Evidence map›Paper›PMID 40610995›Full record

ArticleBMC public health2025

The potential health impact and healthcare cost savings of different sodium reduction strategies in Canada.

Nadia Flexner, Amanda C Jones, Ben Amies-Cull, Linda Cobiac, Eduardo Nilson, Mary R L'Abbe

Abstract read
In one paragraph

Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

6 authors.

Nadia FlexnerDepartment of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Amanda C JonesDepartment of Public Health, University of Otago, Wellington, New Zealand.
Ben Amies-CullNuffield Department of Primary Care Healthcare Sciences, University of Oxford, Oxford, UK.
Linda CobiacGriffith University, Queensland, Australia.
Eduardo NilsonCenter for Epidemiological Research in Nutrition and Public Health, University of São Paulo, São Paulo, Brazil.
Mary R L'AbbeDepartment of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada. mary.labbe@utoronto.ca.

Funding

CIHR PJT-165858; SA2-152805; Healthy Cities Training Award
6 · The paper itself

Abstract

backgroundHigh dietary sodium is the main dietary risk factor for non-communicable diseases due to its impact on cardiovascular diseases, the leading cause of death globally. The objective of the study was to estimate the number of avoidable ischemic heart disease (IHD) and stroke incidence cases, and their associated healthcare cost and Quality-Adjusted Life Year (QALY) savings resulting from different sodium reduction strategies and recommendations in Canada.

methodsWe used the PRIMEtime model, a proportional multi-state lifetable model. Outcomes were modeled over the lifetime of the population alive in 2019, at a 1.5% discount rate, and from the public healthcare system perspective. Nationally representative data were used as inputs for the model.

resultsFully meeting Health Canada's sodium reduction targets was estimated to prevent 219,490 (95% UI (Uncertainty Interval), 73,409-408,630) cases of IHD, and 164,435 (95% UI, 56,121-305,770) strokes. This led to a gain of 276,185 (95% UI, 85,414-552,616) QALYs, and healthcare costs savings of CAD 4,212 (95% UI, 1,303-8,206) million over the lifetime of the 2019 cohort. Sodium reduction intake through front-of-package labeling (FOPL) regulations has the potential to prevent between 35,930 (95% UI, 8,058-80,528) and 124,744 (95% UI, 40,125-235,643) cases of IHD, and between 26,869 (95% UI, 5,235-61,621) and 93,129 (95% UI, 30,296-176,014) strokes. This results in QALY gains ranging from 45,492 (95% UI, 10,281-106,579) to 157,628 (95% UI, 46,701-320,622), and healthcare costs savings ranging from CAD 695 (95% UI, 160-1,580) to CAD 2,415 (95% UI, 722-4,746) million over the lifetime of the 2019 Canadian cohort. All sodium reduction strategies tested were cost saving.

conclusionsReducing population-level sodium intakes is feasible and has the potential to improve health outcomes and save healthcare costs in Canada. From interventions tested, most health and healthcare costs gains were attributed to fully meeting sodium reduction targets, which highlights the importance of changing the voluntary nature of these targets to mandatory. A combination of strategies, mandatory sodium reduction targets and implementation of the 'high in' FOPL symbol would provide the most benefit from a public health standpoint.

Indexed as

Cost SavingsHealth Care CostsHealth Impact AssessmentMyocardial IschemiaSodium, DietaryStrokeAdultAgedCanadaFemaleHumansMaleMiddle AgedQuality-Adjusted Life YearsSodium, DietaryCardiovascular diseaseCost-utility analysisFood policyHealth impactMulti-state lifetable modelSodium reduction

Identifiers

PMID40610995
PMCPMC12224586

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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.