Imperial College London

Dr Paraskevi Seferidi

Faculty of MedicineSchool of Public Health

Research Fellow
 
 
 
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Contact

 

paraskevi.seferidi14

 
 
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Location

 

Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Publication Type
Year
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14 results found

Seferidi P, Millett C, Laverty AA, 2021, Industry self-regulation fails to deliver healthier diets, again Public Health England's replacement must take bolder action, BMJ-BRITISH MEDICAL JOURNAL, Vol: 372, ISSN: 1756-1833

Journal article

Seferidi P, Scrinis G, Huybrechts I, Woods J, Vineis P, Millett Cet al., 2020, The neglected environmental impacts of ultra-processed foods, The Lancet Planetary Health, Vol: 4, Pages: e437-e438, ISSN: 2542-5196

Journal article

Crookes C, Palladino R, Seferidi P, Hirve R, Siskou O, Filippidis Fet al., 2020, The impact of the economic crisis on household health expenditure in Greece: an interrupted time series analysis, BMJ Open, Vol: 10, Pages: 1-11, ISSN: 2044-6055

Objectives and setting The 2008 financial crisis had a particularly severe impact onGreece. To contain spending, the government capped public health expenditure andintroduced increased cost-sharing. The Greek case is important for studying theimpact of recessions on health systems. This study analysed changes in householdhealth expenditure in Greece over the economic crisis and explored whether theimpact differed across socioeconomic groups.Participants We used data from the Greek Household Budget Survey for the years2004 and 2008-2017. The dataset comprised 51,654 households, with a total of128,111 members.Design We compared pre- and post-crisis trends in Greek household out-of-pocketpayments for healthcare from 2004-2017 using an interrupted time series analysis.This study explored spending in Euros and as a share of total household purchases.Results Our results indicated that the population level trend in household healthspending was reversed after the crisis began (pre-crisis trend:€0.040 decrease perquarter (95% CI: -0.785 to -0.022), post-crisis trend:€0.315 increase per quarter(95% CI: -0.004 to 0.635)). We also found that spending on inpatient services andpharmaceuticals has been increasing since the start of the crisis, whereas outpatientservices expenditure has been decreasing. Across all households, out-of-pocketpayments incurred a greater financial burden after the crisis relative to pre-existingtrends, but the poorest households incurred a disproportionately higher burden.Conclusions This was the first study to use an interrupted time series analysis toassess the impact of the economic crisis on household health expenditure in Greece.Our findings suggest that there was an erosion of financial protection for Greekhouseholds as a consequence of the economic crisis. This effect was particularlypronounced amongst poorer households, which is indicative of a regressivefinancing system.

Journal article

Seferidi P, Laverty AA, Collins B, Bandosz P, Capewell S, O'Flaherty M, Millett C, Pearson-Stuttard Jet al., 2020, Potential impacts of post-Brexit agricultural policy on fruit and vegetable intake and cardiovascular disease in England: a modelling study, BMJ Nutrition, Prevention & Health, Vol: 3, ISSN: 2516-5542

Background Current proposals for post-Brexit agricultural policy do not explicitly incorporate public health goals. The revised agricultural policy may be an opportunity to improve population health by supporting domestic production and consumption of fruits and vegetables (F&V). This study aims to quantify the potential impacts of a post-Brexit agricultural policy that increases land allocated to F&V on cardiovascular disease (CVD) mortality and inequalities in England, between 2021 to 2030.Methods We used the previously validated IMPACT Food Policy model and probabilistic sensitivity analysis to translate changes in land allocated to F&V into changes in F&V intake and associated CVD deaths, stratified by age, sex and Index of Multiple Deprivation. The model combined data on F&V agriculture, waste, purchases and intake, CVD mortality projections and appropriate relative risks. We modelled two scenarios, assuming that land allocated to F&V would gradually increase to 10% and 20% of land suitable for F&V production.Results We found that increasing land use for F&V production to 10% and 20% of suitable land would increase fruit intake by approximately 3.7% (95% uncertainty interval: 1.6% to 8.6%) and 17.4% (9.1% to 36.9%), and vegetable intake by approximately 7.8% (4.2% to 13.7%) and 37% (24.3% to 55.7%), respectively, in 2030. This would prevent or postpone approximately 3890 (1950 to 7080) and 18 010 (9840 to 28 870) CVD deaths between 2021 and 2030, under the first and second scenario, respectively. Both scenarios would reduce inequalities, with 16% of prevented or postponed deaths occurring among the least deprived compared with 22% among the most deprived.Conclusion Post-Brexit agricultural policy presents an important opportunity to improve dietary intake and associated cardiovascular mortality by supporting domestic production of F&V as part of a comprehensive strategy that intervenes across the supply chain.

