title: Predicting the health impact of lowering salt consumption in Turkey using the DYNAMO health impact assessment tool.
abstract: OBJECTIVE
  To estimate the impact of three daily salt consumption scenarios on the prevalence and incidence of ischaemic heart disease (IHD) and cerebrovascular disease in 2025 in the Turkish population aged ≥30 years using the DYNAMO Health Impact Assessment tool.
  
  
  METHODS
  Statistical disease modelling study.
  
  
  METHODS
  DYNAMO health impact assessment was populated using data from Turkey to estimate the prevalence and incidence of IHD and cerebrovascular disease in 2025. TurkSTAT data were used for demographic data, and national surveys were used for salt consumption and disease-specific burden. Three salt consumption scenarios were modelled: (1) reference scenario: mean salt consumption stays the same from 2012-2013 until 2025; (2) gradual decline: daily salt intake reduces steadily by 0.47 g per year by lowering salt intake from bread by 50% and from table salt by 40% by 2025; and (3) World Health Organization (WHO) advice: daily salt intake of 5 g per day from 2013 until 2025.
  
  
  RESULTS
  The gradual decline scenario would lead to a decrease in the prevalence of IHD and cerebrovascular disease by 0.3% and 0.2%, respectively, and a decrease in the incidence by 0.6 and 0.4 per 1000, respectively. Following WHO's advice would lead to a decrease in the prevalence of IHD and cerebrovascular disease by 0.8% and 0.5%, respectively, and a decrease in the incidence by 1.0 and 0.7 per 1000, respectively.
  
  
  CONCLUSIONS
  This model indicates that Turkey can lower its future cardiovascular disease burden by following the gradual decline scenario. Following WHO's advice would achieve an even greater benefit.
authors.affiliation: Department of Public Health, Dokuz Eylul University, Izmir, Turkey. Electronic address: erdemerkoyun@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Erkoyun
authors.affiliation: Department of Public Health, Izmir Katip Celebi University, Izmir, Turkey.
authors.forename: K
authors.initials: K
authors.lastname: Sözmen
authors.affiliation: Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, Dublin, Ireland.
authors.forename: K
authors.initials: K
authors.lastname: Bennett
authors.affiliation: Department of Public Health, Dokuz Eylul University, Izmir, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Unal
authors.affiliation: Department of Statistics and Mathematical Modelling, National Institute of Public Health and the Environment, Bilthoven, The Netherlands; Department of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
authors.forename: H C
authors.initials: HC
authors.lastname: Boshuizen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000453:epidemiology*; D005260:Female; D062489:Health Impact Assessment; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D017202:Myocardial Ischemia / Q000453:epidemiology*; D015995:Prevalence; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage*; D014421:Turkey / Q000453:epidemiology
chemical_list: D017673:Sodium Chloride, Dietary
keywords: Cardiovascular diseases; Cerebrovascular disease; Disease modelling; Health impact assessment; Ischaemic heart disease; Salt consumption