Article
Development and application of the TFA macrosimulation model: a case study of modelling the impact of trans fatty acid (TFA) elimination policies in Brazil
Registro en:
1471-2458
10.1186/s12889-022-14361-9
Autor
Nilson, Eduardo Augusto Fernandes
Khandpur, Neha
Gomes, Fabio da Silva
Resumen
Eduardo Augusto Fernandes Nilson - Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta à informação no documento. Todos os dados de pesquisa utilizados no artigo estão disponível no repositório GitHub (https://github.com/eduardonilson/TFA-CVD-model/tree/main). Introduction: The consumption of trans-fatty acids (TFA) is directly associated with cardiovascular disease risk and
is responsible for a significant health burden globally. The policy strategies for reducing TFA include limiting their
content in foods and eliminating partially hydrogenated oils (PHO) in the market. This study aims to describe a
comparative risk assessment macrosimulation model and to apply this tool to estimate the potential reductions in
CVD mortality gained from the compared scenarios of TFA reduction/elimination in Brazil.
Methodology: We developed and implemented a comparative risk assessment macrosimulation model estimates
the potential CVD mortality reduction (coronary heart disease – CHD- and stroke) if TFA intake is reduced in diets.
The TFA macrosimulation model estimates the change in the annual number of NCD deaths between baseline with
current TFA consumption levels and alternate or counterfactual scenarios, such as considering different limits to TFA
content in foods and the elimination of PHO in Brazil in 2018. The model incorporated additional outputs related to
other impacts of TFA reduction on DPP, such as Years of Life Lost, Years of Productive Life Lost, and related economic
impacts of premature deaths.
Results: In 2018, a 2% limit for TFA in the oils and fats and a 5% limit of TFAs for other foods could avert or postpone
approximately 2,000 deaths (UI 95% 1,899-2,142) and save US$ 32.1 million savings in productivity losses to the
economy associated to premature deaths. An intermediate scenario, applying a 2% limit of TFA in all food products
In Brazil could prevent or postpone approximately 6,300 deaths (UI 95% 5,925-6,684) and the premature deaths
prevented would represent US$ 100.2 million in economic saving. Finally, by banning PHO, approximately 10,500
deaths could be prevented or postponed (UI 95% 9,963 − 10,909), corresponding to US$ 166.7 million in savings to
the economy because of premature deaths.
Conclusion: The TFA macrosimulation model can efficiently compare different policy scenarios for trans fats
reduction policies at the country level and proves that the elimination of PHOs from the food market in Brazil may significantly reduce the health burden of trans fatty acids in the country compared to other policy options. The model
also represents a useful public health tool to support TFA reduction and elimination policies in other countries.