Journal article

Seferidi P, Laverty AA, Pearson-Stuttard J, Collins B, Bandosz P, Capewell S, O'Flaherty M, Millett Cet al., 2019, Impacts of post-Brexit agricultural policy on fruit and vegetable intake and cardiovascular disease, Publisher: OXFORD UNIV PRESS, ISSN: 1101-1262

Conference paper

Seferidi P, Laverty AA, Pearson-Stuttard J, Collins B, Bandosz P, Capewell S, O'Flaherty M, Millett Cet al., 2019, IMPACTS OF POST-BREXIT AGRICULTURAL POLICY ON FRUIT AND VEGETABLE INTAKE AND CARDIOVASCULAR DISEASE IN ENGLAND: A MODELLING ANALYSIS, Publisher: BMJ PUBLISHING GROUP, Pages: A4-A4, ISSN: 0143-005X

Conference paper

Laverty A, Kypridemos C, Seferidi P, Vamos EP, Pearson-Stuttard J, Collins B, Capewell S, Fleming K, O'Flaherty M, Millett Cet al., 2019, IMPACT OF THE PUBLIC HEALTH RESPONSIBILITY DEAL ON SALT INTAKE, CARDIOVASCULAR DISEASE AND GASTRIC CANCER: INTERRUPTED TIME SERIES AND MICROSIMULATION STUDY, Publisher: BMJ PUBLISHING GROUP, Pages: A5-A5, ISSN: 0143-005X

Conference paper

Laverty AA, Kypridemos C, Seferidi P, Vamos EP, Pearson-Stuttard J, Collins B, Capewell S, Mwatsama M, Cairney P, Fleming K, O'Flaherty M, Millett Cet al., 2019, Quantifying the impact of the Public Health Responsibility Deal on salt intake, cardiovascular disease and gastric cancer burdens: interrupted time series and microsimulation study, Journal of Epidemiology and Community Health, Vol: 73, Pages: 881-887, ISSN: 0143-005X

Background In 2011, England introduced the PublicHealth Responsibility Deal (RD), a public-privatepartnership (PPP) which gave greater freedom to thefood industry to set and monitor targets for salt intakes.We estimated the impact of the RD on trends in saltintake and associated changes in cardiovascular disease(CVD) and gastric cancer (GCa) incidence, mortality andeconomic costs in England from 2011–2025.Methods We used interrupted time series modelswith 24 hours’ urine sample data and the IMPACTNCDmicrosimulation model to estimate impacts of changes insalt consumption on CVD and GCa incidence, mortalityand economic impacts, as well as equity impacts.Results Between 2003 and 2010 mean salt intake wasfalling annually by 0.20 grams/day among men and 0.12g/d among women (P-value for trend both < 0.001).After RD implementation in 2011, annual declines insalt intake slowed statistically significantly to 0.11 g/damong men and 0.07 g/d among women (P-values fordifferences in trend both P < 0.001). We estimated thatthe RD has been responsible for approximately 9900(interquartile quartile range (IQR): 6700 to 13,000)additional cases of CVD and 1500 (IQR: 510 to 2300)additional cases of GCa between 2011 and 2018. Ifthe RD continues unchanged between 2019 and 2025,approximately 26 000 (IQR: 20 000 to 31,000) additionalcases of CVD and 3800 (IQR: 2200 to 5300) cases ofGCa may occur.Interpretation Public-private partnerships such as theRD which lack robust and independent target setting,monitoring and enforcement are unlikely to produceoptimal health gains.

