An appeal to our government for nationwide policies in the prevention of cardiovascular disease.
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ABSTRACT:
SUBMITTER: van Trier TJ
PROVIDER: S-EPMC8489361 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Nutrient profile (NP) models, tools used to rate or evaluate the nutritional quality of foods, are increasingly used by government bodies worldwide to underpin nutrition-related policies. An up-to-date and accessible list of existing NP models is currently unavailable to support their adoption or adaptation in different jurisdictions. This study used a systematic approach to develop a global resource that summarizes key characteristics of NP models with applications in government-led nutrition policies. NP models were identified from an unpublished WHO catalog of NP models last updated in 2012 and from searches conducted in different databases of the peer-reviewed (n = 3; e.g., PubMed) and gray literature (n = 15). Included models had to meet the following inclusion criteria (selected) as of 22 December 2016: 1) developed or endorsed by governmental or intergovernmental organizations, 2) allow for the evaluation of individual food items, and 3) have publicly available nutritional criteria. A total of 387 potential NP models were identified, including n = 361 from the full-text assessment of >600 publications and n = 26 exclusively from the catalog. Seventy-eight models were included. Most (73%) were introduced within the past 10 y, and 44% represent adaptations of ≥1 previously built model. Models were primarily built for school food standards or guidelines (n = 27), food labeling (e.g., front-of-pack; n = 12), and restriction of the marketing of food products to children (n = 10). All models consider nutrients to limit, with sodium, saturated fatty acids, and total sugars being included most frequently; and 86% also consider ≥1 nutrient to encourage (e.g., fiber). No information on validity testing could be identified for 58% of the models. Given the proliferation of NP models worldwide, this new resource will be highly valuable for assisting health professionals and policymakers in the selection of an appropriate model when the establishment of nutrition-related policies requires the use of nutrient profiling.
| S-EPMC6247226 | biostudies-literature
Project description: Not available
| S-EPMC3230082 | biostudies-literature
Project description:The purpose of this review is to describe novel pharmacologic and nonpharmacologic preventive therapies, as well as new strategies to improve delivery of available therapies. Cardiovascular disease (CVD) is the leading cause of death worldwide, and prevention plays a critical role in curbing the global epidemic. Despite available treatment for tobacco addiction, platelet inhibition, blood pressure, and lipid lowering for reduction of atherosclerotic disease, significant gaps in treatment of total CVD remain. We review a range of new preventive treatment options, including drugs for tobacco cessation, platelet/thrombotic inhibition, lipid- and blood pressure-lowering; nonpharmacologic options such as left atrial appendage closure devices and caloric restriction; and strategies such as fixed-dose combination drugs, laboratory screening for drug tailoring, and community-based prevention programs. CVD preventive research continues to evolve and provide clinicians and patients with novel pharmacologic and nonpharmacologic therapies, including new preventive strategies.
| S-EPMC3911909 | biostudies-other
Project description:ObjectiveReducing dietary salt intake is an essential population strategy for cardiovascular disease (CVD) prevention, but evidence on healthcare costs and outcomes is limited in Japan. We aimed to conduct a pilot economic evaluation under hypothetical scenarios of applying the salt reduction policies of England to Japan.MethodsWe examined salt reduction policies in England: media health promotion campaigns, front-of-pack labeling, and voluntary and mandatory reformulation with best-case and worst-case policy cost scenarios. We assumed that these policies were conducted in Japan for 10 years from 2019. We used published data on epidemiology and healthcare expenditures in Japan and the costs and effects of salt reduction policies in England, and defined the benefits as a decrease in national medical expenditures on CVD. We developed a Markov cohort simulation model of the Japanese population. To estimate the annual net benefits of each policy over 10 years, we subtracted monitoring and policy costs from the benefits. We adopted a health sector perspective and a 2% discount rate.ResultsThe cumulative net benefit over 10 years was largest for mandatory reformulation (best case) at 2,015.1 million USD (with costs of USD 48.3 million and benefits of USD 2063.5 million), followed by voluntary reformulation (net benefit: USD 1,895.1 million, cost: USD 48.1 million, benefit: USD 1,943.2 million), mandatory reformulation (worst case, net benefit: USD 1,447.9 million, cost: USD 1,174.5 million, benefit: USD 2,622.3 million), labeling (net benefit: USD 159.5 million, cost: USD 91.6 million, benefit: USD 251.0 million), and a media campaign (net benefit: USD 140.5 million, cost: USD 110.5 million, benefit: USD 251.0 million). There was no change in the superiority or inferiority of policies when the uncertainty of model parameters was considered.ConclusionMandatory reformulation with the best-case cost scenario might be economically preferable to the other alternatives in Japan. In future research, domestic data on costs and effects of salt reduction policies should be incorporated for model refinement.
