AN EVALUATION OF THE HEALTH AND ECONOMIC IMPACT OF THE CURRENT NATIONAL POLICY TO ELIMINATE TRANS FAT ACIDS (TFA) IN ARGENTINA

RUBINSTEIN, ADOLFO; ELORRIAGA, NATALIA; GARAY ULISES; POGGIO, ROSANA; CAPORALE JOAQUIN; MOZAFFARIAN DARIUSH; PICHÓN-RIVIERE ANDRÉS

Granada

Congreso; IUNS 20th International Congress of Nutrition; 2013

IUNS

Backgrund and objectives: On per-calorie basis, TFA increaserisk of coronary heart disease (CHD) more than anyother macronutrient. Argentina has initiated a national policyto reduce TFA through voluntary agreements with industry(2001), mandatory labeling (2006) and elimination of industrializedTFA by 2014. We aimed to evaluate the impact of thispolicy on the reduction of CHD events, DALYs and costs.Methods: A review of dietary trials/local studies, and consultationswith experts/ industry were performed to estimatebaseline consumption in 2000 (2%E ) and replacements usedfrom 2001-2012, where TFA were substituted mainly by higholeicsunflower oil and beef tally. We built an epidemiologicalsimulation model calculating two scenarios: 1) estimating theeffects of isocaloric replacement of TFA on the change of totaland HDL cholesterol ratio Δ TC/HDL) by using alternativesto partially hydrogenated oils; 2) accounting for pleiotrophiceffects of TFA reported in prospective studies. We used Framinghamrisk equations to generate the expected pattern offirst CHD events according to person?s age-sex-risk factors distributions(including ΔTC/HDL) on an Argentine populationbasedsample. We estimated CHD risk before (2000) and afterfull policy implementation (2015), weighting by age-sex-CHDrisk factor prevalence, and calibrated our I; of CHD risk to therisk reported by national statistics.Results: From 2001-2015, based on changes in TC/HDL,2,802 deaths and 24,708 non-fatal CHD events, and 145,715DALYs will have been averted, and USD 106,762,155 saved. Ifwe include the effects reported in prospective studies, almost10% of CHD events would have been averted. Thus, given theapproximated 200,000 annual CHD events in Argentina, neareliminationof industrial TFA might avoid between 2% to 10%of CHD events each year.Conclusions: These results will help inform evidence-basedpolicies in Argentina and other developing countries on thehuge impact of nutritional interventions.