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Sahin K, Yıldıran H. A Therapeutic Approach in the Management of Chronic Kidney Disease: Plant-Based Dietary Models and Associated Parameters. Curr Nutr Rep 2024; 13:39-48. [PMID: 38172460 DOI: 10.1007/s13668-023-00515-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE OF REVIEW Chronic kidney disease is one of the leading causes of death worldwide today. Nutrition and nutrition-related factors have a very important role in both the prevention and management of the disease. Plant-based dietary practices are one of the promising approaches to chronic kidney disease. This review aims to examine the potential benefits and risks of plant-based diet models on symptoms and indices used in diet quality in chronic kidney disease. RECENT FINDINGS Recently, a growing body of evidence has shown that, unlike animal-based diets, diets rich in plant-based nutrients may play an active role in the incidence of chronic kidney disease in many ways and the management of common symptoms, such as metabolic acidosis, uremic toxicity, and hyperphosphatemia. Implementation of existing plant-based dietary patterns in patients with chronic kidney disease may increase the efficacy of the diet and improve patients' quality of life by expanding their food choices. While there are concerns about creatine deficiency, dietary adequacy, and accessibility regarding plant-based diets, available information is limited.
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Affiliation(s)
- Kezban Sahin
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Bandirma Onyedi Eylul University, Balıkesir, 10200, Turkey.
| | - Hilal Yıldıran
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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2
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Mahdi S, Buckland NJ, Chilcott J. Economic and health impacts of the Change4Life Food Scanner app: Findings from a randomized pilot and feasibility study. Front Nutr 2023; 10:1125542. [PMID: 37006945 PMCID: PMC10061026 DOI: 10.3389/fnut.2023.1125542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/28/2023] [Indexed: 03/18/2023] Open
Abstract
IntroductionThe UK Government developed the Change4Life Food Scanner app to provide families with engaging feedback on the nutritional content of packaged foods. There is a lack of research exploring the cost-effectiveness of dietary health promotion apps.MethodsThrough stakeholder engagement, a conceptual model was developed, outlining the pathway by which the Food Scanner app leads to proximal and distal outcomes. The conceptual model informed the development of a pilot randomized controlled trial which investigated the feasibility and acceptability of evaluating clinical outcomes in children and economic effectiveness of the Food Scanner app through a cost-consequence analysis. Parents of 4–11 years-olds (n = 126) were randomized into an app exposure condition (n = 62), or no intervention control (n = 64). Parent-reported Child Health Utility 9 Dimension (CHU9D) outcomes were collected alongside child healthcare resource use and associated costs, school absenteeism and parent productivity losses at baseline and 3 months follow up. Results for the CHU9D were converted into utility scores based on UK adult preference weights. Sensitivity analysis accounted for outliers and multiple imputation methods were adopted for the handling of missing data.Results64 participants (51%) completed the study (intervention: n = 29; control: n = 35). There was a mean reduction in quality adjusted life years between groups over the trial period of –0.004 (SD = 0.024, 95% CI: –0.005; 0.012). There was a mean reduction in healthcare costs of –£30.77 (SD = 230.97; 95% CI: –£113.80; £52.26) and a mean reduction in workplace productivity losses of –£64.24 (SD = 241.66, 95% CI: –£147.54; £19.07) within the intervention arm, compared to the control arm, over the data collection period. Similar findings were apparent after multiple imputation.DiscussionModest mean differences between study arms may have been due to the exploration of distal outcomes over a short follow-up period. The study was also disrupted due to the coronavirus pandemic, which may have confounded healthcare resource data. Although measures adopted were deemed feasible, the study highlighted difficulties in obtaining data on app development and maintenance costs, as well as the importance of economic modeling to predict long-term outcomes that may not be reliably captured over the short-term.Clinical trial registrationhttps://osf.io/, identifier 62hzt.
