Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Nuffield Department of Population Health, University of Oxford, Oxford, Oxfordshire, United Kingdom.
PLoS One. 2019 Dec 27;14(12):e0226975. doi: 10.1371/journal.pone.0226975. eCollection 2019.
Traffic-light labelling (TLL) is a promising front-of-pack system to help consumers make informed dietary choices. It has been shown that adopting TLL in Canada, through an optimistic scenario of avoiding, if possible, foods with red traffic lights, could effectively reduce Canadians' intakes of energy, total fat, saturated fat, and sodium by 5%, 13%, 14% and 6%, respectively. However, the potential health impact of adopting TLL has not been determined in the North American context.
This study modelled the potential impact of adopting TLL on mortality from noncommunicable diseases (NCDs) in Canada, due to the previously predicted improved nutrient intakes.
Investigators used data from adults (n = 19,915) in the 2004 nationally representative Canadian Community Health Survey (CCHS)-Cycle 2.2. Nutrient amounts in foods consumed by CCHS respondents were profiled using the 2013 United Kingdom's TLL criteria. Whenever possible, foods assigned at least one red light (non-compliant foods) were replaced with similar, but compliant, foods identified from a Canadian brand-specific food database. Respondents' nutrient intakes were calculated under the original CCHS scenario and the counterfactual TLL scenario, and entered in the Preventable Risk Integrated ModEl (PRIME) to estimate the health impact of adopting TLL. The primary outcome was the number of deaths attributable to diet-related NCDs that could be averted or delayed based on the TLL scenario compared with the baseline scenario.
PRIME estimated that 11,715 deaths (95% CI 10,500-12,865) per year due to diet-related NCDs, among which 72% are specifically related to cardiovascular diseases, could be prevented if Canadians avoided foods labelled with red traffic lights. The reduction in energy intakes would by itself save 10,490 deaths (9,312-11,592; 90%).
This study, although depicting an idealistic scenario, suggests that TLL (if used to avoid red lights when possible) could be an effective population-wide intervention to improve NCD outcomes in Canada.
信号灯标签(TLL)是一种很有前景的包装系统,可以帮助消费者做出明智的饮食选择。有研究表明,在加拿大,如果可能的话,通过避免使用带有红色信号灯的食物这一乐观情景,采用 TLL 可以分别有效地将加拿大民众的能量、总脂肪、饱和脂肪和钠的摄入量减少 5%、13%、14%和 6%。然而,在北美背景下,采用 TLL 的潜在健康影响尚未确定。
本研究通过预测营养摄入量的改善,对加拿大采用 TLL 对非传染性疾病(NCD)死亡率的潜在影响进行建模。
研究人员使用了 2004 年全国代表性的加拿大社区健康调查(CCHS)-第 2.2 周期中成年人(n=19915)的数据。使用 2013 年英国的 TLL 标准来描绘 CCHS 受访者所食用食物中的营养成分。只要有可能,将被分配至少一个红灯(不合格食品)的食物用从加拿大品牌特定食品数据库中找到的类似但符合规定的食物来替代。根据原始 CCHS 情景和假设的 TLL 情景,计算受访者的营养摄入量,并将其输入预防风险综合模型(PRIME),以估计采用 TLL 的健康影响。主要结果是根据 TLL 情景,与基线情景相比,因饮食相关的 NCD 而可以避免或延迟的死亡人数。
PRIME 估计,如果加拿大人避免食用带有红色信号灯的食物,每年可预防 11715 例(95%CI 10500-12865)与饮食相关的 NCD 死亡,其中 72%是专门与心血管疾病相关的。仅减少能量摄入本身就可避免 10490 例死亡(9312-11592;90%)。
虽然本研究描绘了一个理想化的情景,但表明 TLL(如果用于尽可能避免红灯)可能是一种有效的人群干预措施,可以改善加拿大的 NCD 结果。