title: Quantifying the Socio-Economic Benefits of Reducing Industrial Dietary Trans Fats: Modelling Study.
abstract: BACKGROUND
  Coronary Heart Disease (CHD) remains a leading cause of UK mortality, generating a large and unequal burden of disease. Dietary trans fatty acids (TFA) represent a powerful CHD risk factor, yet to be addressed in the UK (approximately 1% daily energy) as successfully as in other nations. Potential outcomes of such measures, including effects upon health inequalities, have not been well quantified. We modelled the potential effects of specific reductions in TFA intake on CHD mortality, CHD related admissions, and effects upon socioeconomic inequalities.
  
  
  RESULTS
  We extended the previously validated IMPACTsec model, to estimate the potential effects of reductions (0.5% & 1% reductions in daily energy) in TFA intake in England and Wales, stratified by age, sex and socioeconomic circumstances. We estimated reductions in expected CHD deaths in 2030 attributable to these two specific reductions. Output measures were deaths prevented or postponed, life years gained and hospital admissions. A 1% reduction in TFA intake energy intake would generate approximately 3,900 (95% confidence interval (CI) 3,300-4,500) fewer deaths, 10,000 (8,800-10,300) (7% total) fewer hospital admissions and 37,000 (30,100-44,700) life years gained. This would also reduce health inequalities, preventing five times as many deaths and gaining six times as many life years in the most deprived quintile compared with the most affluent. A more modest reduction (0.5%) would still yield substantial health gains.
  
  
  CONCLUSIONS
  Reducing intake of industrial TFA could substantially decrease CHD mortality and hospital admissions, and gain tens of thousands of life years. Crucially, this policy could also reduce health inequalities. UK strategies should therefore aim to minimise industrial TFA intake.
authors.affiliation: Clinical Academic Graduate School, Division of Medical Sciences, University of Oxford, Oxford, United Kingdom; Division of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Pearson-Stuttard
authors.affiliation: Population Health Research Institute, St George's, University of London, London, United Kingdom.
authors.forename: Julia
authors.initials: J
authors.lastname: Critchley
authors.affiliation: Division of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom.
authors.forename: Simon
authors.initials: S
authors.lastname: Capewell
authors.affiliation: Division of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom.
authors.forename: Martin
authors.initials: M
authors.lastname: O'Flaherty
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003324:Coronary Artery Disease / Q000209:etiology / Q000401:mortality*; D004041:Dietary Fats / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D044242:Trans Fatty Acids / Q000009:adverse effects*
chemical_list: D004041:Dietary Fats; D044242:Trans Fatty Acids