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Affiliation(s)
- Sundus Mahdi
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
- *Correspondence: Sundus Mahdi,
| | - Nicola J. Buckland
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Jim Chilcott
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
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Slapø H, Bugge AB, Sandaker I, Lekhal S. Can in-store interventions reduce the socioeconomic gap in fruit and vegetable purchases in grocery stores? A descriptive study of volume sales from 2012 to 2020 in Norway's largest grocery store chain. Appetite 2022; 176:106100. [PMID: 35660077 DOI: 10.1016/j.appet.2022.106100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 11/29/2022]
Abstract
Fruits and vegetable (FVs) consumption is an essential determinant of health, and intake is strongly patterned by socioeconomic status (SES). Inside grocery store interventions have increasingly been explored to promote healthier diets, especially for people with lower SES. This study describes how the supermarket chain Kiwi used a combination of in-store interventions to increase annual sales of FVs between 2012 and 2020. In particular, this study examined how sales developed in counties with different demographic characteristics (e.g., education, income, overweight and obesity, and self-reported FVs consumption level) in order to evaluate whether the effect differs between different populations. The primary outcome measurement was annual volume sales, adjusted for new stores opening and closing during the study period, also called like-for-like sales. The study has used a descriptive study design. The chain used interventions such as better placement, promoting healthy foods, giving out discounts, and placing "on the go" FVs and cups with portioned FVs at the cash registry. Results show that like-for-like volume sales of FVs grew by 34.1% during the study period. The increase was especially strong for vegetables, which increased by 41.8%, compared to fruits and berries, which increased by 25%. Sales increased for all eleven counties in Norway. Using the Spearman correlation, a moderately positive association was found between the number of overweight or obese people in counties and the development in FVs sales. To conclude, in-store interventions positively impacted FVs sales. More research in an experimental context is needed to determine if interventions may reduce the socioeconomic gap in FVs consumption.
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Affiliation(s)
- Helena Slapø
- Department of Behavioral Sciences, Oslo Metropolitan University, P.O. BOX 4 St., Olavs Plass, N-0130, Oslo, Norway.
| | - Annechen Bahr Bugge
- Consumption Research Norway, Oslo Metropolitan University, P.O. BOX 4 St., Olavs Plass, N-0130, Oslo, Norway.
| | - Ingunn Sandaker
- Department of Behavioral Sciences, Oslo Metropolitan University, P.O. BOX 4 St., Olavs Plass, N-0130, Oslo, Norway.
| | - Samira Lekhal
- Morbid Obesity Centre, Vestfold Hospital Trust, Halfdan Wilhelmsens allé 17, 3116, Tønsberg, Norway.
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Cambeses-Franco C, González-García S, Feijoo G, Moreira MT. Driving commitment to sustainable food policies within the framework of American and European dietary guidelines. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 807:150894. [PMID: 34653446 DOI: 10.1016/j.scitotenv.2021.150894] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/15/2021] [Accepted: 10/05/2021] [Indexed: 06/13/2023]
Abstract
Diet and nutrition are essential factors in promoting good health throughout life. Their role as determinants of chronic non-communicable diseases is widely recognized. Additionally, the demand for food involves relevant environmental burdens that have to be taken into account on the way to achieving the Sustainable Development Goals. As an important part of nutrition policy, food-based dietary guidelines (FBDGs) have been revised. The key question is: Are environmental considerations being incorporated into them? To address this issue, we modeled and compared both the main environmental indicators in terms of carbon footprint (CF) and water footprint (WF), and nutritional quality (according to the Nutrient Rich Diet index, NRD9.3 and a health gain score) of dietary guidelines from Northern and Southern Europe and America. Particularly, the FBDGs compared were Dutch Dietary Guidelines (DDG), New Nordic Diet (NND), Spanish Strategy for Nutrition, Physical Activity and Obesity Prevention (NAOS), Mediterranean Diet (MD), Italian Dietary Guidelines (IDG) and American Dietary Guidelines (DGA). The IDG and MD offered the best profiles from a climate change perspective (2.04 and 2.21 kgCO2eq·day-1). Overall, DGA had the highest CF (2.98 kgCO2eq·day-1). WF presented greater fluctuations, not only due to daily-recommended amounts, but also because of different climate conditions and production systems of the reference countries. Hence, WF ranged from 1760 L·person-1·day-1 in IDG to 3181 L·person-1·day-1 in NAOS. Finally, the nutritional value of MD, which had the highest NRD9.3 (477) and health gain score (178), has been demonstrated when the comparison was made with DDG, the one with the lowest health gain score (97) and DGA, the worst in terms of NRD9.3 (391). To go ahead of the FBDGs that bet on all dimensions of sustainability, multi-criteria analysis is needed. Nutrition and environmental performance are not the only aspects of the problem; economy and sociocultural variables should be considered.
