A COMPREHENSIVE AND MULTIDIMENSIONAL RESEARCH APPROACH TO INFORM POLICY MAKERS AND OTHER STAKEHOLDERS ON THE IMPACT OF CURRENT NATIONAL POLICIES TO REDUCE SALT AND TRANS-FATTY ACIDS IN  ARGENTINA

In Argentina, CVD causes about 100,000 deaths/year and 250,000 events at a cost of more than one billion dollars. The Ministry of Health agreed with food industry and bakeries to reduce sodium in processed foods and bread. Also, a change in the Codex Alimentarius was negotiated to decrease TFA to less than 5% of total fat in processed food by 2014. Our aim is to develop a comprehensive approach to inform stakeholders about the impact of current salt and TFA policies.

This project includes three leading institutions involved in CVD prevention: Institute of Clinical Effectiveness (IECS), Centro de Estudios de Estado y Sociedad (CEDES) and Federacion Interamericana del Corazon (FIC) Argentina, with the following specific objectives: 1) cost-effectiveness model of salt reduction (CEDES) and TFA reduction (IECS); 2) qualitative approach to explore attitudes and behaviours on decision makers/food industry representatives (FIC-Argentina) and consumers (CEDES); 3) a systematic review of local sources of food composition focused on salt and TFA (IECS); 4) two food composition databases:, a web-based database compiling the data obtained in 3) (IECS) and data of sodium and TFA content of all processed foods to monitor food reformulation policies (FIC Argentina); 5) chemical analysis of selected foods to evaluate the reliability of labels (FIC  Argentina); 6) design and validation of a survey to explore patterns of salt and TFA intake (CEDES) and field testing of the survey on general population (IECS). Additionally, we will develop a common dissemination strategy of deliverables targeted to policy makers and other stakeholders.

The evaluation of the impact of these policies is critical for resource-allocation decisions on NCD in Argentina.

The Principal Investigator from CEDES is Raul Mejia, MD, PhD and the specific objectives to be accomplished are:

1) Cost-effectiveness analysis: The Coronary Heart Disease (CHD) Policy Model, a state-transition (Markov)computer simulation model of the incidence and prevalence of CHD and of the mortality and costs associated with CHD in Argentina, will be used to evaluate the projected effectiveness and cost-effectiveness of the national dietary salt reduction program implemented in Argentina. The CHD Policy Model has been successfully adapted to create national CVD models for Argentina.

2) A qualitative approach will be used to explore knowledge, perceptions, attitudes and
behaviors on the consumption of salt, dietary sodium and TFAs and its relationship to health and nutritional food labeling. We will conduct in-depth interviews and focus groups using the “Guide for interviews” developed by MSc. Adriana Blanco-Metzler, supported by PAHO.

3) Surveillance questionnaire: A questionnaire to assess sodium and TFAs consumption will be developed and validated.




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