims: We used data from a recent systematic review to investigate weight regain after behavioural weight management programmes (BWMPs, sometimes referred to as lifestyle modification programmes) and its impact on quality-of-life and cost-effectiveness.

Materials And Methods: Trial registries, databases and forward-citation searching (latest search December 2019) were used to identify randomized trials of BWMPs in adults with overweight/obesity reporting outcomes at ≥12 months, and after programme end. Two independent reviewers screened records.

Avoidable burden of stomach cancer and potential gains in healthy life years from gradual reductions in salt consumption in Vietnam, 2019-2030: a modelling study.

Objective: Excess salt consumption is causally linked with stomach cancer, and salt intake among adults in Vietnam is about twice the recommended levels. The aim of this study was to quantify the future burden of stomach cancer that could be avoided from population-wide salt reduction in Vietnam.

Design: A dynamic simulation model was developed to quantify the impacts of achieving the 2018 National Vietnam Health Program (8 g/d by 2025 and 7 g/d by 2030) and the WHO (5 g/d) salt reduction policy targets.

Forecast of myocardial infarction incidence, events and prevalence in England to 2035 using a microsimulation model with endogenous disease outcomes.

Background: Models that forecast non-communicable disease rates are poorly designed to predict future changes in trend because they are based on exogenous measures of disease rates. We introduce microPRIME, which forecasts myocardial infarction (MI) incidence, events and prevalence in England to 2035. microPRIME can forecast changes in trend as all MI rates emerge from competing trends in risk factors and treatment.

Estimating BMI distributions by age and sex for local authorities in England: a small area estimation study.

Objectives: Rates of overweight and obesity vary across England, but local rates have not been estimated for over 10 years. We aimed to produce new small area estimates of body mass index (BMI) by age and sex for each lower tier and unitary local authority in England, to provide up-to-date and more detailed estimates for the use of policy-makers and academics working in non-communicable disease risk and health inequalities.

Design: We used generalised linear modelling to estimate the relationship between BMI with social/demographic markers in a cross-sectional survey, then used this model to impute a BMI for each adult in locally-representative populations.

Dietary Salt Reduction, Prevalence of Hypertension and Avoidable Burden of Stroke in Vietnam: Modelling the Health and Economic Impacts.

Dietary salt reduction has been recommended as a cost-effective population-wide strategy to prevent cardiovascular disease. The health and economic impact of salt consumption on the future burden of stroke in Vietnam is not known. To estimate the avoidable incidence of and deaths from stroke, as well as the healthy life years and healthcare costs that could be gained from reducing salt consumption in Vietnam.

Modelling future trajectories of obesity and body mass index in England.

Background: Obesity is a leading risk for poor health outcomes in England. We examined best- and worst-case scenarios for the future trajectory of the obesity epidemic.

Methods: Taking the last 27 years of Health Survey for England data, we determined both position and shape of the adult body mass index (BMI) distribution and projected these parameters 20 years forward in time.

Impact of the 2003 to 2018 Population Salt Intake Reduction Program in England: A Modeling Study.

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Cost-effectiveness analysis of population salt reduction interventions to prevent cardiovascular disease in Cameroon: mathematical modelling study.

Background: Reducing dietary sodium (salt) intake has been proposed as a population-wide strategy to reduce blood pressure and cardiovascular disease (CVD). The cost-effectiveness of such strategies has hitherto not been investigated in Cameroon.

Methods: A multicohort multistate life table Markov model was used to evaluate the cost-effectiveness of three population salt reduction strategies: mass media campaign, school-based salt education programme and low-sodium salt substitute.

The potential health impact of restricting less-healthy food and beverage advertising on UK television between 05.30 and 21.00 hours: A modelling study.

Background: Restrictions on the advertising of less-healthy foods and beverages is seen as one measure to tackle childhood obesity and is under active consideration by the UK government. Whilst evidence increasingly links this advertising to excess calorie intake, understanding of the potential impact of advertising restrictions on population health is limited.

Methods And Findings: We used a proportional multi-state life table model to estimate the health impact of prohibiting the advertising of food and beverages high in fat, sugar, and salt (HFSS) from 05.

Health Gain, Cost Impacts, and Cost-Effectiveness of a Mass Media Campaign to Promote Smartphone Apps for Physical Activity: Modeling Study.

Background: Physical activity smartphone apps are a promising strategy to increase population physical activity, but it is unclear whether government mass media campaigns to promote these apps would be a cost-effective use of public funds.

Objective: We aimed to estimate the health impacts, costs, and cost-effectiveness of a one-off national mass media campaign to promote the use of physical activity apps.

Methods: We used an established multistate life table model to estimate the lifetime health gains (in quality-adjusted life years [QALYs]) that would accrue if New Zealand adults were exposed to a one-off national mass media campaign to promote physical activity app use, with a 1-year impact on physical activity, compared to business-as-usual.

Fuelling walking and cycling: human powered locomotion is associated with non-negligible greenhouse gas emissions.

Reducing motorized transport and increasing active transport (i.e. transport by walking, cycling and other active modes) may reduce greenhouse gas (GHG) emissions and improve health.

Modelling the health impact of food taxes and subsidies with price elasticities: The case for additional scaling of food consumption using the total food expenditure elasticity.

Background: Food taxes and subsidies are one intervention to address poor diets. Price elasticity (PE) matrices are commonly used to model the change in food purchasing. Usually a PE matrix is generated in one setting then applied to another setting with differing starting consumptions and prices of foods.

Prospective impact of tobacco eradication and overweight and obesity eradication on future morbidity and health-adjusted life expectancy: simulation study.

Background: Interventions that reduce morbidity, in addition to mortality, warrant prioritisation. It is important to understand the magnitude of potential morbidity and health gains from changing risk factor distributions. We quantified the impact of tobacco compared with overweight/obesity eradication on future morbidity and health-adjusted life expectancy (HALE) for the New Zealand population alive in 2011.

Achieving Healthy and Sustainable Diets: A Review of the Results of Recent Mathematical Optimization Studies.

Climate protection and other environmental concerns render it critical that diets and agriculture systems become more sustainable. Mathematical optimization techniques can assist in identifying dietary patterns that both improve nutrition and reduce environmental impacts. Here we review 12 recent studies in which such optimization was used to achieve nutrition and environmental sustainability aims.

Can cost-effectiveness results be combined into a coherent league table? Case study from one high-income country.

Background: Doubts exist around the value of compiling league tables for cost-effectiveness results for health interventions, primarily due to methods differences. We aimed to determine if a reasonably coherent league table could be compiled using published studies for one high-income country: New Zealand (NZ).

Methods: Literature searches were conducted to identify NZ-relevant studies published in the peer-reviewed journal literature between 1 January 2010 and 8 October 2017.