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Affiliation(s)
- Cristina Cambeses-Franco
- CRETUS Centre, Department of Chemical Engineering, School of Engineering, Universidad de Santiago de Compostela, Rúa Lope Gómez de Marzoa s/n, 15782 Santiago de Compostela, Spain.
| | - Sara González-García
- CRETUS Centre, Department of Chemical Engineering, School of Engineering, Universidad de Santiago de Compostela, Rúa Lope Gómez de Marzoa s/n, 15782 Santiago de Compostela, Spain
| | - Gumersindo Feijoo
- CRETUS Centre, Department of Chemical Engineering, School of Engineering, Universidad de Santiago de Compostela, Rúa Lope Gómez de Marzoa s/n, 15782 Santiago de Compostela, Spain
| | - María Teresa Moreira
- CRETUS Centre, Department of Chemical Engineering, School of Engineering, Universidad de Santiago de Compostela, Rúa Lope Gómez de Marzoa s/n, 15782 Santiago de Compostela, Spain
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Abstract
The rapid changes that societies have gone through in the last few decades have led to the increase in the prevalence of malnutrition in all its forms and to the degradation of natural resources and the environment. The change in the dietary habits and production systems are responsible for much of this change. Some territorial diets have been shown as potentially capable of reversing these trends by positively contributing to the health of people and the environment such as the Mediterranean Diet and the New Nordic Diet. In this paper, we review the contribution of these 2 diets to health and nutrition and to environmental, sociocultural, and economic sustainability proposing pertinent indicators. Learning from a culturally established diet and a constructed one, tradeoff could be reached to ensure better health and sustainability outcomes. Strong factors for achieving this goal lie in building on the sociocultural appropriation of diets, having the proper tools and indicators, investing in cross-sector collaboration and policy coherence, and having the necessary political support to push the agenda of sustainability forward.
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Affiliation(s)
- Fatima Hachem
- 17107Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Davy Vanham
- 99013European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Luis A Moreno
- 16765Universidad de Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
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6
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Lonnie M, Johnstone AM. The public health rationale for promoting plant protein as an important part of a sustainable and healthy diet. NUTR BULL 2020. [DOI: 10.1111/nbu.12453] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- M. Lonnie
- Department of Human Nutrition Faculty of Food Science University of Warmia and Mazury in Olsztyn Olsztyn Poland
| | - A. M. Johnstone
- The Rowett Institute School of Medicine Medical Sciences and Nutrition University of Aberdeen Aberdeen UK
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Defining a Healthy Diet: Evidence for The Role of Contemporary Dietary Patterns in Health and Disease. Nutrients 2020; 12:nu12020334. [PMID: 32012681 PMCID: PMC7071223 DOI: 10.3390/nu12020334] [Citation(s) in RCA: 360] [Impact Index Per Article: 90.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/22/2020] [Accepted: 01/26/2020] [Indexed: 02/07/2023] Open
Abstract
The definition of what constitutes a healthy diet is continually shifting to reflect the evolving understanding of the roles that different foods, essential nutrients, and other food components play in health and disease. A large and growing body of evidence supports that intake of certain types of nutrients, specific food groups, or overarching dietary patterns positively influences health and promotes the prevention of common non-communicable diseases (NCDs). Greater consumption of health-promoting foods and limited intake of unhealthier options are intrinsic to the eating habits of certain regional diets such as the Mediterranean diet or have been constructed as part of dietary patterns designed to reduce disease risk, such as the Dietary Approaches to Stop Hypertension (DASH) or Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets. In comparison with a more traditional Western diet, these healthier alternatives are higher in plant-based foods, including fresh fruits and vegetables, whole grains, legumes, seeds, and nuts and lower in animal-based foods, particularly fatty and processed meats. To better understand the current concept of a “healthy diet,” this review describes the features and supporting clinical and epidemiologic data for diets that have been shown to prevent disease and/or positively influence health. In total, evidence from epidemiological studies and clinical trials indicates that these types of dietary patterns reduce risks of NCDs including cardiovascular disease and cancer.
