Health and Economic Impacts of Eight Different Dietary Salt Reduction Interventions
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{"title"=>"Health and economic impacts of eight different dietary salt reduction interventions", "type"=>"journal", "authors"=>[{"first_name"=>"Nhung", "last_name"=>"Nghiem", "scopus_author_id"=>"55248409000"}, {"first_name"=>"Tony", "last_name"=>"Blakely", "scopus_author_id"=>"7006795650"}, {"first_name"=>"Linda J.", "last_name"=>"Cobiac", "scopus_author_id"=>"35108698100"}, {"first_name"=>"Amber L.", "last_name"=>"Pearson", "scopus_author_id"=>"55509586400"}, {"first_name"=>"Nick", "last_name"=>"Wilson", "scopus_author_id"=>"34974926700"}], "year"=>2015, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"19326203", "scopus"=>"2-s2.0-84929380133", "pui"=>"604371901", "doi"=>"10.1371/journal.pone.0123915", "isbn"=>"1932-6203 (Electronic) 1932-6203 (Linking)", "sgr"=>"84929380133", "pmid"=>"25910259"}, "id"=>"76ba343d-968f-3d6b-8e19-2c513f01d911", "abstract"=>"BACKGROUND: Given the high importance of dietary sodium (salt) as a global disease risk factor, our objective was to compare the impact of eight sodium reduction interventions, including feasible and more theoretical ones, to assist prioritisation.\\n\\nMETHODS: Epidemiological modelling and cost-utility analysis were performed using a Markov macro-simulation model. The setting was New Zealand (NZ) (2.3 million citizens, aged 35+ years) which has detailed individual-level administrative cost data.\\n\\nRESULTS: Of the most feasible interventions, the largest health gains were from (in descending order): (i) mandatory 25% reduction in sodium levels in all processed foods; (ii) the package of interventions performed in the United Kingdom (UK); (iii) mandatory 25% reduction in sodium levels in bread, processed meats and sauces; (iv) media campaign (as per a previous UK one); (v) voluntary food labelling as currently used in NZ; (vi) dietary counselling as currently used in NZ. Even larger health gains came from the more theoretical options of a \"sinking lid\" on the amount of food salt released to the national market to achieve an average adult intake of 2300 mg sodium/day (211,000 QALYs gained, 95% uncertainty interval: 170,000 - 255,000), and from a salt tax. All the interventions produced net cost savings (except counselling - albeit still cost-effective). Cost savings were especially large with the sinking lid (NZ$ 1.1 billion, US$ 0.7 billion). Also the salt tax would raise revenue (up to NZ$ 452 million/year). Health gain per person was greater for Māori (indigenous population) men and women compared to non-Māori.\\n\\nCONCLUSIONS: This study substantially expands on the range of previously modelled salt reduction interventions and suggests that some of these might achieve major health gains and major cost savings (particularly the regulatory interventions). They could also reduce ethnic inequalities in health.", "link"=>"http://www.mendeley.com/research/health-economic-impacts-eight-different-dietary-salt-reduction-interventions-3", "reader_count"=>32, "reader_count_by_academic_status"=>{"Unspecified"=>3, "Professor > Associate Professor"=>1, "Student > Doctoral Student"=>1, "Researcher"=>5, "Student > Postgraduate"=>1, "Other"=>3, "Student > Master"=>10, "Student > Bachelor"=>4, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>1, "Professor"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>3, "Professor > Associate Professor"=>1, "Student > Doctoral Student"=>1, "Researcher"=>5, "Student > Postgraduate"=>1, "Other"=>3, "Student > Master"=>10, "Student > Bachelor"=>4, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>1, "Professor"=>1}, "reader_count_by_subject_area"=>{"Engineering"=>1, "Unspecified"=>4, "Biochemistry, Genetics and Molecular Biology"=>1, "Nursing and Health Professions"=>4, "Medicine and Dentistry"=>13, "Agricultural and Biological Sciences"=>3, "Social Sciences"=>2, "Immunology and Microbiology"=>1, "Economics, Econometrics and Finance"=>3}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>13}, "Social Sciences"=>{"Social Sciences"=>2}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>3}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>3}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>4}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Unspecified"=>{"Unspecified"=>4}}, "reader_count_by_country"=>{"New Zealand"=>1}, "group_count"=>2}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/2038773"], "description"=>"<p>Input parameters relating to the interventions costs.</p>", "links"=>[], "tags"=>["cost savings", "sodium reduction interventions", "uk", "Salt Reduction Interventions BackgroundGiven", "sodium levels", "qaly", "salt tax", "modelled salt reduction interventions", "disease risk factor", "nz", "health gains"], "article_id"=>1393600, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Nhung Nghiem", "Tony Blakely", "Linda J. Cobiac", "Amber L. Pearson", "Nick Wilson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0123915.t003", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Input_parameters_relating_to_the_interventions_costs_/1393600", "title"=>"Input parameters relating to the interventions costs.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-04-24 02:50:20"}
