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New NICE guidelines recommend further reductions in food salt, fat content

Comments from Attila Simon, on behalf of the EACPR Exercise, Basic and Translational Research Section

The National Institute for Health and Clinical Excellence Public Health Guidance: Prevention of Cardiovascular Disease at Population Level - June 2010

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The NICE (National Institute for Health and Clinical Excellence) Guideline here presented, provide a nice proof of the fact that a close cooperation among politicians, industrial enterprises and non-governmental organizations (NGOs) is required in order to effectively improve the prevention of cardiovascular diseases at the level of the general population. The Guideline focus on action to be taken for the enhancement of the related objectives.

The NICE Guideline presents examples of regulations and measures to be implemented at the level of the general public in recognition of the fact that changes impacting the entire population are seen as yielding superior results compared to those confined to specific groups of high risk individuals. It is emphasized that the impact of the various risk factors ought to be examined and analysed not merely on average overall occurrence, but also separately, within each particular group of population.

This approach may also produce some desired results in the elimination ofhealth inequities. It would be hard to dispute that there have been substantial differences among EU countries as to the respective results achieved in fighting cardiovascular diseases in the specific areas indicated in the Guidelines (such as the reduction in the consumption of salt; or the increase of physical exercise.) The example of a major industrialised country with well developed institutions of high standing and great traditions, such as the United Kingdom, may exert a favourable influence in the search for improved methods and better practices conducted by other EU countries.

Data collected in the UK on the number of lives that can be saved, and also, the cost reductions demonstrably achieved by improved practices may constitute a significant incentive for the prevention experts and civilian groups of other EU countries to use their own statistics and reports as a leverage in political decision-making.

An especially commendable feature of the Guidelines is that it treats the measures recommended for improved prevention in their complexity as they impact each other. For instance, it is pointed out that through a reduction in the production of animal related foodstuffs the glass house effect will also be reduced. This complexity in the approach taken encourages us to contemplate issues going beyond the direct impact of the proposed practices such as the expected results in reducing CHD mortality, or obesity.