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Wilson N, Cleghorn CL, Cobiac LJ, Mizdrak A, Nghiem N. Achieving Healthy and Sustainable Diets: A Review of the Results of Recent Mathematical Optimization Studies. Adv Nutr 2019; 10:S389-S403. [PMID: 31728498 PMCID: PMC6855945 DOI: 10.1093/advances/nmz037] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/26/2018] [Accepted: 03/19/2019] [Indexed: 12/26/2022] Open
Abstract
Climate protection and other environmental concerns render it critical that diets and agriculture systems become more sustainable. Mathematical optimization techniques can assist in identifying dietary patterns that both improve nutrition and reduce environmental impacts. Here we review 12 recent studies in which such optimization was used to achieve nutrition and environmental sustainability aims. These studies used data from China, India, and Tunisia, and from 7 high-income countries (France, Finland, Italy, the Netherlands, Sweden, the United Kingdom, and the United States). Most studies aimed to reduce greenhouse gas emissions (10 of 12) and half aimed also to reduce ≥1 other environmental impact, e.g., water use, fossil energy use, land use, marine eutrophication, atmospheric acidification, and nitrogen release. The main findings were that in all 12 studies, the diets optimized for sustainability and nutrition were more plant based with reductions in meat, particularly ruminant meats such as beef and lamb (albeit with 6 of 12 of studies involving increased fish in diets). The amount of dairy products also tended to decrease in most (7 of 12) of the studies with more optimized diets. Other foods that tended to be reduced included: sweet foods (biscuits, cakes, and desserts), savory snacks, white bread, and beverages (alcoholic and soda drinks). These findings were broadly compatible with the findings of 7 out of 8 recent review articles on the sustainability of diets. The literature suggests that healthy and sustainable diets may typically be cost neutral or cost saving, but this is still not clear overall. There remains scope for improvement in such areas as expanding research where there are no competing interests; improving sustainability metrics for food production and consumption; consideration of infectious disease risks from livestock agriculture and meat; and researching optimized diets in settings where major policy changes have occurred (e.g., Mexico's tax on unhealthy food).
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Affiliation(s)
- Nick Wilson
- BODE Programme, University of Otago, Wellington, New Zealand,Address correspondence to NW (e-mail: )
| | | | - Linda J Cobiac
- BODE Programme, University of Otago, Wellington, New Zealand
| | - Anja Mizdrak
- BODE Programme, University of Otago, Wellington, New Zealand
| | - Nhung Nghiem
- BODE Programme, University of Otago, Wellington, New Zealand
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9
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Eme PE, Douwes J, Kim N, Foliaki S, Burlingame B. Review of Methodologies for Assessing Sustainable Diets and Potential for Development of Harmonised Indicators. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1184. [PMID: 30986991 PMCID: PMC6479933 DOI: 10.3390/ijerph16071184] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 03/22/2019] [Accepted: 03/25/2019] [Indexed: 12/28/2022]
Abstract
The underlying values and priorities that drive policy responses depend largely on the constructs that researchers and decision makers select to measure and the metrics used. Despite much recent attention being given to sustainable diets and food systems and to the importance of clearly measuring sustainability to meet targets, to achieve goals, and to appraise dietary and environmental policies, it is not commonly agreed how the different indicators of sustainable diets are assessed. The evidence base for assessment of these indicators are frequently weak, fragmented, and arbitrary. The aim of this paper was to compare a range of published methods and indicators for assessing sustainable diets and food systems in order to harmonise them. Keyword and reference searches were performed in PubMed, Scopus, CAB Abstracts, and Web of Knowledge. Fifty-two studies (21 proposed methods and 31 used methods) that combined environment, nutrition and health, and socioeconomic aspects of sustainable diets were reviewed. The majority (over 90%) of the studies focused on high-income countries. Twenty-eight studies assessed the environmental effects of different dietary practices, eight of the studies examined the nutrition and health indicators used for assessing sustainable food systems, and seven studies assessed the social and economic costs of diets. A classification of the elements was developed, and common elements are proposed for standardizing. These elements were categorized into nutrition and health indicators, environment indicators, and socioeconomic indicators. Standardized or harmonized indicators can be used for consistency and applicability purposes and to support, implement, and monitor relevant policies.
