Estimated health benefits, costs, and cost-effectiveness of eliminating industrial transfatty acids in Australia: A modelling study

Background: trans-fatty acids (TFAs) are a well-known risk factor of ischemic heart disease (IHD). In Australia, the highest TFA intake is concentrated to the most socioeconomically disadvantaged groups. Elimination of industrial TFA (iTFA) from the Australian food supply could result in reduced IHD mortality and morbidity while improving health equity. However, such legislation could lead to additional costs for both government and food industry. Thus, we assessed the potential cost-effectiveness, health gains, and effects on health equality of an iTFA ban from the Australian food supply. Methods and findings: Markov cohort models were used to estimate the impact on IHD burden and health equity, as well as the cost-effectiveness of a national ban of iTFA in Australia. Intake of TFA was assessed using the 2011–2012 Australian National Nutrition and Physical Activity Survey. The IHD burden attributable to TFA was calculated by comparing the current level of TFA intake to a counterfactual setting where consumption was lowered to a theoretical minimum distribution with a mean of 0.5% energy per day (corresponding to TFA intake only from nonindustrial sources, e.g., dairy foods). Policy costs, avoided IHD events and deaths, health-adjusted life years (HALYs) gained, and changes in IHD-related healthcare costs saved were estimated over 10 years and lifetime of the adult Australian population. Cost-effectiveness was assessed by calculation of incremental cost-effectiveness ratios (ICERs) using net policy cost and HALYs gained. Health benefits and healthcare cost changes were also assessed in subgroups based on socioeconomic status, defined by Socio-Economic Indexes for Areas (SEIFA) quintile, and remoteness. Compared to a base case of no ban and current TFA intakes, elimination of iTFA was estimated to prevent 2,294 (95% uncertainty interval [UI]: 1,765; 2,851) IHD deaths and 9,931 (95% UI: 8,429; 11,532) IHD events over the first 10 years. The greatest health benefits were accrued to the most socioeconomically disadvantaged quintiles and among Australians living outside of major cities. The intervention was estimated to be cost saving (net cost <0 AUD) or cost-effective (i.e., ICER < AUD 169,361/HALY) regardless of the time horizon, with ICERs of 1,073 (95% UI: dominant; 3,503) and 1,956 (95% UI: 1,010; 2,750) AUD/HALY over 10 years and lifetime, respectively. Findings were robust across several sensitivity analyses. Key limitations of the study include the lack of recent data of TFA intake and the small sample sizes used to estimate intakes in subgroups. As with all simulation models, our study does not prove that a ban of iTFA will prevent IHD, rather, it provides the best quantitative estimates and corresponding uncertainty of a potential effect in the absence of stronger direct evidence. Conclusions: Our model estimates that a ban of iTFAs could avert substantial numbers of IHD events and deaths in Australia and would likely be a highly cost-effective strategy to reduce social–economic and urban–rural inequalities in health. These findings suggest that elimination of iTFA can cost-effectively improve health and health equality even in countries with low iTFA intake

N,N′-Bis(6-methyl-2-pyrid­yl)oxamide

In the crystal structure of the title compound, C14H14N4O2, the mol­ecules are almost planar (mean deviation 0.028 Å) and a weak intra­molecular N—H⋯O hydrogen bond between the H atom bound to an oxamide N atom and a carbonyl O atom is found. The asymmetric unit consits of one half-mol­ecule which is located on a centre of inversion

Evidence Gaps in Assessments of the Healthiness of Online Supermarkets Highlight the Need for New Monitoring Tools: a Systematic Review

Purpose of Review: Online grocery shopping is increasingly popular, but the extent to which these food environments encourage healthy or unhealthy purchases is unclear. This review identifies studies assessing the healthiness of real-world online supermarkets and frameworks to support future efforts. Recent Findings: A total of 18 studies were included and 17 assessed aspects of online supermarkets. Pricing and promotional strategies were commonly applied to unhealthy products, while nutrition labelling may not meet regulated requirements or support consumer decision-making. Few studies investigated the different and specific ways online supermarkets can influence consumers. One framework for comprehensively capturing the healthiness of online supermarkets was identified, particularly highlighting the various ways retailers can tailor the environment to target individuals. Summary: Comprehensive assessments of online supermarkets can identify the potential to support or undermine healthy choices and dietary patterns. Common, validated instruments to facilitate consistent analysis and comparison are needed, particularly to investigate the new opportunities the online setting offers to influence consumers

Methyl 4-[(5-chloro­pyrimidin-2-yl)carbamo­yl]benzoate

Mol­ecules of the title compound, C13H10ClN3O3, form centrosymmetric dimers via inter­molecular N—H⋯N hydrogen bonds generating an R 2 2(8) motif. The dimers are further connected through an O⋯Cl—C halogen bond [O⋯Cl = 3.233 (1) Å and O⋯Cl—C = 167.33 (1)°] into a chain along [110]. The secondary amide group adopts a cis conformation. Weak C—H⋯N hydrogen bonds among the methyl benzoate and pyrimidyl rings are also observed in the crystal structure