  • {"files"=>["https://ndownloader.figshare.com/files/2038771"], "description"=>"<p>Input parameters to the modelling: selected baseline and epidemiological parameters</p>", "links"=>[], "tags"=>["cost savings", "sodium reduction interventions", "uk", "Salt Reduction Interventions BackgroundGiven", "sodium levels", "qaly", "salt tax", "modelled salt reduction interventions", "disease risk factor", "nz", "health gains"], "article_id"=>1393598, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Nhung Nghiem", "Tony Blakely", "Linda J. Cobiac", "Amber L. Pearson", "Nick Wilson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0123915.t001", "stats"=>{"downloads"=>0, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Input_parameters_to_the_modelling_selected_baseline_and_epidemiological_parameters_/1393598", "title"=>"Input parameters to the modelling: selected baseline and epidemiological parameters", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-04-24 02:50:20"}
  • {"files"=>["https://ndownloader.figshare.com/files/2038768"], "description"=>"<p>Cost-effectiveness plane with the eight salt-reduction interventions for the New Zealand adult population.</p>", "links"=>[], "tags"=>["cost savings", "sodium reduction interventions", "uk", "Salt Reduction Interventions BackgroundGiven", "sodium levels", "qaly", "salt tax", "modelled salt reduction interventions", "disease risk factor", "nz", "health gains"], "article_id"=>1393595, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Nhung Nghiem", "Tony Blakely", "Linda J. Cobiac", "Amber L. Pearson", "Nick Wilson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0123915.g001", "stats"=>{"downloads"=>0, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Cost_effectiveness_plane_with_the_eight_salt_reduction_interventions_for_the_New_Zealand_adult_population_/1393595", "title"=>"Cost-effectiveness plane with the eight salt-reduction interventions for the New Zealand adult population.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-04-24 02:50:20"}
  • {"files"=>["https://ndownloader.figshare.com/files/2038776"], "description"=>"<p><sup><b>a</b></sup> CVD mortality rates in 2021, and rate differences in CVD mortality rates, per 100,000 population. The CVD mortality rates were calculated by dividing all CVD deaths generated by the Markov model in the year 2021 by the number of people who were alive in that year (because we expected that the mortality rates would be stable after 10 years of starting the interventions). Rate differences and ratios for Māori compared with non-Māori (within sex by age-group). All rates started as per those in 2011 (they decrease by 2% per annum up to 2031, then remain constant, in the actual Markov model).</p><p><sup><b>b</b></sup> QALYs gained are per individual in the relevant age/sex/ethnic group accumulated over the 10 year period from 2011 to 2021 (all discounted at 3%). These are over and above the total expected QALYs in remaining life in the “Do Nothing” scenario (also discounted at 3%).</p><p><sup><b>c</b></sup> In an “equity analysis” we applied non-Māori mortality rates and non-Māori levels of morbidity (prevalent years lived with disability [pYLDs]) to both Māori and non-Māori (this effectively expanded the envelope for potential health gain for Māori).</p><p>Ethnic inequality impacts after 10 years from two sodium reduction interventions (CVD mortality rates, rate ratios and rate differences, and QALYs gained for individuals given model structure assumptions and parameter inputs for selected age-groups).</p>", "links"=>[], "tags"=>["cost savings", "sodium reduction interventions", "uk", "Salt Reduction Interventions BackgroundGiven", "sodium levels", "qaly", "salt tax", "modelled salt reduction interventions", "disease risk factor", "nz", "health gains"], "article_id"=>1393603, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Nhung Nghiem", "Tony Blakely", "Linda J. Cobiac", "Amber L. Pearson", "Nick Wilson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0123915.t006", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Ethnic_inequality_impacts_after_10_years_from_two_sodium_reduction_interventions_CVD_mortality_rates_rate_ratios_and_rate_differences_and_QALYs_gained_for_individuals_given_model_structure_assumptions_and_parameter_inputs_for_selected_age_groups_/1393603", "title"=>"Ethnic inequality impacts after 10 years from two sodium reduction interventions (CVD mortality rates, rate ratios and rate differences, and QALYs gained for individuals given model structure assumptions and parameter inputs for selected age-groups).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-04-24 02:50:20"}
