The potential impacts of Brexit on diet and cardiovascular disease in England

Introduction The UK’s decision to exit the EU (Brexit) will change its trading relationships and agricultural policies, which are currently regulated by the EU. Trade and agriculture are determinants of the food system and can therefore influence diet and associated health. This thesis aims to estimate the potential impact of different post-Brexit trade and agricultural policy scenarios on dietary consumption and associated cardiovascular disease (CVD) mortality and inequalities in England through their effect on the soft-drinks industry levy (SDIL) effectiveness and fruit and vegetable (F&V) prices and availability. Methods This thesis used the previously validated IMPACT Food Policy model and probabilistic sensitivity analysis to estimate the impact of modelled scenarios on coronary heart disease (CHD) and/or stroke mortality, stratified by age, sex, and Index of Multiple Deprivation. The model combined publicly available secondary data, including published estimates from meta-analyses, nationally representative surveys, and trade and agricultural statistics from official sources. Results This thesis suggested that the SDIL would be resilient to potential changes in the price of sugar under different post-Brexit trade options, benefiting CHD mortality outcomes and reducing CHD inequalities under all modelled Brexit scenarios in 2021. It also suggested that Brexit would increase price and decrease consumption of F&V under all modelled post-Brexit trade scenarios, contributing to higher CVD mortality in England between 2021 and 2030, with minor impacts on CVD inequalities. Finally, it suggested that the post-Brexit agricultural policy can improve F&V consumption by increasing agricultural land allocated to F&V. This would reduce CVD mortality between 2021 and 2030 in England, especially among more deprived groups. Conclusions These findings suggest that Brexit presents both a threat and an opportunity to the UK food system. Post-Brexit trade and agricultural policies should align with dietary recommendations and public health aims and provide a regulatory environment that promotes population health.Open Acces