Small changes in snacking behaviour: the potential impact on CVD mortality.

OBJECTIVE To examine the potential public health impact on CHD and stroke mortality of replacing one 'unhealthy' snack with one 'healthy' snack per person, per day, across the UK population. METHODS Nutritional information was obtained for different 'unhealthy' (such as crisps, chocolate bars, cakes and pastries) and 'healthy' snack products (such as fresh fruit, dried fruit, unsalted nuts or seeds). Expected changes in dietary intake were calculated. The mean change in total blood cholesterol levels was estimated using the Keys equation. The effect of changing cholesterol and salt levels on CHD deaths and on stroke deaths was calculated using the appropriate equations from the Law and He meta-analyses. The estimated reductions in cardiovascular deaths were then tested in a sensitivity analysis. RESULTS Substituting one 'healthy' snack would reduce saturated fat intake by approximately 4.4 g per person per day, resulting in approximately 2400 fewer CHD deaths and 425 fewer stroke deaths per year. The associated 500 mg decrease in salt intake would result in approximately 1790 fewer CHD deaths and 1330 fewer stroke deaths. CONCLUSIONS Simply replacing one unhealthy snack with one healthy snack per day might prevent approximately 6000 cardiovascular deaths every year in the UK.