  • {"files"=>["https://ndownloader.figshare.com/files/2038775"], "description"=>"<p>Types of costs (NZ$) by intervention (expressed per adult in 2011).</p>", "links"=>[], "tags"=>["cost savings", "sodium reduction interventions", "uk", "Salt Reduction Interventions BackgroundGiven", "sodium levels", "qaly", "salt tax", "modelled salt reduction interventions", "disease risk factor", "nz", "health gains"], "article_id"=>1393602, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Nhung Nghiem", "Tony Blakely", "Linda J. Cobiac", "Amber L. Pearson", "Nick Wilson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0123915.t005", "stats"=>{"downloads"=>0, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Types_of_costs_NZ_by_intervention_expressed_per_adult_in_2011_/1393602", "title"=>"Types of costs (NZ$) by intervention (expressed per adult in 2011).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-04-24 02:50:20"}
  • {"files"=>["https://ndownloader.figshare.com/files/2038769"], "description"=>"<p>Cost-effectiveness plane with further detail on four of the salt-reduction interventions on the New Zealand adult population (for comparisons with the other interventions—see <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0123915#pone.0123915.g001\" target=\"_blank\">Fig 1</a>).</p>", "links"=>[], "tags"=>["cost savings", "sodium reduction interventions", "uk", "Salt Reduction Interventions BackgroundGiven", "sodium levels", "qaly", "salt tax", "modelled salt reduction interventions", "disease risk factor", "nz", "health gains"], "article_id"=>1393596, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Nhung Nghiem", "Tony Blakely", "Linda J. Cobiac", "Amber L. Pearson", "Nick Wilson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0123915.g002", "stats"=>{"downloads"=>0, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Cost_effectiveness_plane_with_further_detail_on_four_of_the_salt_reduction_interventions_on_the_New_Zealand_adult_population_for_comparisons_with_the_other_interventions_see_Fig_1_/1393596", "title"=>"Cost-effectiveness plane with further detail on four of the salt-reduction interventions on the New Zealand adult population (for comparisons with the other interventions—see Fig 1).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-04-24 02:50:20"}
  • {"files"=>["https://ndownloader.figshare.com/files/2038778", "https://ndownloader.figshare.com/files/2038779"], "description"=>"<div><p>Background</p><p>Given the high importance of dietary sodium (salt) as a global disease risk factor, our objective was to compare the impact of eight sodium reduction interventions, including feasible and more theoretical ones, to assist prioritisation.</p><p>Methods</p><p>Epidemiological modelling and cost-utility analysis were performed using a Markov macro-simulation model. The setting was New Zealand (NZ) (2.3 million citizens, aged 35+ years) which has detailed individual-level administrative cost data.</p><p>Results</p><p>Of the most feasible interventions, the largest health gains were from (in descending order): (i) mandatory 25% reduction in sodium levels in all processed foods; (ii) the package of interventions performed in the United Kingdom (UK); (iii) mandatory 25% reduction in sodium levels in bread, processed meats and sauces; (iv) media campaign (as per a previous UK one); (v) voluntary food labelling as currently used in NZ; (vi) dietary counselling as currently used in NZ. Even larger health gains came from the more theoretical options of a “sinking lid” on the amount of food salt released to the national market to achieve an average adult intake of 2300 mg sodium/day (211,000 QALYs gained, 95% uncertainty interval: 170,000 – 255,000), and from a salt tax. All the interventions produced net cost savings (except counselling – albeit still cost-effective). Cost savings were especially large with the sinking lid (NZ$ 1.1 billion, US$ 0.7 billion). Also the salt tax would raise revenue (up to NZ$ 452 million/year). Health gain per person was greater for Māori (indigenous population) men and women compared to non-Māori.</p><p>Conclusions</p><p>This study substantially expands on the range of previously modelled salt reduction interventions and suggests that some of these might achieve major health gains and major cost savings (particularly the regulatory interventions). They could also reduce ethnic inequalities in health.</p></div>", "links"=>[], "tags"=>["cost savings", "sodium reduction interventions", "uk", "Salt Reduction Interventions BackgroundGiven", "sodium levels", "qaly", "salt tax", "modelled salt reduction interventions", "disease risk factor", "nz", "health gains"], "article_id"=>1393605, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Nhung Nghiem", "Tony Blakely", "Linda J. Cobiac", "Amber L. Pearson", "Nick Wilson"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0123915.s001", "https://dx.doi.org/10.1371/journal.pone.0123915.s002"], "stats"=>{"downloads"=>0, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Health_and_Economic_Impacts_of_Eight_Different_Dietary_Salt_Reduction_Interventions_/1393605", "title"=>"Health and Economic Impacts of Eight Different Dietary Salt Reduction Interventions", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2015-04-24 02:50:20"}
