Abstract Body: Introduction: Consumption of packaged foods and beverages high in sodium, sugar, and saturated fat is increasing in Ethiopia. The Ethiopian government is considering a comprehensive policy package including front-of-pack labeling (FoPL), and restrictions on marketing and procurement to discourage purchase of products exceeding nutrient thresholds. The potential dietary and health impact of this policy is unknown.
Objectives: To estimate the dietary and health impacts of implementing the policy package in Ethiopia.
Methods: We applied a comparative risk-assessment model to simulate the impact of these policies among adults (≥20 years). Sales data from Euromonitor Passport Database were used as intake proxies, linked with sodium and sugar content from Mintel Global New Products Database. Historic trends were used to project future consumption, and policy-effect on nutrient sales were derived from a real-world evaluation of a similar policy package. Reductions in sodium and sugar intake were used to estimate changes in blood pressure and body-mass index using data from clinical trials, and then converted into averted deaths and disability-adjusted life years (DALYs) using data from global databases and a national survey. Outcomes were estimated for 2025 and 2040 under two packaged food consumption scenarios: current trends (low) and 10% annual growth observed in other middle-income countries (high).
Results: Without the policy package, sodium intake from packaged foods is projected to rise from 98 (95% uncertainty interval: 77-119) mg/day (2025) to 125 (96-157) mg/day (low) or 406 (319-500) mg/day (high) by 2040, and sugar from 6.1 (5.7-6.6) g/day to 7.6 (7.0-8.1) g/day (low) or 25.7 (24.1-27.3) g/day (high) (Figure 1). Without policy action, these increases could raise noncommunicable disease (NCD) burden, especially from cardiovascular diseases (Figure 2). Immediate implementation of the policy package could reduce sodium intake by 23% (19–27%) and sugar by 27% (25–29%), averting 384 (253–556) deaths and 5,145 (3,739–6,930) DALYs. Projected benefits substantially increase for both low- and high-trends by 2040 (Figure 3).
Conclusions: A policy package including FoPL plus marketing and procurement restrictions, could yield immediate, meaningful health gains in Ethiopia. By 2040, under either current trends or 10% annual growth in packaged-food consumption, these policies could attenuate the projected rise in NCDs driven by sodium and sugar in packaged foods.