Evidence map›Paper›PMID 31258214›Full record

ArticleBulletin of the World Health Organization2019

Modelling impacts of food industry co-regulation on noncommunicable disease mortality, Portugal.

Francisco Goiana-da-Silva, David Cruz-E-Silva, Luke Allen, Maria João Gregório, Milton Severo, Paulo Jorge Nogueira, Alexandre Morais Nunes, Pedro Graça, Carla Lopes, Marisa Miraldo and 5 more

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Article in Bulletin of the World Health Organization, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
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  4. Article
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  9. Review
  10. Policy options for tackling diet-related noncommunicable diseases.Bulletin of the World Health Organization · 2019
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Francisco Goiana-da-SilvaCentre for Health Policy, Institute of Global Health Innovation, Imperial College London, South Kensington Campus, London SW7 2AZ, England.
David Cruz-E-SilvaCentre for Innovation, Technology and Policy Research, University of Lisbon, Lisbon, Portugal.
Luke AllenNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England.
Maria João GregórioFaculty of Nutrition and Food Sciences, University of Porto, Oporto, Portugal.
Milton SeveroDepartment of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Oporto, Portugal.
Paulo Jorge NogueiraPreventive and Public Health Institute, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
Alexandre Morais NunesCentre for Public Administration and Public Policies,Institute of Social and Political Sciences, University of Lisbon, Lisbon, Portugal.
Pedro GraçaFaculty of Nutrition and Food Sciences, University of Porto, Oporto, Portugal.
Carla LopesDepartment of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Oporto, Portugal.
Marisa MiraldoDepartment of Management & Centre for Health Economics and Policy Innovation, Imperial College Business School, London, England.
João BredaWHO European Office for the Prevention and Control of Noncommunicable Diseases, WHO Regional Office for Europe, Moscow, Russian Federation.
Kremlin WickramasingheWHO European Office for the Prevention and Control of Noncommunicable Diseases, WHO Regional Office for Europe, Moscow, Russian Federation.
Ara DarziDepartment of Surgery and Cancer, Imperial College London, London, England.
Fernando AraújoUniversity Hospital of São João, Faculty of Medicine, University of Porto, Oporto, Portugal.
Bente MikkelsenDivision of Noncommunicable Diseases and Promoting Health through the Life-course, WHO Regional Office for Europe, Copenhagen, Denmark.

Funding

World Health Organization 001
6 · The paper itself

Abstract

objectiveTo model the reduction in premature deaths attributed to noncommunicable diseases if targets for reformulation of processed food agreed between the Portuguese health ministry and the food industry were met.

methodsThe 2015 co-regulation agreement sets voluntary targets for reducing sugar, salt and trans-fatty acids in a range of products by 2021. We obtained government data on dietary intake in 2015-2016 and on population structure and deaths from four major noncommunicable diseases over 1990-2016. We used the Preventable Risk Integrated ModEl tool to estimate the deaths averted if reformulation targets were met in full. We projected future trends in noncommunicable disease deaths using regression modelling and assessed whether Portugal was on track to reduce baseline premature deaths from noncommunicable diseases in the year 2010 by 25% by 2025, and by 30% before 2030.

findingsIf reformulation targets were met, we projected reductions in intake in 2015-2016 for salt from 7.6 g/day to 7.1 g/day; in total energy from 1911 kcal/day to 1897 kcal/day due to reduced sugar intake; and in total fat (% total energy) from 30.4% to 30.3% due to reduced trans-fat intake. This consumption profile would result in 248 fewer premature noncommunicable disease deaths (95% CI: 178 to 318) in 2016. We projected that full implementation of the industry agreement would reduce the risk of premature death from 11.0% in 2016 to 10.7% by 2021.

conclusionThe co-regulation agreement could save lives and reduce the risk of premature death in Portugal. Nevertheless, the projected impact on mortality was insufficient to meet international targets.

Indexed as

DietFood IndustryHumansMortality, PrematureNoncommunicable DiseasesPortugalRisk Factors

Identifiers

PMID31258214
PMCPMC6593340

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.