  • {"files"=>["https://ndownloader.figshare.com/files/2038774"], "description"=>"<p><sup>a</sup> Based on 2000 Monte Carlo simulations for the NZ adult population aged 35+ years and alive in 2011 modelled out to death or age 100. Numbers are rounded to two or three meaningful digits.</p><p><sup>b</sup> No intervention costs are included in this “do nothing comparator” (the costs of the currently existing programmes of “Counselling” and the “Endorsement Label Programme” are removed and are shown instead in the subsequent rows for results that are “incremental to ‘do nothing’”).</p><p>Population level results for the cost, health gain and cost-effectiveness of the interventions (95% uncertainty intervals in parentheses)<a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0123915#t004fn001\" target=\"_blank\"><sup>a</sup></a>.</p>", "links"=>[], "tags"=>["cost savings", "sodium reduction interventions", "uk", "Salt Reduction Interventions BackgroundGiven", "sodium levels", "qaly", "salt tax", "modelled salt reduction interventions", "disease risk factor", "nz", "health gains"], "article_id"=>1393601, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Nhung Nghiem", "Tony Blakely", "Linda J. Cobiac", "Amber L. Pearson", "Nick Wilson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0123915.t004", "stats"=>{"downloads"=>0, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Population_level_results_for_the_cost_health_gain_and_cost_effectiveness_of_the_interventions_95_uncertainty_intervals_in_parentheses_a_/1393601", "title"=>"Population level results for the cost, health gain and cost-effectiveness of the interventions (95% uncertainty intervals in parentheses)<sup>a</sup>.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-04-24 02:50:20"}
  • {"files"=>["https://ndownloader.figshare.com/files/2038772"], "description"=>"<p><sup>a</sup> Values given for the average adult. In the modelling we adjusted these values for men and women by ratios of 4013/3544 and 3115/3544 respectively, given the variation in sodium intakes (in mg) according to the nutrition survey data [<a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0123915#pone.0123915.ref053\" target=\"_blank\">53</a>].</p><p>Input parameters relating to the interventions effects (for further details see <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0123915#pone.0123915.s001\" target=\"_blank\">S1 File</a>)</p>", "links"=>[], "tags"=>["cost savings", "sodium reduction interventions", "uk", "Salt Reduction Interventions BackgroundGiven", "sodium levels", "qaly", "salt tax", "modelled salt reduction interventions", "disease risk factor", "nz", "health gains"], "article_id"=>1393599, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Nhung Nghiem", "Tony Blakely", "Linda J. Cobiac", "Amber L. Pearson", "Nick Wilson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0123915.t002", "stats"=>{"downloads"=>0, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Input_parameters_relating_to_the_interventions_effects_for_further_details_see_S1_File_/1393599", "title"=>"Input parameters relating to the interventions effects (for further details see S1 File)", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-04-24 02:50:20"}

PMC Usage Stats | Further Information

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  • {"unique-ip"=>"14", "full-text"=>"15", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"6"}
  • {"unique-ip"=>"18", "full-text"=>"26", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2020", "month"=>"7"}
  • {"unique-ip"=>"20", "full-text"=>"20", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2020", "month"=>"8"}
  • {"unique-ip"=>"19", "full-text"=>"21", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"9"}
  • {"unique-ip"=>"47", "full-text"=>"58", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"10"}
  • {"unique-ip"=>"36", "full-text"=>"37", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"11"}
  • {"unique-ip"=>"40", "full-text"=>"44", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"12"}

Relative Metric

{"start_date"=>"2015-01-01T00:00:00Z", "end_date"=>"2015-12-31T00:00:00Z", "subject_areas"=>[]}
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