| S-EPMC10665469 | biostudies-literature
Project description:PURPOSE:Local governments can implement food service guideline (FSG) policies, which, in large cities, may reach millions of people. This study identified FSG policies among the 20 largest US cities and analyzed them for key FSG policy attributes. DESIGN:Quantitative research. SETTING:Local government facilities. PARTICIPANTS:Twenty largest US cities. MEASURES:Frequency of FSG policies and percent alignment to tool. ANALYSIS:Using municipal legal code libraries and other data sources, FSG policies enacted as of December 31, 2016, were identified. Full-text reviews were conducted of identified policies to determine whether they met inclusion criteria. Included policies were analyzed for key policy attributes specific to nutrition, behavioral design, implementation, and facility efficiency. RESULTS:Searches identified 469 potential FSG policies, of which 6 policies across 5 cities met inclusion criteria. Five policies met a majority of criteria assessed by the classification tool. Overall alignment to the tool ranged from 17% to 88%. Of the 6 policies, 5 met a majority of the nutrition attributes and 5 met at least 50% of attributes associated with implementation. No policies met the attributes associated with facility efficiency. CONCLUSION:The FSG policies were identified in 5 of the 20 US cities. Policy alignment was high for nutrition and implementation attributes. This analysis suggests that when cities adopt FSG policies, many develop policies that align with key policy attributes. These policies can serve as models for other jurisdictions to create healthier food access through FSGs.
| S-EPMC6824960 | biostudies-literature
Project description:ObjectiveThe aim of this study was to assess the extent to which public support for outbreak containment policies varies with respect to the severity of an infectious disease outbreak.MethodsA web-enabled survey was administered to 1017 residents of Singapore during the coronavirus disease 2019 (COVID-19) pandemic, and was quota-sampled based on age, sex, and ethnicity. A fractional-factorial design was used to create hypothetical outbreak vignettes characterised by morbidity and fatality rates, and local and global spread of an infectious disease. Each respondent was asked to indicate which response policies (among five policies restricting local movement and four border control policies) they would support in five randomly assigned vignettes. Binomial logistic regressions were used to predict the probabilities of support as a function of outbreak attributes, personal characteristics, and perceived policy effectiveness.ResultsLikelihood of support varied across government response policies but was generally higher for border control policies compared with internal policies. The fatality rate was the most important factor for internal policies, while the degree of global spread was the most important for border control policies. In general, individuals who were less healthy, had higher-income, and were older were more likely to support these policies. Perceived effectiveness of a policy was a consistent and positive predictor of public support.ConclusionsOur findings suggest that campaigns to promote public support should be designed specifically to each policy and tailored to different segments of the population. They should also be adapted based on the evolving conditions of the outbreak in order to receive continued public support.
| S-EPMC8035860 | biostudies-literature
Project description:The outbreak of novel COVID-19 disease elicited a wide range of anti-contagion and economic policies like school closure, income support, contact tracing, and so forth, in the mitigation and suppression of the spread of the SARS-CoV-2 virus. However, a systematic evaluation of these policies has not been made. Here, 17 implemented policies from the Oxford COVID-19 Government Response Tracker dataset employed in 90 countries from December 31, 2019, to August 31, 2020, were analyzed. A Poisson regression model was applied to analyze the relationship between policies and daily confirmed cases using a generalized estimating equations approach. A lag is a fixed time displacement in time series data. With that, lagging (0, 3, 7, 10, and 14 days) was also considered during the analysis since the effects of policies implemented on a given day may affect the number of confirmed cases several days after implementation. The countries were divided into three groups depending on the number of waves of the pandemic observed in each country. Through subgroup analysis, we showed that with and without lagging, contact tracing and containment policies were significant for countries with two waves, while closing, economic, and health policies were significant for countries with three waves. Wave-specific analysis for each wave showed that significant health, economic, and containment policies varied across waves of the pandemic. Emergency investment in healthcare was consistently significant among the three groups of countries, while the Stringency index was significant among all waves of the pandemic. These findings may help in making informed decisions regarding whether, which, or when these policies should be intensified or lifted.
