17 results found
Pearson-Stuttard J, Ezzati M, Gregg E, 2019, Multimorbidity—a defining challenge for health systems, Lancet Public Health, Vol: 4, Pages: e599-e600, ISSN: 2468-2667
Mullee A, Romaguera D, Pearson-Stuttard J, et al., 2019, Association between soft drink consumption and mortality in 10 European countries., JAMA Internal Medicine, ISSN: 2168-6106
Importance: Soft drinks are frequently consumed, but whether this consumption is associated with mortality risk is unknown and has been understudied in European populations to date. Objective: To examine the association between total, sugar-sweetened, and artificially sweetened soft drink consumption and subsequent total and cause-specific mortality. Design, Setting, and Participants: This population-based cohort study involved participants (n = 451 743 of the full cohort) in the European Prospective Investigation into Cancer and Nutrition (EPIC), an ongoing, large multinational cohort of people from 10 European countries (Denmark, France, Germany, Greece, Italy, the Netherlands, Norway, Spain, Sweden, and the United Kingdom), with participants recruited between January 1, 1992, and December 31, 2000. Excluded participants were those who reported cancer, heart disease, stroke, or diabetes at baseline; those with implausible dietary intake data; and those with missing soft drink consumption or follow-up information. Data analyses were performed from February 1, 2018, to October 1, 2018. Exposure: Consumption of total, sugar-sweetened, and artificially sweetened soft drinks. Main Outcomes and Measures: Total mortality and cause-specific mortality. Hazard ratios (HRs) and 95% CIs were estimated using multivariable Cox proportional hazards regression models adjusted for other mortality risk factors. Results: In total, 521 330 individuals were enrolled. Of this total, 451 743 (86.7%) were included in the study, with a mean (SD) age of 50.8 (9.8) years and with 321 081 women (71.1%). During a mean (range) follow-up of 16.4 (11.1 in Greece to 19.2 in France) years, 41 693 deaths occurred. Higher all-cause mortality was found among participants who consumed 2 or more glasses per day (vs consumers of <1 glass per month) of total soft drinks (hazard ratio [HR], 1.17; 95% CI, 1.11-1.22; P < .001), sugar-sweetened soft drinks (HR, 1.08;
Pearson-Stuttard J, Gregg EW, 2019, Decreasing mortality masks a growing morbidity gap in patients with heart failure, Lancet Public Health, Vol: 4, Pages: E365-E366, ISSN: 2468-2667
Seferidi P, Laverty A, Pearson-Stuttard J, et 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
Bennett J, Pearson-Stuttard J, Kontis V, et al., 2018, Contributions of diseases and injuries to widening life expectancy inequalities in England from 2001 to 2016: population-based analysis of vital registration data, The Lancet Public Health, Vol: 3, Pages: e586-e597, ISSN: 2468-2667
BackgroundLife expectancy inequalities in England have increased steadily since the 1980s. Our aim was to investigate how much deaths from different diseases and injuries and at different ages have contributed to this rise to inform policies that aim to reduce health inequalities.MethodsWe used vital registration data from the Office for National Statistics on population and deaths in England, by underlying cause of death, from 2001 to 2016, stratified by sex, 5-year age group, and decile of the Index of Multiple Deprivation (based on the ranked scores of Lower Super Output Areas in England in 2015). We grouped the 7·65 million deaths by their assigned International Classification of Diseases (10th revision) codes to create categories of public health and clinical relevance. We used a Bayesian hierarchical model to obtain robust estimates of cause-specific death rates by sex, age group, year, and deprivation decile. We calculated life expectancy at birth by decile of deprivation and year using life-table methods. We calculated the contributions of deaths from each disease and injury, in each 5-year age group, to the life expectancy gap between the most deprived and affluent deciles using Arriaga's method.FindingsThe life expectancy gap between the most affluent and most deprived deciles increased from 6·1 years (95% credible interval 5·9–6·2) in 2001 to 7·9 years (7·7–8·1) in 2016 in females and from 9·0 years (8·8–9·2) to 9·7 years (9·6–9·9) in males. Since 2011, the rise in female life expectancy has stalled in the third, fourth, and fifth most deprived deciles and has reversed in the two most deprived deciles, declining by 0·24 years (0·10–0·37) in the most deprived and 0·16 years (0·02–0·29) in the second-most deprived by 2016. Death rates from every disease and at every age were higher in depriv
Seferidi P, Laverty AA, Pearson-Stuttard J, et 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.