A systematic review of the sources of dietary salt around the world

Excess salt intake contributes to hypertension and increased cardiovascular disease risk. Efforts to implement effective salt-reduction strategies require accurate data on the sources of salt consumption. We therefore performed a systematic review to identify the sources of dietary salt around the world. We systematically searched peer-reviewed and gray literature databases for studies that quantified discretionary (salt added during cooking or at the table) and nondiscretionary sources of salt and those that provided information about the food groups contributing to dietary salt intake. Exploratory linear regression analysis was also conducted to assess whether the proportion of discretionary salt intake is related to the gross domestic product (GDP) per capita of a country. We identified 80 studies conducted in 34 countries between 1975 and 2018. The majority (n = 44, 55%) collected data on dietary salt sources within the past 10 y and were deemed to have a low or moderate risk of bias (n = 75, 94%). Thirty-two (40%) studies were judged to be nationally representative. Populations in Brazil, China, Costa Rica, Guatemala, India, Japan, Mozambique, and Romania received more than half of their daily salt intake from discretionary sources. A significant inverse correlation between discretionary salt intake and a country's per capita GDP was observed (P < 0.0001), such that for every $10,000 increase in per capita GDP, the amount of salt obtained from discretionary sources was lower by 8.7% (95% CI: 5.1%, 12%). Bread products, cereal and grains, meat products, and dairy products were the major contributors to dietary salt intake in most populations. There is marked variation in discretionary salt use around the world that is highly correlated with the level of economic development. Our findings have important implications for the type of salt-reduction strategy likely to be effective in a country

5-Iodo­pyrimidin-2-amine

The mol­ecule of the title compound, C4H4IN3, has crystallographic mirror plane symmetry. In the crystal, the mol­ecules are connected through N—H⋯N hydrogen bonds into polymeric tapes extended along the a axis, which are typical of 2-amino­pyrimidines. Each mol­ecule acts as a double donor and a double acceptor in the hydrogen bonding

6,6′-Dimethyl-2,2′-[oxalylbis(aza­nedi­yl)]dipyridinium dichloride acetonitrile solvate

In the crystal structure of the title compound, C14H16N4O2 2+·2Cl−·CH3CN, weak inter­molecular N—H⋯Cl hydrogen bonds are found between the H atoms bound to the pyridine and amine N atoms and the chloride anions. The asymmetric unit consits of one half cationic mol­ecule which is located on a centre of inversion, one chloride anion in a general position and one half acetonitrile mol­ecule which is located on a twofold axis. Because of symmetry, the C—H hydrogens of the acetonitrile solvent mol­ecule are disordered over two orientations

N 1,N 2-Bis(6-methyl-2-pyrid­yl)formamidine

In the crystal structure of the title mol­ecule, C13H14N4, the two pyridyl rings are not coplanar but twisted about the C—N bond with an inter­planar angle of 71.1 (1)°. In the crystal, the mol­ecules form dimers, situated on crystallographic centres of inversion, which are connected via a pair of N—H⋯N hydrogen bonds. C—H⋯π-electron ring inter­actions are also present in the crystal structure. The title mol­ecule adopts an s–cis–anti–s–cis conformation in the solid state

N-(6-Methyl-2-pyrid­yl)formamide

The mol­ecule of the title compound, C7H8N2O, is essentially planar with a maximum deviation of 0.0439 (1) Å from the best plane. In the crystal, N—H⋯O hydrogen bonds between self-complementary amide groups join mol­ecules into centrosymmetric dimers

Estimating the potential impact of the Australian government's reformulation targets on household sugar purchases

BACKGROUND: Countries around the world are putting in place sugar reformulation targets for packaged foods to reduce excess sugar consumption. The Australian government released its voluntary sugar reformulation targets for nine food categories in 2020. We estimated the potential impact of these targets on household sugar purchases and examined differences by income. For comparison, we also modelled the potential impact of the UK sugar reduction targets on per capita sugar purchases as the UK has one of the most comprehensive sugar reduction strategies in the world. METHODS: Grocery purchase data from a nationally representative consumer panel (n=7,188) in Australia was linked with a large database (FoodSwitch) with product-specific sugar content information for packaged foods (n=25,261); both datasets were collected in 2018. Potential reductions in per capita sugar purchases were calculated overall and by food category. Differences in sugar reduction across income level were assessed by analysis of variance. RESULTS: In 2018, the total sugar acquired from packaged food and beverage purchases consumed at-home was 56.1 g/day per capita. Australia's voluntary reformulation targets for sugar covered 2,471/25,261 (9.8%) unique products in the FoodSwitch dataset. Under the scenario that all food companies adhered to the voluntary targets, sugar purchases were estimated to be reduced by 0.9 g/day per capita, which represents a 1.5% reduction in sugar purchased from packaged foods. However, if Australia adopted the UK targets, over twice as many products would be covered (n=4,667), and this would result in a more than four times greater reduction in sugar purchases (4.1 g/day per capita). It was also estimated that if all food companies complied with Australia's voluntary sugar targets, reductions to sugar would be slightly greater in low-income households compared with high-income households by 0.3 g/day (95%CI 0.2 - 0.4 g/day, p<0.001). CONCLUSIONS: Sugar-reduction policies have the potential to substantially reduce population sugar consumption and may help to reduce health inequalities related to excess sugar consumption. However, the current reformulation targets in Australia are estimated to achieve only a small reduction to sugar intakes, particularly in comparison to the UK's sugar reduction program