Abstract:
BACKGROUND:trans-fatty acids (TFAs) are a well-known risk factor of ischemic heart disease (IHD). In Australia, the highest TFA intake is concentrated to the most socioeconomically disadvantaged groups. Elimination of industrial TFA (iTFA) from the Australian food supply could result in reduced IHD mortality and morbidity while improving health equity. However, such legislation could lead to additional costs for both government and food industry. Thus, we assessed the potential cost-effectiveness, health gains, and effects on health equality of an iTFA ban from the Australian food supply. METHODS AND FINDINGS:Markov cohort models were used to estimate the impact on IHD burden and health equity, as well as the cost-effectiveness of a national ban of iTFA in Australia. Intake of TFA was assessed using the 2011-2012 Australian National Nutrition and Physical Activity Survey. The IHD burden attributable to TFA was calculated by comparing the current level of TFA intake to a counterfactual setting where consumption was lowered to a theoretical minimum distribution with a mean of 0.5% energy per day (corresponding to TFA intake only from nonindustrial sources, e.g., dairy foods). Policy costs, avoided IHD events and deaths, health-adjusted life years (HALYs) gained, and changes in IHD-related healthcare costs saved were estimated over 10 years and lifetime of the adult Australian population. Cost-effectiveness was assessed by calculation of incremental cost-effectiveness ratios (ICERs) using net policy cost and HALYs gained. Health benefits and healthcare cost changes were also assessed in subgroups based on socioeconomic status, defined by Socio-Economic Indexes for Areas (SEIFA) quintile, and remoteness. Compared to a base case of no ban and current TFA intakes, elimination of iTFA was estimated to prevent 2,294 (95% uncertainty interval [UI]: 1,765; 2,851) IHD deaths and 9,931 (95% UI: 8,429; 11,532) IHD events over the first 10 years. The greatest health benefits were accrued to the most socioeconomically disadvantaged quintiles and among Australians living outside of major cities. The intervention was estimated to be cost saving (net cost <0 AUD) or cost-effective (i.e., ICER < AUD 169,361/HALY) regardless of the time horizon, with ICERs of 1,073 (95% UI: dominant; 3,503) and 1,956 (95% UI: 1,010; 2,750) AUD/HALY over 10 years and lifetime, respectively. Findings were robust across several sensitivity analyses. Key limitations of the study include the lack of recent data of TFA intake and the small sample sizes used to estimate intakes in subgroups. As with all simulation models, our study does not prove that a ban of iTFA will prevent IHD, rather, it provides the best quantitative estimates and corresponding uncertainty of a potential effect in the absence of stronger direct evidence. CONCLUSIONS:Our model estimates that a ban of iTFAs could avert substantial numbers of IHD events and deaths in Australia and would likely be a highly cost-effective strategy to reduce social-economic and urban-rural inequalities in health. These findings suggest that elimination of iTFA can cost-effectively improve health and health equality even in countries with low iTFA intake.
journal_name
PLoS Medjournal_title
PLoS medicineauthors
Marklund M,Zheng M,Veerman JL,Wu JHYdoi
10.1371/journal.pmed.1003407subject
Has Abstractpub_date
2020-11-02 00:00:00pages
e1003407issue
11eissn
1549-1277issn
1549-1676pii
PMEDICINE-D-19-03970journal_volume
17pub_type
杂志文章相关文献
PLOS MEDICINE文献大全abstract:BACKGROUND:Although cigarette smoking, excessive alcohol drinking, obesity, and several other well-studied unhealthy lifestyle-related factors each have been linked to the risk of multiple chronic diseases and premature death, little is known about the combined impact on mortality outcomes, in particular among Chinese ...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1000339
更新日期:2010-09-14 00:00:00
abstract:BACKGROUND:There is very limited data on the time trend of diabetes incidence in Asia. Using population-level data, we report the secular trend of the incidence of type 1 and type 2 diabetes in Hong Kong between 2002 and 2015. METHODS AND FINDINGS:The Hong Kong Diabetes Surveillance Database hosts clinical information...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1003052
更新日期:2020-02-20 00:00:00
abstract:BACKGROUND:The anti-human epidermal growth factor receptor 2 (HER2) monoclonal antibody trastuzumab improves outcomes in patients with node-positive HER2+ early breast cancer. Given trastuzumab's high cost, we aimed to estimate its cost-effectiveness by heterogeneity in age and estrogen receptor (ER) and progesterone r...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1002067
更新日期:2016-08-09 00:00:00
abstract:BACKGROUND:Quantitative estimation of the extent to which the immune system's protective effect against one herpes simplex virus type 2 (HSV-2) infection protects against infection with additional HSV-2 strains is important for understanding the potential for HSV-2 vaccine development. Using viral genotyping, we estima...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1002475
更新日期:2017-12-27 00:00:00
abstract:BACKGROUND:Midwifery continuity of care is the only health system intervention shown to reduce preterm birth (PTB) and improve perinatal survival, but no trial evidence exists for women with identified risk factors for PTB. We aimed to assess feasibility, fidelity, and clinical outcomes of a model of midwifery continui...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1003350
更新日期:2020-10-06 00:00:00
abstract:BACKGROUND:Childhood obstructive sleep apnea (OSA) is associated with neuropsychological deficits of memory, learning, and executive function. There is no evidence of neuronal brain injury in children with OSA. We hypothesized that childhood OSA is associated with neuropsychological performance dysfunction, and with ne...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.0030301
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:For treating multidrug-resistant tuberculosis (MDR TB), the World Health Organization (WHO) recommends a regimen of at least four second-line drugs that are likely to be effective as well as pyrazinamide. WHO guidelines indicate only marginal benefit for regimens based directly on drug susceptibility testing...
