Evidence map›Paper›PMID 39486901›Full record

ArticleThe Lancet. Public health2024

Estimated health benefits, costs, and cost-effectiveness of implementing WHO's sodium benchmarks for packaged foods in India: a modelling study.

Kathy Trieu, Liping Huang, Leopold N Aminde, Linda Cobiac, Daisy H Coyle, Mary Njeri Wanjau, Sudhir Raj Thout, Bruce Neal, Jason H Y Wu, Lennert Veerman and 2 more

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In one paragraph

Article in The Lancet. Public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Kathy TrieuThe George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia. Electronic address: ktrieu@georgeinstitute.org.au.
Liping HuangThe George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
Leopold N AmindeSchool of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia.
Linda CobiacSchool of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia.
Daisy H CoyleThe George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
Mary Njeri WanjauSchool of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia.
Sudhir Raj ThoutThe George Institute for Global Health, Hyderabad, India.
Bruce NealThe George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia; Department of Epidemiology and Biostatistics, Imperial College London, London, UK.
Jason H Y WuThe George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia; School of Population Health, University of New South Wales, Sydney, NSW, Australia.
Lennert VeermanSchool of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia.
Matti MarklundThe George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; The Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Rachita GuptaWHO, Country Office India, New Delhi, India.

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundExcess dietary sodium intake has been associated with death and disability. WHO has released global sodium benchmarks for packaged foods to support countries to reduce population sodium intake. This study aimed to assess the potential health effect, costs, and cost effectiveness of implementing these WHO sodium benchmarks in India.

methodsWe used a multiple cohort, proportional multistate, life table (Markov) model to estimate the health gains and cost effectiveness for adults if sodium content in packaged foods complied with the WHO benchmarks compared to the status quo. We used India-specific dietary surveys, food composition tables, foods sales data, and sodium content data from packaged food labels to estimate sodium intake before and after the intervention. Data on blood pressure, cardiovascular disease, and chronic kidney disease burden were obtained from the Global Burden of Diseases, Injuries, and Risk Factors study, and the effect of sodium reduction on blood pressure and disease risk was modelled on the basis of meta-analyses of randomised trials and cohort studies. Intervention and health-care costs were used to estimate net costs, and calculate the incremental cost per health-adjusted life-year (HALY) gained. Costs and HALYs were discounted at 3%.

findingsIn the first 10 years, compliance with the WHO sodium benchmarks was estimated to avert a mean of 0·3 (95% uncertainty interval [UI] 0·2-0·5) million deaths from cardiovascular diseases and chronic kidney disease, a mean of 1·7 (95% UI 1·0-2·4) million incident cardiovascular disease events, and 0·7 (0·4-1·0) million new chronic kidney disease cases, compared with current practice. Over 10 years, the intervention was projected to be cost saving (100·0% probability), generating 1·0 (0·6 to 1·4) billion HALYs and US$0·8 (95% UI 0·3 to 1·4) million in cost savings. Over the population lifetime, the intervention could prevent 4·2 (2·4-6·0) million deaths from cardiovascular diseases and chronic kidney disease, 14·0 (8·2-20·1) million incident cardiovascular disease events, and 4·8 (2·8-6·8) new chronic kidney disease cases, with an 84·2% probability of being cost-saving and 100·0% probability of being cost-effective.

interpretationOur modelling data suggest a high potential for compliance with WHO sodium benchmarks for packaged food being associated with substantial health gains and cost savings, making a strong case for India to mandate the implementation of the WHO sodium benchmarks, particularly as packaged food consumption continues to rise.

fundingWHO Country Office India.

Indexed as

BenchmarkingCost-Benefit AnalysisWorld Health OrganizationAdultCardiovascular DiseasesFemaleFood LabelingFood PackagingHumansIndiaMaleMiddle AgedQuality-Adjusted Life YearsSodium, DietarySodium, Dietary

Identifiers

PMID39486901
PMCPMC11535755

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LicenceCC BY
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Registered trials

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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.