ArticleJournal of epidemiology and community health2019
Quantifying the impact of the Public Health Responsibility Deal on salt intake, cardiovascular disease and gastric cancer burdens: interrupted time series and microsimulation study.
Article in Journal of epidemiology and community health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- Estimated health and economic effects of different salt reduction strategies on cardiovascular disease in Brazil: a microsimulation analysis.Scientific reports · 2026Article
- The estimated impact of mandatory front-of-pack nutrition labelling policies on adult obesity prevalence and obesity-related mortality in England: a modelling study.The Lancet regional health. Europe · 2026Article
- Exploring the contribution of risk factors on major illness: a microsimulation study in England, 2023-2043.Nature communications · 2025Article
- A critical interrogation of the legitimacy of commercial actors in food policy partnerships.Health promotion international · 2025Article
- Simulated retail food environments: A literature review of systems science approaches to advance equity in access to healthy diets.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2025Review
- Public health economic modelling in evaluations of salt and/or alcohol policies: a systematic scoping review.BMC public health · 2025Article
- Industry influence on public health policy formulation in the UK: a complex systems approach.Health promotion international · 2024Article
- Projected health and economic impacts of sugar-sweetened beverage taxation in Germany: A cross-validation modelling study.PLoS medicine · 2023Article
- Article
- Economic effects of dietary salt reduction policies for cardiovascular disease prevention in Japan: a simulation study of hypothetical scenarios.Frontiers in nutrition · 2023Article
- Changes in the salt content of packaged foods sold in supermarkets between 2015-2020 in the United Kingdom: A repeated cross-sectional study.PLoS medicine · 2022Article
- Applications of Complex Systems Models to Improve Retail Food Environments for Population Health: A Scoping Review.Advances in nutrition (Bethesda, Md.) · 2022Article
- Ultra-processed foods and cancer risk: from global food systems to individual exposures and mechanisms.British journal of cancer · 2022Review
- Simulation Modeling for the Economic Evaluation of Population-Based Dietary Policies: A Systematic Scoping Review.Advances in nutrition (Bethesda, Md.) · 2021Article
- The estimated health impact of sodium reduction through food reformulation in Australia: A modeling study.PLoS medicine · 2021Article
- Estimating the health and economic effects of the voluntary sodium reduction targets in Brazil: microsimulation analysis.BMC medicine · 2021Article
- Improvement in the Mortality-to-Incidence Ratios for Gastric Cancer in Developed Countries With High Health Expenditures.Frontiers in public health · 2021Article
- A continuous data driven translational model to evaluate effectiveness of population-level health interventions: case study, smoking ban in public places on hospital admissions for acute coronary events.Journal of translational medicine · 2020Article
- Priority Actions to Advance Population Sodium Reduction.Nutrients · 2020Review
- Healthy Foods and Healthy Diets. How Government Policies Can Steer Food Reformulation.Nutrients · 2020Review
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundIn 2011, England introduced the Public Health Responsibility Deal (RD), a public-private partnership (PPP) which gave greater freedom to the food industry to set and monitor targets for salt intakes. We estimated the impact of the RD on trends in salt intake and associated changes in cardiovascular disease (CVD) and gastric cancer (GCa) incidence, mortality and economic costs in England from 2011-2025.
methodsWe used interrupted time series models with 24 hours' urine sample data and the IMPACT
resultsBetween 2003 and 2010 mean salt intake was falling annually by 0.20 grams/day among men and 0.12 g/d among women (P-value for trend both < 0.001). After RD implementation in 2011, annual declines in salt intake slowed statistically significantly to 0.11 g/d among men and 0.07 g/d among women (P-values for differences in trend both P < 0.001). We estimated that the RD has been responsible for approximately 9900 (interquartile quartile range (IQR): 6700 to 13,000) additional cases of CVD and 1500 (IQR: 510 to 2300) additional cases of GCa between 2011 and 2018. If the RD continues unchanged between 2019 and 2025, approximately 26 000 (IQR: 20 000 to 31,000) additional cases of CVD and 3800 (IQR: 2200 to 5300) cases of GCa may occur.
interpretationPublic-private partnerships such as the RD which lack robust and independent target setting, monitoring and enforcement are unlikely to produce optimal health gains.
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