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首页> 外文期刊>BMC Public Health >The health gains and cost savings of dietary salt reduction interventions, with equity and age distributional aspects
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The health gains and cost savings of dietary salt reduction interventions, with equity and age distributional aspects

机译：饮食性减盐干预措施的健康收益和成本节省，以及公平和年龄分布方面

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Background A “diet high in sodium” is the second most important dietary risk factor for health loss identified in the Global Burden of Disease Study 2013. We therefore aimed to model health gains and costs (savings) of salt reduction interventions related to salt substitution and maximum levels in bread, including by ethnicity and age. We also ranked these four interventions compared to eight other modelled interventions. Methods A Markov macro-simulation model was used to estimate QALYs gained and net health system costs for four dietary sodium reduction interventions, discounted at 3?% per annum. The setting was New Zealand (NZ) (2.3 million adults, aged 35+ years) which has detailed individual-level administrative cost data. Results The health gain was greatest for an intervention where most (59?%) of the sodium in processed foods was replaced by potassium and magnesium salts. This intervention gained 294,000 QALYs over the remaining lifetime of the cohort (95 % UI: 238,000 to 359,000; 0.13 QALY per 35+ year old). Such salt substitution also produced the highest net cost-savings of NZ$ 1.5 billion (US$ 1.0 billion) (95 % UI: NZ$ 1.1 to 2.0 billion). All interventions generated relatively larger per capita QALYs for men vs women and for the indigenous Māori population vs non-Māori (e.g., 0.16 vs 0.12 QALYs per adult for the 59?% salt substitution intervention). Of relevance to workforce productivity, in the first 10?years post-intervention, 22?% of the QALY gain was among those aged Conclusions The benefits are consistent with the international literature, with large health gains and cost savings possible from some, but not all, sodium reduction interventions. Health gain appears likely to occur among working-age adults and all interventions contributed to reducing health inequalities.
机译：背景信息“高钠饮食”是2013年《全球疾病负担研究》中确定的第二大最重要的饮食健康失衡风险因素。因此，我们旨在模拟与食盐替代和补盐相关的减盐干预措施的健康收益和成本（节省）。面包中的最高含量，包括种族和年龄。与其他八种模拟干预相比，我们还对这四种干预进行了排名。方法采用马尔可夫宏观模拟模型来估算四种饮食减少钠盐干预措施获得的QALYs和净卫生系统成本，折现率为每年3％。设置地点是新西兰（NZ）（230万成年人，年龄35岁以上），其中包含详细的个人级行政费用数据。结果对于采用钾盐和镁盐替代加工食品中大部分钠（59％）的干预措施，健康收益最大。在该研究组的剩余生命周期中，这项干预措施获得了294,000个QALY（95％UI：238,000至359,000;每35岁以上的人0.13 QALY）。这样的盐替代也节省了最高的净成本，为15亿新西兰元（10亿美元）（95％的UI：1.1到20亿新西兰元）。所有干预措施产生的男性和女性人均QALY相对较大，而土著毛利人群体与非毛利人的人均QALY相对较高（例如，对59％的盐替代干预而言，每个成年人的QALYs为0.16 vs 0.12）。与劳动力生产率相关，在干预后的前10年中，QALY收益中有22％是老年人。结论结论收益与国际文献一致，虽然有一些好处，但可以带来较大的健康收益和成本节约，但并非如此所有，减少钠的干预措施。在工作年龄的成年人中似乎有可能获得健康增益，所有干预措施均有助于减少健康不平等。

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