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01-12-2021 | Coronary Heart Disease | Research article

Estimating the health and economic effects of the voluntary sodium reduction targets in Brazil: microsimulation analysis

Authors: Eduardo Augusto Fernandes Nilson, Jonathan Pearson-Stuttard, Brendan Collins, Maria Guzman-Castillo, Simon Capewell, Martin O’Flaherty, Patrícia Constante Jaime, Chris Kypridemos

Published in: BMC Medicine | Issue 1/2021

Abstract

Background

Excessive sodium consumption is one of the leading dietary risk factors for non-communicable diseases, including cardiovascular disease (CVD), mediated by high blood pressure. Brazil has implemented voluntary sodium reduction targets with food industries since 2011. This study aimed to analyse the potential health and economic impact of these sodium reduction targets in Brazil from 2013 to 2032.

Methods

We developed a microsimulation of a close-to-reality synthetic population (IMPACT_NCD-BR) to evaluate the potential health benefits of setting voluntary upper limits for sodium content as part of the Brazilian government strategy. The model estimates CVD deaths and cases prevented or postponed, and disease treatment costs. Model inputs were informed by the 2013 National Health Survey, the 2008–2009 Household Budget Survey, and high-quality meta-analyses, assuming that all individuals were exposed to the policy proportionally to their sodium intake from processed food. Costs included costs of the National Health System on CVD treatment and informal care costs. The primary outcome measures of the model are cardiovascular disease cases and deaths prevented or postponed over 20 years (2013–2032), stratified by age and sex.

Results

The study found that the application of the Brazilian voluntary sodium targets for packaged foods between 2013 and 2032 could prevent or postpone approximately 110,000 CVD cases (95% uncertainty intervals (UI): 28,000 to 260,000) among men and 70,000 cases among women (95% UI: 16,000 to 170,000), and also prevent or postpone approximately 2600 CVD deaths (95% UI: − 1000 to 11,000), 55% in men. The policy could also produce a net cost saving of approximately US$ 220 million (95% UI: US$ 54 to 520 million) in medical costs to the Brazilian National Health System for the treatment of CHD and stroke and save approximately US$ 71 million (95% UI: US$ 17 to170 million) in informal costs.

Conclusion

Brazilian voluntary sodium targets could generate substantial health and economic impacts. The reduction in sodium intake that was likely achieved from the voluntary targets indicates that sodium reduction in Brazil must go further and faster to achieve the national and World Health Organization goals for sodium intake.

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Title: Estimating the health and economic effects of the voluntary sodium reduction targets in Brazil: microsimulation analysis
Authors: Eduardo Augusto Fernandes Nilson
Jonathan Pearson-Stuttard
Brendan Collins
Maria Guzman-Castillo
Simon Capewell
Martin O’Flaherty
Patrícia Constante Jaime
Chris Kypridemos
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Coronary Heart Disease
Stroke
Published in: BMC Medicine / Issue 1/2021
Electronic ISSN: 1741-7015
DOI: https://doi.org/10.1186/s12916-021-02099-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Estimating the health and economic effects of the voluntary sodium reduction targets in Brazil: microsimulation analysis

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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