| S-EPMC8516948 | biostudies-literature
Project description: Not available
| S-EPMC7210201 | biostudies-literature
Project description:BackgroundSmoke-free legislation has been associated with lower rates of cardiovascular disease hospital admissions in ecological studies. However, prior studies lacked detailed information on individual-level factors (eg, sociodemographic and clinical characteristics) that could potentially confound associations. Our objective was to estimate associations of smoke-free policies with incident cardiovascular disease in a longitudinal cohort after controlling for sociodemographics, cardiovascular disease risk factors, and policy covariates.MethodsLongitudinal data from 3783 black and white adults in the CARDIA study (Coronary Artery Risk Development in Young Adults; 1995-2015) were linked to state, county, and local 100% smoke-free policies in bars, restaurants, and nonhospitality workplaces by Census tract. Extended Cox regression estimated hazard ratios (HRs) of incident cardiovascular disease associated with time-dependent smoke-free policy exposures. Models were adjusted for sociodemographic characteristics, cardiovascular disease risk factors, state cigarette tax, participant-reported presence of a smoking ban at their workplace, field center, and metropolitan statistical area poverty.ResultsDuring a median follow-up of 20 years (68 332 total person-years), 172 participants had an incident cardiovascular disease event (2.5 per 1000 person-years). Over the follow-up period, 80% of participants lived in areas with smoke-free policies in restaurants, 67% in bars, and 65% in nonhospitality workplaces. In fully adjusted models, participants living in an area with a restaurant, bar, or workplace smoke-free policy had a lower risk of incident cardiovascular disease compared with those in areas without smoke-free policies (HR, 0.75, 95% confidence interval, 0.49-1.15; HR, 0.76, 95% confidence interval, 0.47-1.24; HR, 0.54, 95% confidence interval, 0.34-0.86, respectively; HR, 0.58, 95% confidence interval, 0.33-1.00 for living in an area with all 3 types of policies compared with none). The estimated preventive fraction was 25% for restaurant policies, 24% for bar policies, and 46% for workplace policies.ConclusionsConsistent with prior ecological studies, these individual-based data add to the evidence that 100% smoke-free policies are associated with lower risk of cardiovascular disease among middle-aged adults.
| S-EPMC6202173 | biostudies-literature
Project description:AimThe outbreak of the new coronavirus pandemic (SARS-CoV-2) was initiated in December 2019, and within a couple of months it became a global health emergency. Given the importance to assess the evolution and transmissibility of SARS-CoV-2 and to forecast the next scenario of the pandemic, mainly in countries with limited healthcare systems, we estimated the reproductive number (R0) of SARS-CoV-2 in Jammu and Kashmir (J&K), India, and a possible scenario for this pandemic in the region.Subject and methodsWe estimated the reproductive number (R0) of SARS-CoV-2 in its first outbreak stage in the northwestern region of Himalaya, India, and we also predicted new daily cases for the next 90 days using different R0, testing a plausible end of the SARS-CoV-2 outbreak.ResultsOur results showed a considerable increase in the number of cases, but with a tendency to asymptote. Anantnag, Bandipora, Baramulla, Shopian, and Srinagar districts showed more than 100 cases and Kulgam and Kathua districts showed strong growth of the number of cases from the beginning of May, without a tendency to normalization. The estimated R0 for the J&K region was 1.041; but by decreasing the RO by 10, 25, and 50%, we observed a great decrease in the daily number of new cases, especially by decreasing by 50%.ConclusionIn this study, we indicate positive effects of the preventive measures, such as lockdown and social distancing, taken in the J&K region, showing a stabilization of the growth curves of new cases of SARS-CoV-2, which tends to a strong decrease over time as the R0 decreases.
| S-EPMC8049861 | biostudies-literature