Ezzati M, Pearson-Stuttard J, Bennett J, et al., 2018, Acting on non-communicable diseases in low- and middle-income tropical countries, Nature, Vol: 559, Pages: 507-516, ISSN: 0028-0836
The classical portrayal of poor health in tropical countries is one of infections and parasites, contrasting with wealthy western countries, where unhealthy diet and behaviours cause non-communicable diseases (NCDs) like heart disease and cancer. Using international mortality data, we show that most NCDs cause more deaths at any age in low- and middle-income tropical countries than in high-income western countries. Causes of NCDs in low- and middle-income countries include poor nutrition and living environment, infections, insufficient regulation of tobacco and alcohol, and under-resourced and inaccessible healthcare. We identify a comprehensive set of actions across health, social, economic and environmental sectors that can confront NCDs in low- and middle-income tropical countries and reduce global health inequalities.
Pearson-Stuttard J, Zhou B, Kontis V, et al., 2018, Worldwide burden of cancer attributable to diabetes and high body-mass index: a comparative risk assessment, LANCET DIABETES & ENDOCRINOLOGY, Vol: 6, Pages: E6-E15, ISSN: 2213-8587
d'Arcy JL, Coffey S, Loudon MA, et al., 2016, Large-scale community echocardiographic screening reveals a major burden of undiagnosed valvular heart disease in older people: the OxVALVE Population Cohort Study, European Heart Journal, Vol: 37, Pages: 3515-3522, ISSN: 0195-668X
Pearson-Stuttard J, Hooton W, Critchley J, et al., Cost-effectiveness analysis of eliminating industrial and all trans fats in England and Wales: modelling study, Journal of Public Health, ISSN: 1741-3842
Pearson-Stuttard J, Blundell S, Harris T, et al., 2016, Diabetes and infection: assessing the association with glycaemic control in population-based studies, LANCET DIABETES & ENDOCRINOLOGY, Vol: 4, Pages: 148-158, ISSN: 2213-8587
Pearson-Stuttard J, Modeling Future Cardiovascular Disease Mortality in the United States: National Trends and Racial and Ethnic Disparities., Circulation, ISSN: 0009-7322
Afshin A, Penalvo J, Del Gobbo L, et al., 2015, CVD Prevention Through Policy: a Review of Mass Media, Food/Menu Labeling, Taxation/Subsidies, Built Environment, School Procurement, Worksite Wellness, and Marketing Standards to Improve Diet, Current Cardiology Reports, Vol: 17, ISSN: 1523-3782
Allen K, Pearson-Stuttard J, Hooton W, et al., Potential of trans fats policies to reduce socioeconomic inequalities in mortality from coronary heart disease in England: cost effectiveness modelling study, BMJ, Pages: h4583-h4583
Pearson-Stuttard J, Critchley J, Capewell S, et al., 2015, Quantifying the socio-economic benefits of reducing industrial dietary trans fats: modelling study, PLoS One, Vol: 10, Pages: e0132524-e0132524, ISSN: 1932-6203
Background:Coronary Heart Disease (CHD) remains a leading cause of UK mortality, generating a large and unequal burden of disease. Dietary trans fatty acids (TFA) represent a powerful CHD risk factor, yet to be addressed in the UK (approximately 1% daily energy) as successfully as in other nations. Potential outcomes of such measures, including effects upon health inequalities, have not been well quantified. We modelled the potential effects of specific reductions in TFA intake on CHD mortality, CHD related admissions, and effects upon socioeconomic inequalities.Methods & Results:We extended the previously validated IMPACTsec model, to estimate the potential effects of reductions (0.5% & 1% reductions in daily energy) in TFA intake in England and Wales, stratified by age, sex and socioeconomic circumstances. We estimated reductions in expected CHD deaths in 2030 attributable to these two specific reductions. Output measures were deaths prevented or postponed, life years gained and hospital admissions. A 1% reduction in TFA intake energy intake would generate approximately 3,900 (95% confidence interval (CI) 3,300–4,500) fewer deaths, 10,000 (8,800–10,300) (7% total) fewer hospital admissions and 37,000 (30,100–44,700) life years gained. This would also reduce health inequalities, preventing five times as many deaths and gaining six times as many life years in the most deprived quintile compared with the most affluent. A more modest reduction (0.5%) would still yield substantial health gains.Conclusions:Reducing intake of industrial TFA could substantially decrease CHD mortality and hospital admissions, and gain tens of thousands of life years. Crucially, this policy could also reduce health inequalities. UK strategies should therefore aim to minimise industrial TFA intake.
Pearson-Stuttard J, Bajekal M, Scholes S, et al., 2012, Recent UK trends in the unequal burden of coronary heart disease, Heart, Vol: 98, Pages: 1573-1582, ISSN: 1355-6037
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