Abstract P325: Quantifying the UK Social and Economic Benefits of Potential Policies to Reduce dietary Trans Fats: Modelling Study.

Abstract

Background: Industrial trans fatty acids (TFAs) are commonly added to processed foods as a cheap way to increase shelf-life and enhance palatability. Natural TFA are found in small quantities in meat and dairy products. TFA substantially increase the risk of Coronary Heart Disease (CHD). The UK burden of CHD remains large, and unequal across socio-economic groups. TFA intake is also unequal, with largest intake in the most deprived groups. Methods: We modelled three policy options for reducing TFA in the English diet; a) increased labelling requirements resulting in partial voluntary reformulation; b) a ban on TFA in all restaurant & take-away food, and c) a total TFA ban in all processed foods. We quantified health benefits for the period 2015-2020 for each policy (deaths prevented and life-years-gained -LYG). Analyses were stratified by age, gender, and socioeconomic quintiles (IMDQ). Mortality gains were linked to economic cost and benefits: direct healthcare costs, productivity loss averted, and informal care; government costs comprising legislative and monitoring; and costs to industry. Results were tested in a probabilistic sensitivity analysis. Results: The most effective UK policy in reducing CHD mortality from 2015-2020, would be a total TFA ban resulting in approximately 8,600 fewer CHD deaths [95% confidence interval 3,400 - 14,700] with a substantial inequality reduction of some 3,300 deaths [1,300 - 6,000]. Labelling with partial voluntary reformulation might result in approximately 2,500 fewer CHD deaths [1,100 - 4,600]; and an inequality reduction of some 800 deaths [300 - 1,400]. Whilst a TFA ban in restaurant and take-away food could yield approximately 2,200 fewer CHD deaths [900 - 3,800]; and an inequality reduction of some 700 [300 - 1,200]). All policies would be cost-saving for the government due to big reductions in health care costs. A total ban could achieve annual societal savings of approximately £96 million The labelling and restaurant and take-away bans might gain £12 - £14 million savings for, representing £8,600 to £3,700-£4,800 per QALY. Industry costs might reach some £210 million if extensive reformulations were required, but could be negligible if reformulations were absorbed into natural product reformulation cycles. Conclusions: Policies to reduce TFA consumption in the English population are a priority public health measure. As both TFA consumption and CHD burden are higher deprived groups, any TFA reduction will reduce inequalities in CHD mortality. A total ban on TFA in ALL processed foods would have the greatest coverage across social groups. It would also represent a good investment from a societal perspective. Policies with less comprehensive coverage would be correspondingly less effective at reducing mortality, inequalities and cost effective, but would still yield substantial health, and economic gains.