title: Estimating the cardiovascular mortality burden attributable to the European Common Agricultural Policy on dietary saturated fats.
abstract: OBJECTIVE
  To estimate the burden of cardiovascular disease within 15 European Union countries (before the 2004 enlargement) as a result of excess dietary saturated fats attributable to the Common Agricultural Policy (CAP).
  
  
  METHODS
  A spreadsheet model was developed to synthesize data on population, diet, cholesterol levels and mortality rates. A conservative estimate of a reduction in saturated fat consumption of just 2.2 g was chosen, representing 1% of daily energy intake. The fall in serum cholesterol concentration was then calculated, assuming that this 1% reduction in saturated fat consumption was replaced with 0.5% monounsaturated and 0.5% polyunsaturated fats. The resulting reduction in cardiovascular and stroke deaths was then estimated, and a sensitivity analysis conducted.
  
  
  RESULTS
  Reducing saturated fat consumption by 1% and increasing monounsaturated and polyunsaturated fat by 0.5% each would lower blood cholesterol levels by approximately 0.06 mmol/l, resulting in approximately 9800 fewer coronary heart disease deaths and 3000 fewer stroke deaths each year.
  
  
  CONCLUSIONS
  The cardiovascular disease burden attributable to CAP appears substantial. Furthermore, these calculations were conservative estimates, and the true mortality burden may be higher. The analysis contributes to the current wider debate concerning the relationship between CAP, health and chronic disease across Europe, together with recent international developments and commitments to reduce chronic diseases. The reported mortality estimates should be considered in relation to the current CAP and any future reforms.
authors.affiliation: Division of Public Health, University of Liverpool, Liverpool, England. ffionlw@liv.ac.uk
authors.forename: Ffion
authors.initials: F
authors.lastname: Lloyd-Williams
authors.forename: Martin
authors.initials: M
authors.lastname: O'Flaherty
authors.forename: Modi
authors.initials: M
authors.lastname: Mwatsama
authors.forename: Christopher
authors.initials: C
authors.lastname: Birt
authors.forename: Robin
authors.initials: R
authors.lastname: Ireland
authors.forename: Simon
authors.initials: S
authors.lastname: Capewell
mesh_terms: D000328:Adult; D000368:Aged; D000383:Agriculture / Q000191:economics / Q000331:legislation & jurisprudence*; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000517:prevention & control; D002784:Cholesterol / Q000097:blood*; D004034:Diet Surveys; D004041:Dietary Fats / Q000008:administration & dosage* / Q000009:adverse effects / Q000145:classification; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage; D002149:Energy Intake / Q000502:physiology; D005060:Europe / Q000453:epidemiology; D005062:European Union; D005227:Fatty Acids / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005523:Food Supply / Q000191:economics / Q000331:legislation & jurisprudence*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018673:Nutrition Policy / Q000191:economics / Q000331:legislation & jurisprudence*; D011336:Probability; D012307:Risk Factors; D020521:Stroke / Q000401:mortality* / Q000517:prevention & control
chemical_list: D004041:Dietary Fats; D004042:Dietary Fats, Unsaturated; D005227:Fatty Acids; D002784:Cholesterol