New research shows urgency to act on Nigeria’s trans fat elimination policy

GEORGE INSTITUTE FOR GLOBAL HEALTH

Significantly reducing trans fat levels in the Nigerian food supply could prevent approximately 10,000 heart disease deaths and save 90 million USD (12 billion Naira, ₦) in healthcare costs over a decade. New findings by The George Institute for Global Health on the health and economic benefits of enacting the country’s trans fat elimination policy were published today in BMJ Global Health.

In 2023, Nigeria followed South Africa as only the second African country to adopt a best practice trans fat elimination policy and is now working to implement regulations. The cost-effectiveness model assessed the impact of limiting industrially produced trans fats to less than two percent of total fats in all foods, fats, and oils in the Nigerian food supply.

The research also found that the policy could prevent or postpone 67,000 cases of heart disease within the first ten years. This equates to a total of 260,000 deaths and 480,000 cases of heart disease prevented across the entire lifetime of the population.

Lead author and Senior Research Fellow at The George Institute Dr Matti Marklund said, “Although trans fat intakes in Nigeria may be considerably lower than in many other countries, our analysis indicates that its trans fat policy could still save thousands of lives in just a matter of years.”

The analysis found the policy to be cost-saving, meaning that it would improve health while generating net savings. Total healthcare savings could amount to approximately 90 million USD (12 billion ₦) in the first ten years, and around 520 million USD (185 billion ₦) over the population’s lifetime.

It would cost the government and food industry an estimated 17 million USD (6.2 billion ₦) to implement the policy over the first ten years and 26 million USD (9.4 billion ₦) over the population’s lifetime. For every government dollar invested this would correspond to 66 USD in healthcare cost savings. 

“The implementation costs represent a small fraction of the substantial savings that a trans fat limit can offer healthcare systems, mirroring findings from a separate study we led in Kenya last year,” added Dr Marklund.

Industrial trans fats are a group of harmful substances produced during partial hydrogenation, a process where vegetable oils are hardened to solid fats that can be used in processed, fried, and street foods. They are also a well-known risk factor for heart disease but can be substituted with healthier alternatives without affecting food quality.

Globally, industrial trans fats are responsible for around 500,000 premature deaths from heart disease every year, mostly in low- and middle-income countries.2 But only 53 countries have best-practice trans fat policies in place, most of which are high-income countries, leaving around half the world’s population exposed to health harms.3

Prof Dike Ojji, Head of the Cardiovascular Research Unit at the University of Abuja and a senior author of the research said, “Governments must act swiftly to address the rising burden of cardiovascular disease that endanger the health of populations, care services, and economies across Africa. We hope the mounting evidence supporting the elimination of trans fats will encourage other African nations to emulate Nigeria’s best practice policy.”

The World Health Organization (WHO) lists elimination of industrial trans fats as an effective intervention for the prevention of noncommunicable diseases like heart disease. The organisation says the top two best-practice policies are setting a mandatory limit of 2g trans fat per 100g of total fat in all foods, and a ban on the production and use of partially hydrogenated oils. Earlier this year, the WHO revised its target for the virtual elimination of industrial trans fats globally to 2025.4

This research was funded by the Northwestern University Havey Institute for Global Health and the National Institutes of Health.

References

1. Marklund M, et al. Estimated health benefits, costs, and cost-effectiveness of eliminating industrial trans-fatty acids in Nigeria: cost-effectiveness analysis BMJ Glob Health. 2024. https://doi.org/10.1136/bmjgh-2023-014294
2. World Health Organization. Countdown to 2023: WHO report on global trans-fat elimination 2022. 2023. https://www.who.int/publications/i/item/9789240067233
3. World Health Organization. TFA Country Score Card. 2023. Accessed April 2024. https://extranet.who.int/nutrition/gina/en/scorecard/TFA
4. World Health Organization. WHO awards countries for progress in eliminating industrially produced trans fats for first time. 2024. Accessed April 2024. https://www.who.int/news/item/29-01-2024-who-awards-countries-for-progress-in-eliminating-industrially-produced-trans-fats-for-first-time

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JOURNAL

BMJ Global Health

DOI

10.1136/bmjgh-2023-014294 

METHOD OF RESEARCH

Computational simulation/modeling

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Estimated health benefits, costs and cost-effectiveness of eliminating industrial trans-fatty acids in Nigeria: cost-effectiveness analysis

ARTICLE PUBLICATION DATE

17-Apr-2024

COI STATEMENT

MM report grant support from Resolve to Save Lives and the World Health Organization; and travel support from the Nordic Dairy Congress 2022; all outside of the present work. MDH has received travel support from the American Heart Association and World Heart Federation. MDH has an appointment at The George Institute for Global Health, which has a patent, license and has received investment funding with intent to commercialise fixed-dose combination therapy through its social enterprise business, George Medicines. MDH has pending patents for heart failure polypills.