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Affiliation(s)
- Paul Eze Eme
- School of Health Sciences, College of Health Science, Massey University, Palmerston North 4442, New Zealand.
| | - Jeroen Douwes
- Centre of Public Health Research, Massey University, Wellington 6140, New Zealand.
| | - Nicholas Kim
- School of Health Sciences, College of Health Science, Massey University, Palmerston North 4442, New Zealand.
| | - Sunia Foliaki
- Centre of Public Health Research, Massey University, Wellington 6140, New Zealand.
| | - Barbara Burlingame
- School of Health Sciences, College of Health Science, Massey University, Palmerston North 4442, New Zealand.
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10
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Jones AD, Hoey L, Blesh J, Miller L, Green A, Shapiro LF. A Systematic Review of the Measurement of Sustainable Diets. Adv Nutr 2016; 7:641-64. [PMID: 27422501 PMCID: PMC4942861 DOI: 10.3945/an.115.011015] [Citation(s) in RCA: 127] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Sustainability has become an integral consideration of the dietary guidelines of many countries in recent decades. However, a lack of clear metrics and a shared approach to measuring the multiple components of sustainable diets has hindered progress toward generating the evidence needed to ensure the credibility of new guidelines. We performed a systematic literature review of empirical research studies on sustainable diets to identify the components of sustainability that were measured and the methods applied to do so. Two independent reviewers systematically searched 30 databases and other sources with the use of a uniform set of search terms and a priori exclusion criteria. In total, 113 empirical studies were included in the final review. Nearly all of the studies were focused on high-income countries. Although there was substantial heterogeneity in the components of sustainability measured, the estimated greenhouse gas emissions (GHGEs) of various dietary patterns were by far most commonly measured (n = 71 studies). Estimating the GHGEs of foods through various stages of production, use, and recycling with the use of the Life Cycle Assessment approach was the most common method applied to measure the environmental impacts of diets (n = 49 studies). Many components of sustainable diets identified in existing conceptual frameworks are disproportionately underrepresented in the empirical literature, as are studies that examine consumer demand for sustainable dietary alternatives. The emphasis in the literature on high-income countries also overlooks the production and dietary alternatives most relevant to low- and middle-income countries. We propose 3 methodological and measurement approaches that would both improve the global relevance of our understanding of sustainable diets and attend more completely to the existing multidimensional, multiscale conceptual framing of sustainable diets.
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Affiliation(s)
| | - Lesli Hoey
- College of Architecture and Urban Planning, University of Michigan, Ann Arbor, MI
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Khakimov B, Poulsen SK, Savorani F, Acar E, Gürdeniz G, Larsen TM, Astrup A, Dragsted LO, Engelsen SB. New Nordic Diet versus Average Danish Diet: A Randomized Controlled Trial Revealed Healthy Long-Term Effects of the New Nordic Diet by GC–MS Blood Plasma Metabolomics. J Proteome Res 2016; 15:1939-54. [DOI: 10.1021/acs.jproteome.6b00109] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Bekzod Khakimov
- Department
of Food Science, Faculty of Science, University of Copenhagen, Rolighedsvej
26, DK-1958 Frederiksberg
C, Denmark
| | - Sanne Kellebjerg Poulsen
- Department
of Nutrition Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, DK-1958 Frederiksberg C, Denmark
| | - Francesco Savorani
- Department
of Food Science, Faculty of Science, University of Copenhagen, Rolighedsvej
26, DK-1958 Frederiksberg
C, Denmark
| | - Evrim Acar
- Department
of Food Science, Faculty of Science, University of Copenhagen, Rolighedsvej
26, DK-1958 Frederiksberg
C, Denmark
| | - Gözde Gürdeniz
- Department
of Nutrition Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, DK-1958 Frederiksberg C, Denmark
| | - Thomas M. Larsen
- Department
of Nutrition Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, DK-1958 Frederiksberg C, Denmark
| | - Arne Astrup
- Department
of Nutrition Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, DK-1958 Frederiksberg C, Denmark
| | - Lars O. Dragsted
- Department
of Nutrition Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, DK-1958 Frederiksberg C, Denmark
| | - Søren Balling Engelsen
- Department
of Food Science, Faculty of Science, University of Copenhagen, Rolighedsvej
