title: Potential of trans fats policies to reduce socioeconomic inequalities in mortality from coronary heart disease in England: cost effectiveness modelling study.
abstract: OBJECTIVE
  To determine health and equity benefits and cost effectiveness of policies to reduce or eliminate trans fatty acids from processed foods, compared with consumption remaining at most recent levels in England.
  
  
  METHODS
  Epidemiological modelling study.
  
  
  METHODS
  Data from National Diet and Nutrition Survey, Low Income Diet and Nutrition Survey, Office of National Statistics, and health economic data from other published studies
  
  
  METHODS
  Adults aged ≥25, stratified by fifths of socioeconomic circumstance.
  
  
  METHODS
  Total ban on trans fatty acids in processed foods; improved labelling of trans fatty acids; bans on trans fatty acids in restaurants and takeaways.
  
  
  METHODS
  Deaths from coronary heart disease prevented or postponed; life years gained; quality adjusted life years gained. Policy costs to government and industry; policy savings from reductions in direct healthcare, informal care, and productivity loss.
  
  
  RESULTS
  A total ban on trans fatty acids in processed foods might prevent or postpone about 7200 deaths (2.6%) from coronary heart disease from 2015-20 and reduce inequality in mortality from coronary heart disease by about 3000 deaths (15%). Policies to improve labelling or simply remove trans fatty acids from restaurants/fast food could save between 1800 (0.7%) and 3500 (1.3%) deaths from coronary heart disease and reduce inequalities by 600 (3%) to 1500 (7%) deaths, thus making them at best half as effective. A total ban would have the greatest net cost savings of about £265m (€361m, $415m) excluding reformulation costs, or £64m if substantial reformulation costs are incurred outside the normal cycle.
  
  
  CONCLUSIONS
  A regulatory policy to eliminate trans fatty acids from processed foods in England would be the most effective and equitable policy option. Intermediate policies would also be beneficial. Simply continuing to rely on industry to voluntary reformulate products, however, could have negative health and economic outcomes.
authors.affiliation: Lancaster Medical School, Lancaster University, Lancaster LA1 4YW, UK Department of Public Health and Policy, Liverpool University, Liverpool L69 3GB, UK allenk@liverpool.ac.uk.
authors.forename: Kirk
authors.initials: K
authors.lastname: Allen
authors.affiliation: Division of Medical Sciences, University of Oxford, Oxford OX3 9DU, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Pearson-Stuttard
authors.affiliation: Pembroke College Alumni, University of Oxford, Oxford OX1 1DW, UK.
authors.forename: William
authors.initials: W
authors.lastname: Hooton
authors.affiliation: Lancaster Medical School, Lancaster University, Lancaster LA1 4YW, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Diggle
authors.affiliation: Department of Public Health and Policy, Liverpool University, Liverpool L69 3GB, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Capewell
authors.affiliation: Department of Public Health and Policy, Liverpool University, Liverpool L69 3GB, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: O'Flaherty
mesh_terms: D000328:Adult; D003327:Coronary Disease / Q000191:economics / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control*; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D004739:England; D005511:Food Handling; D006801:Humans; D007881:Legislation, Food; D019057:Quality-Adjusted Life Years; D012959:Socioeconomic Factors; D044242:Trans Fatty Acids / Q000009:adverse effects*
chemical_list: D044242:Trans Fatty Acids