Background Coronary Heart Disease (CHD) disease remains a leading cause of UK mortality, generating a large and unequal burden of disease. Dietary trans fats represent a powerful CHD risk factor. However, UK efforts to reduce the dietary intake of industrial trans fats (currently approximately 1% of daily energy) have been less successful than some other nations, such as Denmark, Iceland, Austria, Switzerland and the USA. Furthermore, the potential outcomes of such measures, and the effects upon health inequalities, have not been well quantified. We therefore aimed to model the potential effects of specific reductions in trans fats intake on CHD mortality, CHD related admissions, and further examined the potential distribution of these effects by socio-economic position up to 2030.
Methods We extended the previously validated IMPACTsec model, to estimate the potential effects of reductions in trans fats intake upon the England and Wales population aged 25 years and above. We stratified these estimates by age, sex and socio-economic circumstances (SEC). We estimated a reduction in expected CHD deaths in 2030 attributable to a modest reduction in industrial trans fats intake (-0.5% energy) and a complete ban (-1% energy). Main output measures were deaths prevented or postponed, life years gained and hospital admissions. Results were tested in a probabilistic sensitivity analysis.
Results Reducing trans fats consumption in the England and Wales population by 0.5% of daily energy intake would result in approximately 1900 fewer deaths per year (minimum estimate 1700, maximum estimate 2200), some 5000 fewer hospital admissions (min 4300, max 5700), and approximately 18,000 additional life years (min 15,000, max 22,000). This would also reduce health inequalities, preventing about six times as many deaths and gaining six times as many life years in the most deprived quintile compared with the most affluent. Complete elimination of industrial trans fats (a 1% reduction in energy) would generate approximately 3900 (min 3300, max 4400) fewer deaths, 10,000 (min 8800, max 10,300) fewer hospital admissions, and approximately 37,000 (min 30,000, max 45,000) life years gained. Reductions in inequalities would be correspondingly large.
Discussion Reducing dietary intake of industrial trans fats could substantially decrease CHD mortality and hospital admissions, and gain tens of thousands of life years. Crucially, this policy could also reduce health inequalities. UK strategies should therefore aim to minimise industrial trans fats intakes, as successfully achieved in many other European countries.
- socio-economic status
- coronary heart disease burden
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