26, DK-1958 Frederiksberg
C, Denmark
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12
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Abdullah MMH, Gyles CL, Marinangeli CPF, Carlberg JG, Jones PJH. Cost-of-illness analysis reveals potential healthcare savings with reductions in type 2 diabetes and cardiovascular disease following recommended intakes of dietary fiber in Canada. Front Pharmacol 2015; 6:167. [PMID: 26321953 PMCID: PMC4531234 DOI: 10.3389/fphar.2015.00167] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 07/27/2015] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Type 2 diabetes (T2D) and cardiovascular disease (CVD) are leading causes of mortality and two of the most costly diet-related ailments worldwide. Consumption of fiber-rich diets has been repeatedly associated with favorable impacts on these co-epidemics, however, the healthcare cost-related economic value of altered dietary fiber intakes remains poorly understood. In this study, we estimated the annual cost savings accruing to the Canadian healthcare system in association with reductions in T2D and CVD rates, separately, following increased intakes of dietary fiber by adults. METHODS A three-step cost-of-illness analysis was conducted to identify the percentage of individuals expected to consume fiber-rich diets in Canada, estimate increased fiber intakes in relation to T2D and CVD reduction rates, and independently assess the potential annual savings in healthcare costs associated with the reductions in rates of these two epidemics. The economic model employed a sensitivity analysis of four scenarios (universal, optimistic, pessimistic, and very pessimistic) to cover a range of assumptions within each step. RESULTS Non-trivial healthcare and related savings of CAD$35.9-$718.8 million in T2D costs and CAD$64.8 million-$1.3 billion in CVD costs were calculated under a scenario where cereal fiber was used to increase current intakes of dietary fiber to the recommended levels of 38 g per day for men and 25 g per day for women. Each 1 g per day increase in fiber consumption resulted in annual CAD$2.6 to $51.1 million savings for T2D and $4.6 to $92.1 million savings for CVD. CONCLUSION Findings of this analysis shed light on the economic value of optimal dietary fiber intakes. Strategies to increase consumers' general knowledge of the recommended intakes of dietary fiber, as part of healthy diet, and to facilitate stakeholder synergy are warranted to enable better management of healthcare and related costs associated with T2D and CVD in Canada.
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Affiliation(s)
- Mohammad M. H. Abdullah
- Department of Human Nutritional Sciences and Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, MBCanada
| | - Collin L. Gyles
- Department of Agribusiness and Agricultural Economics, University of Manitoba, Winnipeg, MBCanada
| | | | - Jared G. Carlberg
- Department of Agribusiness and Agricultural Economics, University of Manitoba, Winnipeg, MBCanada
| | - Peter J. H. Jones
- Department of Human Nutritional Sciences and Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, MBCanada
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13
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Cost-Effectiveness of a New Nordic Diet as a Strategy for Health Promotion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:7370-91. [PMID: 26133129 PMCID: PMC4515662 DOI: 10.3390/ijerph120707370] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 06/12/2015] [Accepted: 06/25/2015] [Indexed: 11/16/2022]
Abstract
Inappropriate diets constitute an important health risk and an increasing environmental burden. Healthy regional diets may contribute to meeting this dual challenge. A palatable, healthy and sustainable New Nordic diet (NND) based on organic products from the Nordic region has been developed. This study assesses whether a large-scale introduction of NND is a cost-effective health promotion strategy by combining an economic model for estimating the utility-maximizing composition of NND, a life cycle assessment model to assess environmental effects of the dietary change, and a health impact model to assess impacts on the disease burden. Consumer expenditure for food and beverages in the NND is about 16% higher than currently, with the largest relative difference in low-income households. Environmental loads from food consumption are 15%–25% lower, and more than 18,000 disability-adjusted life years (DALY) will be saved per year in Denmark. NND exhibits a cost-effectiveness ratio of about €73,000–94,000 per DALY saved. This cost-effectiveness improves considerably, if the NND’s emphasis on organic and Nordic-origin products is relaxed.
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