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- Projected impact of the Portuguese sugar-sweetened beverage tax on obesity incidence across different age groups: A modelling studyPublication . Goiana-da-Silva, Francisco; Severo, Milton; Cruz e Silva, David; Gregório, Maria João; Allen, Luke N.; Muc, Magdalena; Morais Nunes, Alexandre; Torres, Duarte; Miraldo, Marisa; Ashrafian, Hutan; Rito, Ana; Wickramasinghe, Kremlin; Breda, João; Darzi, Ara; Araújo, Fernando; Lopes, CarlaBackground: 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. Methods and findings: We performed a national market analysis and population-wide modelling study using market data for the years 2014-2018 from the Portuguese Association of Non-Alcoholic Drinks (GlobalData and Nielsen Consumer Panel), dietary data from a national survey (IAN-AF 2015-2016), and obesity incidence data from several cohort studies. Dietary energy density from SSBs was calculated by dividing the energy content (kcal/gram) of all SSBs by the total food consumption (in grams). We used the potential impact fraction (PIF) equation to model the projected impact of the tax-triggered change in sugar consumption on obesity incidence, through both volume reduction and reformulation. Results showed a reduction of 6.6 million litres of SSBs sold per year. Product reformulation led to a decrease in the average energy density of SSBs by 3.1 kcal/100 ml. This is estimated to have prevented around 40-78 cases of obesity per year between 2016 and 2018, with the biggest projected impact observed in adolescents 10 to <18 years old. The model shows that the implementation of this tax allowed for a 4 to 8 times larger projected impact against obesity than would be achieved though reformulation alone. The main limitation of this study is that the model we used includes data from various sources, which can result in biases-despite our efforts to mitigate them-related to the methodological differences between these sources. Conclusions: The tax triggered both a reduction in demand and product reformulation. These, together, can reduce obesity levels among frequent consumers of SSBs. Such taxation is an effective population-wide intervention. Reformulation alone, without the decrease in sales, would have had a far smaller effect on obesity incidence in the Portuguese population.
- Interim 2019/20 influenza vaccine effectiveness: six European studies, September 2019 to January 2020Publication . Rose, Angela; Kissling, Esther; Emborg, Hanne-Dorthe; Larrauri, Amparo; McMenamin, Jim; Pozo, Francisco; Trebbien, Ramona; Mazagatos, Clara; Whitaker, Heather; Machado, Ausenda; Gómez, Verónica; Nunes, Baltazar; Kislaya, Irina; Pechirra, Pedro; Conde, Patrícia; Rodrigues, Ana Paula; Cristóvão, Paula; Costa, Inês; Guiomar, Raquel; European IVE GroupBackground: Influenza A(H1N1)pdm09, A(H3N2) and B viruses were co-circulating in Europe between September 2019 and January 2020. Aim: To provide interim 2019/20 influenza vaccine effectiveness (VE) estimates from six European studies, covering 10 countries and both primary care and hospital settings. Methods: All studies used the test-negative design, although there were some differences in other study characteristics, e.g. patient selection, data sources, case definitions and included age groups. Overall and influenza (sub)type-specific VE was estimated for each study using logistic regression adjusted for potential confounders. Results: There were 31,537 patients recruited across the six studies, of which 5,300 (17%) were cases with 5,310 infections. Most of these (4,466; 84%) were influenza A. The VE point estimates for all ages were 29% to 61% against any influenza in the primary care setting and 35% to 60% in hospitalised older adults (aged 65 years and over). The VE point estimates against A(H1N1)pdm09 (all ages, both settings) was 48% to 75%, and against A(H3N2) ranged from −58% to 57% (primary care) and −16% to 60% (hospital). Against influenza B, VE for all ages was 62% to 83% (primary care only). Conclusions: Influenza vaccination is of continued benefit during the ongoing 2019/20 influenza season. Robust end-of-season VE estimates and genetic virus characterisation results may help understand the variability in influenza (sub) type-specific results across studies.