New NICE guidance on prevention of cardiovascular disease at the population level 

July 2010    Volume 17, Issue 4   Br J Cardiol 2010;17:163-5

Authors:
BJ Cardio Staff

The National Institute for Health and Clinical Excellence (NICE) has published a new guidance on prevention of cardiovascular disease at the population level.

The guidance sets out a range of evidence-based recommendations for effective action to help reduce cardiovascular disease and make it easier to enable individuals to make healthy choices. It focuses mainly on food production and its influence on the nation’s diet, and it aims to change the cardiovascular risk factors faced by the UK population through regulation, legislation, subsidy and taxation or by rearranging the physical layout of communities.

Dr Simon Capewell (University of Liverpool, UK) who is also vice-chair of the NICE Guidance Development Group, said: “There was a feeling that dietary interventions have been largely neglected, yet have a big potential to deliver CVD benefits. The guidance shows how by introducing simple changes at the population level, huge gains could be made in reducing the death toll from cardiovascular disease. This is no longer an optional discussion, but an issue that governments and the rest of society have to confront.” He added: “The idea is to kick-start a debate, and persuade politicians to set both short-term and long-term goals for change”.

Key goals in the NICE document include:

Reducing mean salt intakes to achieve a target of 6 g per day per adult by 2015 and 3 g by 2025, which would lead to around
14–20,000 fewer annual deaths from cardiovascular disease each year.  Reducing salt added during the manufacturing process is considered especially important since this is estimated to represent 70 to 90% of the population’s total salt intake.

• Reducing saturated fat intakes from 14% to 7% of energy intake (to reach the levels seen in Japan), which could prevent up to 30,000 cardiovascular deaths annually.
• Banning the use of trans fats, which could save 4,500–7000 lives each year.
• Restrictions on advertising for foods high in saturated fats, salt
  and sugar.
• Making healthy food alternatives cheaper than junk food.
• More extensive use of the traffic light food labelling systems, which indicates whether food or drink contains a high, medium or low level of salt, fat or sugar.
• Giving local authorities powers to limit fast food outlets.
• Ensuring young people under 16 are protected from all forms of marketing, advertising and promotions which encourage an unhealthy diet.
• Ensure government funding supports physically active modes of travel.

The European Society of Cardiology says the new guidance “delivers important messages for the rest of Europe”. ESC spokesman Dr Lars Rydén (Karolinska Institute, Sweden) added: “This is an extremely strong document that clearly underlines how much can be gained from society by introducing legislative changes protecting the content of diets.”

The full NICE guidance can be found at: http://guidance.nice.org.uk/PH25

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