Projected impact of change in the percentage of energy from each NOVA group intake on cardiovascular disease mortality in Brazil: a modelling study

Abstract

ObjectiveEstimate reductions in cardiovascular mortality achievable through improvement in nutrient intakes according to processing level (NOVA classification), that is, reducing consumption of culinary ingredients (G2), processed (G3) and ultra-processed foods (G4) while encouraging consumption of unprocessed and minimally processed foods (G1).DesignModelling study.SettingGeneral adult population of Brazil.ParticipantsMen and women aged 25 or more years (34 003) investigated in the Household Budget Survey 2017–2018, in the consumption data module.Main outcome measuresWe used the IMPACT Food Policy Model to estimate the reduction in deaths from cardiovascular diseases (CVD) up to 2048 in five scenarios with reductions in saturated fat, trans fat, salt and added sugar intakes resulting from changes in NOVA groups. (1) The optimistic scenario modelised an increase in the energy intake provided by G1 and a reduction in the energy intake from G2, G3 and G4, return to previous levels. (2) The minimal scenario modelised a 3.7% increase in the energy intake from G1, and a reduction in the energy intake from G4 to the 2008–2009 level. (3) The modest scenario only modelised a 25.0% reduction of the energy intake from G2 and G3. (4) The intermediary scenario modelised the minimal scenario plus a 25.0% reduction in the energy intake from G2. (5) Finally, the advanced scenario modelised the minimal scenario plus a 25.0% reduction in the energy intake from G2 and G3.ResultsProposed changes in the optimistic scenario could prevent or delay 52.8% CVD-related deaths by 2048. Changes modelled in the minimal, modest, intermediary and advanced scenarios may result in a 10.1%, 28.4%, 31.4% and 38.6% reduction in 2048 CVD mortality, respectively.ConclusionsSubstantial health gains can be achieved by improving the diet, through plausible modifications aimed at the level of processing as a tool for Brazilian food policies.

The 30-year cardiovascular risk trajectories and their independently associated factors in participants of a Brazilian cohort (CUME Study)

“…The literature points to the harmful effects of processed meats and sodium 44 . Furthermore, it is estimated that 10% to 53% of CVD mortality in 2048 could be prevented or delayed by reducing the intake of salt, saturated fat, trans-fats, and added sugar from lower consumption of processed culinary ingredients, processed and ultra-processed foods, and increased consumption of unprocessed/minimally processed foods in Brazil 45 .…”

The estimated burden of ultra-processed foods on cardiovascular disease outcomes in Brazil: A modeling study

“…Although there are few studies on the estimated impact of these dietary changes, our previous study estimated that if UPF intake increase by around 50% (to intakes similar to those of Mexico), the all-cause attributable deaths would almost double, while if UPF intake tripled (to the intakes equivalent to those in the United States), the attributable deaths would be increased by 250% (28). Also, other study has estimated that the impact of different reduction scenarios for saturated and trans fats, salt and added sugar from culinary ingredients, processed and ultra-processed foods could avert from 37.6 to 196.4 thousand deaths from CVD in Brazil, in 2,048 (24).…”

“…Despite the existing modeling studies to estimate the potential impact of specific dietary risk factors, especially of macro and micronutrient intakes and specific food groups (22), the health effects of dietary patterns based on the purpose and extent of food processing on morbimortality are scarce (23)(24)(25). Our previous study estimated that, approximately, 10.5% (57 thousand) of the all-cause premature deaths in 2019 were attributable to the consumption of UPF.…”