journal_title:PLoS medicine
pub_type: 杂志文章,多中心研究
doi:10.1371/journal.pmed.1001932
更新日期:2015-12-29 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment ...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1001809
更新日期:2015-03-31 00:00:00
abstract:BACKGROUND:Introduction of pneumococcal conjugate vaccines (PCVs) of limited valency is justified in Africa by the high burden of pneumococcal disease. Long-term beneficial effects of PCVs may be countered by serotype replacement. We aimed to determine the impact of PCV-7 vaccination on pneumococcal carriage in rural G...
journal_title:PLoS medicine
pub_type: 杂志文章,随机对照试验
doi:10.1371/journal.pmed.1001107
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:The World Health Organization (WHO) released revised guidelines in 2015 recommending that all people living with HIV, regardless of CD4 count, initiate antiretroviral therapy (ART) upon diagnosis. However, few studies have projected the global resources needed for rapid scale-up of ART. Under the Health Poli...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1001907
更新日期:2015-11-24 00:00:00
abstract:BACKGROUND:Intimate partner violence (IPV) against women is a major global health issue, particularly in low- and middle-income countries (LMICs), that is associated with poor physical and mental health, but its association with breastfeeding practices is understudied. Both the World Health Organization (WHO) and the U...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1002921
更新日期:2019-10-01 00:00:00
abstract::Thomas Platts-Mills and Matthew Perzanowski provide their expert Perspective on a translational study from Custovic and colleagues that identifies pairings of IgE that show value in estimating risk of concurrent asthma. ...
journal_title:PLoS medicine
pub_type: 评论,杂志文章
doi:10.1371/journal.pmed.1002696
更新日期:2018-11-20 00:00:00
abstract:BACKGROUND:Point-of-care CD4 tests at HIV diagnosis could improve linkage to care in resource-limited settings. Our objective is to evaluate the clinical and economic impact of point-of-care CD4 tests compared to laboratory-based tests in Mozambique. METHODS AND FINDINGS:We use a validated model of HIV testing, linkag...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1001725
更新日期:2014-09-16 00:00:00
abstract:BACKGROUND TO THE DEBATE:The UK Medical Research Council defines complex interventions as those comprising "a number of separate elements which seem essential to the proper functioning of the interventions although the 'active ingredient' of the intervention that is effective is difficult to specify." A typical example...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1000086
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Preventive chemotherapy represents a powerful but short-term control strategy for soil-transmitted helminthiasis. Since humans are often re-infected rapidly, long-term solutions require improvements in water, sanitation, and hygiene (WASH). The purpose of this study was to quantitatively summarize the relati...
