title: Small changes in snacking behaviour: the potential impact on CVD mortality.
abstract: OBJECTIVE
  To examine the potential public health impact on CHD and stroke mortality of replacing one 'unhealthy' snack with one 'healthy' snack per person, per day, across the UK population.
  
  
  METHODS
  Nutritional information was obtained for different 'unhealthy' (such as crisps, chocolate bars, cakes and pastries) and 'healthy' snack products (such as fresh fruit, dried fruit, unsalted nuts or seeds). Expected changes in dietary intake were calculated. The mean change in total blood cholesterol levels was estimated using the Keys equation. The effect of changing cholesterol and salt levels on CHD deaths and on stroke deaths was calculated using the appropriate equations from the Law and He meta-analyses. The estimated reductions in cardiovascular deaths were then tested in a sensitivity analysis.
  
  
  RESULTS
  Substituting one 'healthy' snack would reduce saturated fat intake by approximately 4.4 g per person per day, resulting in approximately 2400 fewer CHD deaths and 425 fewer stroke deaths per year. The associated 500 mg decrease in salt intake would result in approximately 1790 fewer CHD deaths and 1330 fewer stroke deaths.
  
  
  CONCLUSIONS
  Simply replacing one unhealthy snack with one healthy snack per day might prevent approximately 6000 cardiovascular deaths every year in the UK.
authors.affiliation: Division of Public Health, University of Liverpool, Whelan Building Quadrangle, Liverpool L69 3GB, UK. ffionlw@liv.ac.uk
authors.forename: Ffion
authors.initials: F
authors.lastname: Lloyd-Williams
authors.forename: Modi
authors.initials: M
authors.lastname: Mwatsama
authors.forename: Robin
authors.initials: R
authors.lastname: Ireland
authors.forename: Simon
authors.initials: S
authors.lastname: Capewell
mesh_terms: D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000401:mortality*; D002784:Cholesterol / Q000097:blood; D002791:Cholesterol, Dietary / Q000008:administration & dosage / Q000009:adverse effects*; D004032:Diet / Q000592:standards; D004041:Dietary Fats / Q000008:administration & dosage / Q000009:adverse effects; D004435:Eating; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D009026:Mortality / Q000639:trends; D016017:Odds Ratio; D011634:Public Health; D012307:Risk Factors; D012982:Sodium, Dietary / Q000008:administration & dosage / Q000009:adverse effects*; D020521:Stroke / Q000097:blood / Q000453:epidemiology / Q000401:mortality*; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D002791:Cholesterol, Dietary; D004041:Dietary Fats; D012982:Sodium, Dietary; D002784:Cholesterol