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Modeling the health impact of legislation to limit the salt content of bread in...

Goiana-da-Silva, Francisco; Cruz-e-Silva, David; Rito, Ana; Lopes, Carla; Muc, Magdalena; Darzi, Ara; Araújo, Fernando; Miraldo, Marisa

Background: Excessive salt consumption—associated with a range of adverse health outcomes—is very high in Portugal, and bread is the second largest source. Current Portuguese legislation sets a maximum limit of 1.4 g salt per 100 g bread, but imported and traditional breads are exempted. In 2017 the Ministry of Health proposed reducing the salt threshold to 1.0/100 g by 2022, however the legislation was vetoed ...


Modeling the health impact of legislation to limit the salt content of bread in...

Goiana-da-Silva, Francisco; Cruz-e-Silva, David; Rito, Ana; C, Lopes; Muc, Magdalena; Darzi, Ara; Araujo, Fernando; Miraldo, Marisa; Nunes, A.

Background: Excessive salt consumption—associated with a range of adverse health outcomes—is very high in Portugal, and bread is the second largest source. Current Portuguese legislation sets a maximum limit of 1.4 g salt per 100 g bread, but imported and traditional breads are exempted. In 2017 the Ministry of Health proposed reducing the salt threshold to 1.0/100 g by 2022, however the legislation was vetoed ...


Projected impact of the Portuguese sugar-sweetened beverage tax on obesity inci...

Goiana-da-Silva, Francisco; Severo, Milton; Cruz e Silva, David; Gregório, Maria João; Allen, Luke N.; Muc, Magdalena; Morais Nunes, Alexandre

Background: Excessive consumption of sugar has a well-established link with obesity. Preliminary results show that a tax levied on sugar-sweetened beverages (SSBs) by the Portuguese government in 2017 led to a drop in sales and reformulation of these products. This study models the impact the market changes triggered by the tax levied on SSBs had on obesity incidence across various age groups in Portugal. Metho...


The Ethics of Taxing Sugar-Sweetened Beverages to Improve Public Health

Goiana-da-Silva, Francisco; Cruz-e-Silva, David; Bartlett, Oliver; Vasconcelos, Joana; Morais Nunes, Alexandre; Ashrafian, Hutan; Miraldo, Marisa

The World Health Organization highlights fiscal policies as priority interventions for the promotion of healthy eating in its Action Plan for the Prevention and Control of Non-communicable Diseases. The taxation of sugar sweetened beverages (SSBs) in particular is noted to be an effective measure, and SSBs taxes have already been implemented in several countries worldwide. However, although the evidence base su...


Front-of-pack labelling policies and the need for guidance

Goiana-da-Silva, Francisco; Cruz-e-Silva, David; Miraldo, Marisa; Calhau, Conceição; Bento, Alexandra; Cruz, Diogo; Almeida, Fernando; Darzi, Ara

Food labels are a challenge for most consumers, and the development of easily understandable labelling is essential when it comes to empowering consumers in making healthier food choices. (...)


Portugal’s voluntary food reformulation agreement and the WHO reformulation tar...

Goiana-da-Silva, Francisco; Cruz-e-Silva, David; Allen, Luke; Nunes, Alexandre Morais; Calhau, Conceição; Rito, Ana; Bento, Alexandra; Miraldo, Marisa

In response to stalling progress in NCD related premature mortality, the Portuguese government declared the ‘Promotion of Healthy Eating’ a national priority and convened a multisectoral task force with representatives from several ministries in order to tackle unhealthy diets. With the inputs from civil society, non-governmental organisations and health authorities, this task force developed the Integrated Str...


Modelling impacts of food industry co-regulation on noncommunicable disease mor...

Goiana da Silva, Francisco; Silva, David Cruz e; Allen, Luke; Gregório, Maria João; Severo, Milton; Nogueira, Paulo Jorge; Nunes, Alexandre Morais

Objective: To model the reduction in premature deaths attributed to noncommunicable diseases if targets for reformulation of processed food agreed between the Portuguese health ministry and the food industry were met. Methods: The 2015 co-regulation agreement sets voluntary targets for reducing sugar, salt and trans-fatty acids in a range of products by 2021. We obtained government data on dietary intake in 201...


Disrupting the landscape: how the Portuguese National Health Service built an o...

Goiania-da-Silva, Francisco; Cruz-e-Silva, David; Morais Nunes, Alexandre; Carriço, Marlene; Costa, Flávia; Miraldo, Marisa; Darzi, Ara

Noncommunicable diseases (NCDs) are the leading causes of death, disease and disability in the WHO European Region and are largely preventable. The private sector has long been using marketing to influence and change people’s lifestyles. In some cases, particularly the food sector, health compromising content is prioritized o ver health-promoting content. However, this case study aims to illustrate how governme...


Portugal’s voluntary food reformulation agreement and the WHO reformulation tar...

Goiana-da-Silva, Francisco; Cruz-e-Silva, David; Allen, Luke; Nunes, Alexandre Morais; Calhau, Conceição; Rito, Ana; Bento, Alexandra; Miraldo, Marisa


Modelling impacts of food industry co-regulation on noncommunicable disease mor...

Goiana-da-Silva, Francisco; Cruz-e-Silva, David; Allen, Luke; Gregório, Maria João; Severo, Milton; Nogueira, Paulo Jorge; Nunes, Alexandre Morais

Objective To model the reduction in premature deaths attributed to noncommunicable diseases if targets for reformulation of processed food agreed between the Portuguese health ministry and the food industry were met. Methods The 2015 co-regulation agreement sets voluntary targets for reducing sugar, salt and trans-fatty acids in a range of products by 2021. We obtained government data on dietary intake in 2015–...


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