Imperial College London
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ProfessorMarisaMiraldo

Business School

Professor in Health Economics and Policy
 
 
 
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Contact

 

m.miraldo Website CV

 
 
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Location

 

418Business School BuildingSouth Kensington Campus

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Summary

 

Publications

Citation

BibTex format

@article{Goiana-Da-Silva:2022:10.3389/fpubh.2022.876827,
author = {Goiana-Da-Silva, F and Miraldo, M},
doi = {10.3389/fpubh.2022.876827},
journal = {Frontiers in Public Health},
pages = {1--9},
title = {Modelling the health impact of legislation to limit the salt content of bread in Portugal: a macro simulation study},
url = {http://dx.doi.org/10.3389/fpubh.2022.876827},
volume = {10},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Excessive salt consumption - associated with a range of adverse health outcomes – is very high in Portugal, and bread is the second largest source. Current Portuguese legislation sets a maximum limit of 1.4g salt per 100g bread, but imported and traditional breads are exempted. In 2017 the Ministry of Health proposed reducing the salt threshold to 1.0g/100g by 2022, however the legislation was vetoed by the European Commission on free-trade grounds. Aims: To estimate the health impact of subjecting imported and traditional breads to the current 1.4g threshold, and to model the potential health impact of implementing the proposed 1.0g threshold. Methods: We gathered bread sales, salt consumption, and epidemiological data from robust publicly available data sources. We used the open source WHO PRIME modelling tool to estimate the number of salt-related deaths that would have been averted in 2016 (the latest year for which all data were available) from; 1) Extending the 1.4g threshold to all types of bread, and 2) Applying the 1.0g threshold to all bread sold in Portugal. We used Monte Carlo simulations to generate confidence intervals. Results: Applying the current 1.4g threshold to imported and traditional bread would have averted 107 deaths in 2016 (95%CI: 43 to 172). Lowering the current threshold from 1.4 to 1.0g and applying it to all bread products would reduce daily salt consumption by 3.6 tonnes per day, saving an estimated 286 lives a year (95%CI 123-454).Conclusions: Salt is an important risk factor in Portugal and bread is a major source. Lowering maximum permissible levels and removing exemptions would save lives. The European Commission should revisit its decision on the basis of this new evidence.
AU  - Goiana-Da-Silva,F
AU  - Miraldo,M
DO  - 10.3389/fpubh.2022.876827
EP  - 9
PY  - 2022///
SN  - 2296-2565
SP  - 1
TI  - Modelling the health impact of legislation to limit the salt content of bread in Portugal: a macro simulation study
T2  - Frontiers in Public Health
UR  - http://dx.doi.org/10.3389/fpubh.2022.876827
UR  - https://www.frontiersin.org/articles/10.3389/fpubh.2022.876827/full
UR  - http://hdl.handle.net/10044/1/98455
VL  - 10
ER  -
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