Journal article

Seferidi P, Laverty A, Pearson-Stuttard J, Bandosz P, Collins B, Guzman-Castillo M, Capewell S, O'Flaherty M, Millett Cet al., 2019, Impacts of Brexit on fruit and vegetable intake and cardiovascular disease in England: a modelling study, BMJ Open, Vol: 9, ISSN: 2044-6055

Objectives To estimate the potential impacts of different Brexit trade policy scenarios on the price and intake of fruits and vegetables (F&V) and consequent cardiovascular disease (CVD) deaths in England between 2021 and 2030.Design Economic and epidemiological modelling study with probabilistic sensitivity analysis.Setting The model combined publicly available data on F&V trade, published estimates of UK-specific price elasticities, national survey data on F&V intake, estimates on the relationship between F&V intake and CVD from published meta-analyses and CVD mortality projections for 2021–2030.Participants English adults aged 25 years and older.Interventions We modelled four potential post-Brexit trade scenarios: (1) free trading agreement with the EU and maintaining half of non-EU free trade partners; (2) free trading agreement with the EU but no trade deal with any non-EU countries; (3) no-deal Brexit; and (4) liberalised trade regime that eliminates all import tariffs.Outcome measures Cumulative coronary heart disease and stroke deaths attributed to the different Brexit scenarios modelled between 2021 and 2030.Results Under all Brexit scenarios modelled, prices of F&V would increase, especially for those highly dependent on imports. This would decrease intake of F&V between 2.5% (95% uncertainty interval: 1.9% to 3.1%) and 11.4% (9.5% to 14.2%) under the different scenarios. Our model suggests that a no-deal Brexit scenario would be the most harmful, generating approximately 12 400 (6690 to 23 390) extra CVD deaths between 2021 and 2030, whereas establishing a free trading agreement with the EU would have a lower impact on mortality, contributing approximately 5740 (2860 to 11 910) extra CVD deaths.Conclusions Trade policy under all modelled Brexit scenarios could increase price and decrease intake of F&V, generating substantial additional CVD mortality in England. The UK government should consider the population healt

Journal article

Seferidi P, Laverty AA, Pearson-Stuttard J, Guzman-Castillo M, Collins B, Capewell S, OFlaherty M, Millett CJet al., 2018, Implications of Brexit on the effectiveness of the UK soft drinks industry levy upon coronary heart disease in England: a modelling study, Public Health Nutrition, Vol: 21, Pages: 3431-3439, ISSN: 1368-9800

Objective:An industry levy on sugar-sweetened beverages (SSB) was implemented in the UK in 2018. One year later, Brexit is likely to change the UK trade regime with potential implications for sugar price. We modelled the effect of potential changes in sugar price due to Brexit on SSB levy impacts upon CHD mortality and inequalities.Design:We modelled a baseline SSB levy scenario; an SSB levy under ‘soft’ Brexit, where the UK establishes a free trading agreement with the EU; and an SSB levy under ‘hard’ Brexit, in which World Trade Organization tariffs are applied. We used the previously validated IMPACT Food Policy model and probabilistic sensitivity analysis to estimate the effect of each scenario on CHD deaths prevented or postponed and life-years gained, stratified by age, sex and socio-economic circumstance, in 2021.Setting:England.Subjects:Adults aged 25 years or older.Results:The SSB levy was associated with approximately 370 (95 % uncertainty interval 220, 560) fewer CHD deaths and 4490 (2690, 6710) life-years gained in 2021. Associated reductions in CHD mortality were 4 and 8 % greater under ‘soft’ and ‘hard’ Brexit scenarios, respectively. The SSB levy was associated with approximately 110 (50, 190) fewer CHD deaths in the most deprived quintile compared with 60 (20, 100) in the most affluent, under ‘hard’ Brexit.Conclusions:Our study found the SSB levy resilient to potential effects of Brexit upon sugar price. Even under ‘hard’ Brexit, the SSB levy would yield benefits for CHD mortality and inequalities. Brexit negotiations should deliver a fiscal and regulatory environment which promotes population health.

Journal article

Seferidi S, Laverty AA, Pearson-Stuttard J, Guzman-Castillo M, Collins B, Capewell S, O'Flaherty M, Millett Cet al., 2018, POTENTIAL IMPACTS OF BREXIT ON CARDIOVASCULAR DISEASE VIA CHANGES TO THE PRICE OF FRUITS AND VEGETABLES: A MODELLING ANALYSIS, Publisher: BMJ PUBLISHING GROUP, Pages: A21-A21, ISSN: 0143-005X

