{
  "abstract": "Background The front-of-pack traffic light system (TLS) labelling was introduced in the UK in 2013 as a voluntary scheme. This policy recommends that packaged products display traffic light colours based on nutrient levels. We estimated the impact of reduced salt intake due to the implementation of TLS on cardiovascular diseases (CVDs) in England.Methods We used the IMPACT NCD, a dynamic microsimulation model of an adult synthetic population of England, created using data from Health Survey of England (individual traits and trends in risk factors), National Diet and Nutrition Survey (NDNS) (salt intake trends), Clinical Practice Research Datalink Aurum, Hospital Episode Statistics, and Office for National Statistics mortality records (trends in disease-specific prevalence and mortality). Two scenarios were modelled: 1) ‘current voluntary implementation’ (i.e., 75% of all packed products featuring TLS) from 2013 to 2024 against a counterfactual scenario in which the pre-TLS trend in salt consumption (as observed from 2009 to 2012 in NDNS) continued, and 2) ‘mandatory implementation’ (i.e., additional 25% coverage) from 2025 to 2036 (a 12-year simulation horizon, similar to the voluntary scenario) compared to the 2009-to-2019 salt consumption trend in NDNS. A 5-year lag time was assumed before changes in salt consumption affected CVD outcomes.Results We present preliminary findings based on an assumed reduced salt consumption due to consumer response to TLS labelling. The current voluntary implementation of TLS labelling (75% coverage) from 2013 to 2024 may have prevented 25,000 CVD case-years [95% uncertainty intervals-UI: 2,900 to 56,000]. The mandatory implementation (additional 25% coverage) from 2025 to 2036 was estimated to prevent 6,200 CVD case-years [95% UI: 1,100 to 30,000]. The impact of current voluntary and mandatory TLS labelling implementation on health inequalities was inconclusive.Conclusion The current voluntary TLS labelling is estimated to prevent CVDs by reducing salt consumption. Mandating this labelling for all packaged products may further reduce the future burden of CVDs.",
  "authors": [
    {
      "affiliations": [
        "Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK"
      ],
      "name": "I Gusti Ngurah Edi Putra"
    },
    {
      "affiliations": [
        "Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK"
      ],
      "name": "Martin O’Flaherty"
    },
    {
      "affiliations": [
        "Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK"
      ],
      "name": "Zoé Colombet"
    },
    {
      "affiliations": [
        "Department of Psychology, University of Liverpool, Liverpool, UK"
      ],
      "name": "Rebecca Evans"
    },
    {
      "affiliations": [
        "Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK"
      ],
      "name": "Brendan Collins"
    },
    {
      "affiliations": [
        "Department of Psychology, University of Liverpool, Liverpool, UK"
      ],
      "name": "Eric Robinson"
    },
    {
      "affiliations": [
        "Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK"
      ],
      "name": "Chris Kypridemos"
    }
  ],
  "title": "OP44 Estimating the impact of reduced salt intake associated with front-of-pack traffic light system labelling on cardiovascular diseases in England: a microsimulation study",
  "uid": "40c3cf36-14d2-52df-8224-a39b6932068a"
}