Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany.
Research Group for Evidence-Based Public Health, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
PLoS One. 2019 Jul 10;14(7):e0218464. doi: 10.1371/journal.pone.0218464. eCollection 2019.
There is evidence that replacing saturated fat (SFA) with polyunsaturated fat (PUFA) lowers ischemic heart disease (IHD). In order to improve the population's diet, the World Health Organization has called for the taxation of foods that are high in SFA. We aimed to assess the potential health gains of a European fat tax by applying the SFA intake reduction that has been observed under the Danish fat tax to six other European countries. For each country, we created a fat tax scenario with a decreased SFA intake and a corresponding increase in PUFA. We compared this fat tax scenario to a reference scenario with no change in SFA intake, and to a guideline scenario with a population-wide SFA intake in line with dietary recommendations. We used DYNAMO-HIA to dynamically project the policy-attributable IHD cases of these three scenarios 10 years into the future. A fat tax would reduce prevalent IHD cases by a minimum of 500 and 300 among males and females in Denmark, respectively, up to a maximum of 5,600 and 4,000 among males and females in the UK. Thereby, the prevented IHD cases under a fat tax scenario would correspond to between 11.0% (in females in the Netherlands) and 29.5% (in females in Italy) of the prevented IHD cases under a guideline scenario, which represents the maximum preventable disease burden. Henceforth, our quantification of beneficial health impacts makes the case for the policy debate on fat taxes.
有证据表明，用多不饱和脂肪（PUFA）代替饱和脂肪（SFA）可以降低缺血性心脏病（IHD）的发病率。为了改善人群的饮食，世界卫生组织呼吁对富含 SFA 的食物征税。我们旨在通过应用丹麦脂肪税观察到的 SFA 摄入量减少来评估欧洲脂肪税的潜在健康收益，并将其应用于其他六个欧洲国家。对于每个国家，我们创建了一个脂肪税方案，该方案减少了 SFA 的摄入量，并相应增加了 PUFA 的摄入量。我们将这种脂肪税方案与 SFA 摄入量不变的参考方案以及与饮食建议一致的 SFA 摄入量在人群中普遍减少的指南方案进行了比较。我们使用 DYNAMO-HIA 动态预测这三种方案的政策归因性 IHD 病例在未来 10 年内的情况。脂肪税将使丹麦男性和女性的现有 IHD 病例分别减少至少 500 例和 300 例，在英国男性和女性中最多可减少 5600 例和 4000 例。因此，在脂肪税方案下预防的 IHD 病例数相当于在指南方案下预防的 IHD 病例数的 11.0%（荷兰女性）至 29.5%（意大利女性），这是最大的可预防疾病负担。因此，我们对健康影响的量化为脂肪税政策的辩论提供了依据。
