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Health and Economic Impacts of Eight Different Dietary Salt Reduction Interventions

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  • Nhung Nghiem
  • Tony Blakely
  • Linda J Cobiac
  • Amber L Pearson
  • Nick Wilson

Abstract

Background: Given the high importance of dietary sodium (salt) as a global disease risk factor, our objective was to compare the impact of eight sodium reduction interventions, including feasible and more theoretical ones, to assist prioritisation. Methods: Epidemiological modelling and cost-utility analysis were performed using a Markov macro-simulation model. The setting was New Zealand (NZ) (2.3 million citizens, aged 35+ years) which has detailed individual-level administrative cost data. Results: Of the most feasible interventions, the largest health gains were from (in descending order): (i) mandatory 25% reduction in sodium levels in all processed foods; (ii) the package of interventions performed in the United Kingdom (UK); (iii) mandatory 25% reduction in sodium levels in bread, processed meats and sauces; (iv) media campaign (as per a previous UK one); (v) voluntary food labelling as currently used in NZ; (vi) dietary counselling as currently used in NZ. Even larger health gains came from the more theoretical options of a “sinking lid” on the amount of food salt released to the national market to achieve an average adult intake of 2300 mg sodium/day (211,000 QALYs gained, 95% uncertainty interval: 170,000 – 255,000), and from a salt tax. All the interventions produced net cost savings (except counselling – albeit still cost-effective). Cost savings were especially large with the sinking lid (NZ$ 1.1 billion, US$ 0.7 billion). Also the salt tax would raise revenue (up to NZ$ 452 million/year). Health gain per person was greater for Māori (indigenous population) men and women compared to non-Māori. Conclusions: This study substantially expands on the range of previously modelled salt reduction interventions and suggests that some of these might achieve major health gains and major cost savings (particularly the regulatory interventions). They could also reduce ethnic inequalities in health.

Suggested Citation

  • Nhung Nghiem & Tony Blakely & Linda J Cobiac & Amber L Pearson & Nick Wilson, 2015. "Health and Economic Impacts of Eight Different Dietary Salt Reduction Interventions," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-18, April.
  • Handle: RePEc:plo:pone00:0123915
    DOI: 10.1371/journal.pone.0123915
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    References listed on IDEAS

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    1. Linda J Cobiac & Anne Magnus & Stephen Lim & Jan J Barendregt & Rob Carter & Theo Vos, 2012. "Which Interventions Offer Best Value for Money in Primary Prevention of Cardiovascular Disease?," PLOS ONE, Public Library of Science, vol. 7(7), pages 1-10, July.
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    Cited by:

    1. Xian Li & Stephen Jan & Lijing L Yan & Alison Hayes & Yunbo Chu & Haijun Wang & Xiangxian Feng & Wenyi Niu & Feng J He & Jun Ma & Yanbo Han & Graham A MacGregor & Yangfeng Wu, 2017. "Cost and cost-effectiveness of a school-based education program to reduce salt intake in children and their families in China," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-17, September.
    2. Nhung Nghiem & Nick Wilson, 2021. "Potential impact of COVID-19 related unemployment on increased cardiovascular disease in a high-income country: Modeling health loss, cost and equity," PLOS ONE, Public Library of Science, vol. 16(5), pages 1-14, May.
    3. Dan Gong & Hong Yuan & Yiying Zhang & Huiqi Li & Donglan Zhang & Xing Liu & Mei Sun & Jun Lv & Chengyue Li, 2020. "Hypertension-Related Knowledge, Attitudes, and Behaviors among Community-Dwellers at Risk for High Blood Pressure in Shanghai, China," IJERPH, MDPI, vol. 17(10), pages 1-12, May.
    4. Liana Jacobi & Nhung Nghiem & Andrés Ramírez‐Hassan & Tony Blakely, 2021. "Food Price Elasticities for Policy Interventions: Estimates from a Virtual Supermarket Experiment in a Multistage Demand Analysis with (Expert) Prior Information," The Economic Record, The Economic Society of Australia, vol. 97(319), pages 457-490, December.
    5. Abhijit Sharma & Salvatore Falco & Iain Fraser, 2019. "Consumption of salt rich products: impact of the UK reduced salt campaign," International Journal of Health Economics and Management, Springer, vol. 19(3), pages 341-357, December.

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