Conference paper

Seferidi P, Laverty AA, Pearson-Stuttard J, Guzman-Castillo M, Collins B, Capewell S, O'Flaherty M, Millett Cet al., 2017, Implications of Brexit for the effectiveness of the UK soft drinks industry levy on coronary heart disease in England: a modelling study, Public Health Science Conference, Publisher: ELSEVIER SCIENCE INC, Pages: S9-S9, ISSN: 0140-6736

Conference paper

Seferidi P, Millett C, Laverty AA, 2017, Sweetened beverage intake in association to energy and sugar consumption and cardiometabolic markers in children, Pediatric Obesity, Vol: 13, Pages: 1-9, ISSN: 2047-6310

BackgroundArtificially sweetened beverages (ASBs) are promoted as healthy alternatives to sugar‐sweetened beverages (SSBs) in order to reduce sugar intake, but their effects on weight control and glycaemia have been debated. This study examines associations of SSBs and ASBs with energy and sugar intake and cardiometabolic measures.MethodsOne thousand six hundred eighty‐seven children aged 4–18 participated in the National Diet and Nutrition Survey Rolling Programme (2008/9–2011/12) in the UK. Linear regression was used to examine associations between SSBs and ASBs and energy and sugar, overall and from solid foods and beverages, and body mass index, waist‐to‐hip ratio and blood analytes. Fixed effects linear regression examined within‐person associations with energy and sugar.ResultsCompared with non‐consumption, SSB consumption was associated with higher sugar intake overall (6.1%; 4.2, 8.1) and ASB consumption with higher sugar intake from solid foods (1.7%; 0.5, 2.9) but not overall, mainly among boys. On SSB consumption days, energy and sugar intakes were higher (216 kcal; 163, 269 and 7.0%; 6.2, 7.8), and on ASB consumption days, sugar intake was lower (−1.0%; −1.8, −0.1) compared with those on non‐consumption days. SSB and ASB intakes were associated with higher levels of blood glucose (SSB: 0.30 mmol L−1; 0.11, 0.49 and ASB: 0.24 mmol L−1; 0.06, 0.43) and SSB intake with higher triglycerides (0.29 mmol L−1; 0.13, 0.46). No associations were found with other outcomes.ConclusionSugar‐sweetened beverage intake was associated with higher sugar intake and both SSBs and ASBs with a less healthy cardiometabolic profile. These findings add to evidence that health policy should discourage all sweetened beverage consumption.

Journal article

Oude Griep LM, Seferidi P, Stamler J, Van Horn L, Chan Q, Tzoulaki I, Steffen LM, Miura K, Ueshima H, Okuda N, Zhao L, Soedamah-Muthu SS, Daviglus ML, Elliott P, INTERMAP Research Groupet al., 2016, Relation of unprocessed, processed red meat and poultry consumption to blood pressure in East Asian and Western adults, Journal of Hypertension, Vol: 34, Pages: 1721-1729, ISSN: 1473-5598

Background: Epidemiologic evidence suggests that relationships of red meat consumption with risk of cardiovascular diseases depends on whether or not the meat is processed, including addition of preservatives, but evidence is limited for blood pressure (BP). Objective: To examine cross-sectional associations with BP of unprocessed and processed red meat and poultry consumption, total and by type, using data from the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP).Design: INTERMAP included 4,680 men and women ages 40-59 years from 17 population samples in Japan, China, the United Kingdom, and the United States. During four visits, eight BP measurements, four multi-pass 24-hr dietary recalls, and two timed 24-hr urine samples were collected.Results: Average daily total unprocessed/processed meat consumption (g/1000 kcal) was 20/5 in East Asian and 38/21 in Western participants. Unprocessed meat intakes comprised red meat for 75% in East Asian and 50% in Western participants. In Westerners, multiple linear regression analyses showed systolic/diastolic BP differences for total unprocessed red meat consumption higher by 25 g/1000 kcal +0.74/+0.57 mmHg (P=0.03/0.01) and for unprocessed poultry of +0.79/+0.16 mmHg (P=0.02/0.50). Unprocessed red meat was not related to BP in East Asian participants. In Westerners, systolic/diastolic BP differences for processed red meat higher by 12.5 g/1000 kcal were +1.20/+0.24 mmHg (P<0.01/0.24), due to consumption of cold cuts and sausages (+1.59/+0.32 mmHg, P<0.001/0.27).Conclusion: These findings are consistent with recommendations to limit meat intake (processed and unprocessed) to maintain and improve cardiovascular health.

Journal article

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