journal_title:PLoS medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1371/journal.pmed.1001620
更新日期:2014-03-25 00:00:00
abstract:BACKGROUND:Counties are the smallest unit for which mortality data are routinely available, allowing consistent and comparable long-term analysis of trends in health disparities. Average life expectancy has steadily increased in the United States but there is limited information on long-term mortality trends in the US ...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.0050066
更新日期:2008-04-22 00:00:00
abstract:BACKGROUND:Growing prevalence of atrial fibrillation (AF) in the ageing population and its associated life-changing health and resource implications have led to a need to improve its early detection. Primary care is an ideal place to screen for AF; however, this is limited by shortages in general practitioner (GP) reso...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1003197
更新日期:2020-07-17 00:00:00
abstract::Hannah Leslie and co-authors discuss priorities in individual countries for health system reform. ...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1002946
更新日期:2019-10-03 00:00:00
abstract::Alexander Tsai and colleagues highlight the complex relationship between poverty and HIV stigma in sub-Saharan Africa, and discuss possible ways to break the cycle. Please see later in the article for the Editors' Summary. ...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1001557
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:The disease burden attributable to mental health problems and to excess or harmful alcohol use is considerable. Despite a strong relationship between these 2 important factors in population health, there are few studies quantifying the mortality risk associated with their co-occurrence in the general populat...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1003030
更新日期:2020-02-03 00:00:00
abstract::Christian Lienhardt and co-authors discuss the conclusions of the PLOS Medicine Collection on advances in clinical trial design for development of new tuberculosis treatments. ...
journal_title:PLoS medicine
pub_type: 杂志文章,评审
doi:10.1371/journal.pmed.1003059
更新日期:2020-02-27 00:00:00
abstract::In a Perspective, Lynn Morris and Nonhlanhla Mkhize discuss the prospects for broadly neutralizing antibodies to be used in preventing HIV infection. ...
journal_title:PLoS medicine
pub_type: 杂志文章,评审
doi:10.1371/journal.pmed.1002436
更新日期:2017-11-14 00:00:00
abstract:BACKGROUND:Pedometers can increase walking and moderate-to-vigorous physical activity (MVPA) levels, but their effectiveness with or without support has not been rigorously evaluated. We assessed the effectiveness of a pedometer-based walking intervention in predominantly inactive adults, delivered by post or through p...
journal_title:PLoS medicine
pub_type: 杂志文章,随机对照试验
doi:10.1371/journal.pmed.1002210
更新日期:2017-01-03 00:00:00
abstract:BACKGROUND:Animal studies suggest vital roles of sphingolipids, especially ceramides, in the pathogenesis of type 2 diabetes (T2D) via pathways involved in insulin resistance, β-cell dysfunction, and inflammation, but human studies are limited. We aimed to evaluate the associations of circulating sphingolipids with inc...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1003451
更新日期:2020-12-09 00:00:00
abstract:BACKGROUND:Our objective was to examine whether gestational diabetes mellitus (GDM) or newborns' high birthweight can be prevented by lifestyle counseling in pregnant women at high risk of GDM. METHOD AND FINDINGS:We conducted a cluster-randomized trial, the NELLI study, in 14 municipalities in Finland, where 2,271 wo...
journal_title:PLoS medicine
pub_type: 杂志文章,随机对照试验
doi:10.1371/journal.pmed.1001036
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:This paper examines the efforts of consultants affiliated with Philip Morris (PM), the world's leading transnational tobacco corporation, to influence scientific research and training in Thailand via the Chulabhorn Research Institute (CRI). A leading Southeast Asian institute for environmental health science...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.0050238
更新日期:2008-12-23 00:00:00
abstract:BACKGROUND:Some 5%-15% of all women experience postpartum depression (PPD), which for many is their first psychiatric disorder. The purpose of this study was to estimate the incidence of postpartum affective disorder (AD), duration of treatment, and rate of subsequent postpartum AD and other affective episodes in a nat...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1002392
更新日期:2017-09-26 00:00:00
abstract:BACKGROUND:In patients treated with cardiotoxic chemotherapies, the presence of cardiovascular risk factors and previous cardiac disease have been strongly correlated to the onset of cardiotoxicity. The influence of overweight and obesity as risk factors in the development of treatment-related cardiotoxicity in breast ...
journal_title:PLoS medicine
pub_type: 临床试验,杂志文章
doi:10.1371/journal.pmed.1002989
更新日期:2019-12-23 00:00:00
abstract:BACKGROUND:It has been suggested throughout the past fifty years that serum uric acid concentrations can help predict the future risk of coronary heart disease (CHD), but the epidemiological evidence is uncertain. METHODS AND FINDINGS:We report a "nested" case-control comparison within a prospective study in Reykjavik...
journal_title:PLoS medicine
pub_type: 杂志文章,meta分析
doi:10.1371/journal.pmed.0020076
更新日期:2005-03-01 00:00:00
abstract::Chris Beyrer and colleagues reflect on an underappreciated trend in multiple African, Asian, and Caribbean settings, in which the provision of HIV and other essential health services for sexual and gender minorities is expanding despite challenging legal and social environments. ...
journal_title:PLoS medicine
pub_type: 社论
doi:10.1371/journal.pmed.1002154
更新日期:2016-10-25 00:00:00