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Luongo G, Jago E, Mah CL. Assessing the potential for healthier consumer food substitutions in Canada: population-level differences in dietary intakes of whole grains, refined grains, red meats, and legumes. Appl Physiol Nutr Metab 2024; 49:340-349. [PMID: 37931243 DOI: 10.1139/apnm-2023-0260] [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] [Indexed: 11/08/2023]
Abstract
The potential for healthier consumer food substitutions is an important factor in the study of food environments, dietary choices, and population nutrition promotion. The burden of diet-related non-communicable diseases is unevenly distributed across Canada and variation in the food environment sub-nationally may be an important explanation. We used population-based 24 h dietary recall data from the 2015 Canadian Community Health Survey-Nutrition for Canadian adults (n = 13 919) to examine dietary intakes of two food group pairings (whole grains/refined grains and legumes/red meats) where consumer substitutions have been recognized to be of importance in promoting healthy and sustainable population diet. We used an ANOVA followed by pairwise comparisons with Bonferroni correction to estimate differences in intakes between provinces for daily weight and proportion of total energy consumed. Based on the Global Burden of Disease Study, Canadians consumed below the average daily requirements of legumes and whole grains and well above the required range of red meat, suggesting room for broad improvements to population diet. Findings also demonstrate that there is potential for targeted shifts in dietary intakes among non-consumers of certain foods (e.g., legumes). This study may inform intervention development for the consumer nutrition environment including food accessibility and affordability to reduce non-communicable disease risk.
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Affiliation(s)
- Gabriella Luongo
- School of Health Administration, Faculty of Health, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd Floor, PO Box 15000, Halifax, NS B3H 4R2, Canada
| | - Emily Jago
- School of Health Administration, Faculty of Health, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd Floor, PO Box 15000, Halifax, NS B3H 4R2, Canada
| | - Catherine L Mah
- School of Health Administration, Faculty of Health, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd Floor, PO Box 15000, Halifax, NS B3H 4R2, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 5th Floor, Toronto, ON M5T 3M7, Canada
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Fernandez MA, Maximova K, Fulkerson JA, Raine KD. Associations between cooking skills, cooking with processed foods, and health: a cross-sectional study. Appl Physiol Nutr Metab 2024; 49:330-339. [PMID: 37931241 DOI: 10.1139/apnm-2023-0293] [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] [Indexed: 11/08/2023]
Abstract
To improve health outcomes, home cooking has been suggested as a solution to reduce intakes of processed foods. However, little is known about how cooking skills or cooking with processed foods influence health. This cross-sectional study examined associations between diet and health outcomes with cooking skills and cooking with processed foods. The dataset included a nationally representative sample of 18 460 adults from Canadian Community Health Survey (CCHS) annual component rapid response modules on food skills. In the CCHS rapid response modules, diet and health outcomes (fruit and vegetable intake, general health, mental health, and obesity) and data related to cooking skills and cooking with processed foods were collected through self-report. Separate logistic regression models were fitted for each outcome, controlling for age, income, and education, and stratified by sex. Adults with poor cooking skills were less likely to have adequate fruit and vegetable intake (≥5 servings per day) (p < 0.001), very good general health (p < 0.001) or mental health (p < 0.001), and obesity (p = 0.02) compared to advanced cooking skills. Adults who cooked with highly processed foods were less likely to have adequate fruit and vegetable intake (p < 0.001), very good general health (p = 0.002) or mental health (p < 0.001), but more likely to have obesity (p = 0.03) compared to cooking with minimally processed foods. Cooking skills alone appear insufficient to protect against obesity. Results suggest that not only are cooking skills important, but the quality of ingredients also matter. Limiting the use of processed foods in addition to improving cooking skills are potential intervention targets to promote better health and diet outcomes.
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Affiliation(s)
- Melissa A Fernandez
- School of Nutrition Sciences, University of Ottawa, Ottawa, ON, Canada
- School of Public Health, University of Alberta, Edmonton, AB, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Katerina Maximova
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Kim D Raine
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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Liu X, Ho MS, Hewings GJD, Dou Y, Wang S, Wang G, Guan D, Li S. Aging Population, Balanced Diet and China's Grain Demand. Nutrients 2023; 15:2877. [PMID: 37447204 DOI: 10.3390/nu15132877] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/12/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
The need to make more accurate grain demand (GD) forecasting has become a major topic in the current international grain security discussion. Our research aims to improve short-term GD prediction by establishing a multi-factor model that integrates the key factors: shifts in dietary structures, population size and age structure, urbanization, food waste, and the impact of COVID-19. These factors were not considered simultaneously in previous research. To illustrate the model, we projected China's annual GDP from 2022 to 2025. We calibrated key parameters such as conversion coefficients from animal foods to feed grain, standard person consumption ratios, and population size using the latest surveys and statistical data that were either out of date or missing in previous research. Results indicate that if the change in diets continued at the rate as observed during 2013-2019 (scenario 1), China's GD is projected to be 629.35 million tons in 2022 and 658.16 million tons in 2025. However, if diets shift to align with the recommendations in the Dietary Guideline for Chinese Residents 2022 (scenario 2), GD would be lower by 5.9-11.1% annually compared to scenario 1. A reduction in feed grain accounts for 68% of this change. Furthermore, for every 1 percentage point increase in the population adopting a balanced diet, GD would fall by 0.44-0.73 million tons annually during that period. Overlooking changes in the population age structure could lead to an overprediction of annual GDP by 3.8% from 2022 to 2025. With an aging population, China's GD would fall slightly, and adopting a balanced diet would not lead to an increase in GD but would have positive impacts on human health and the environment. Our sensitivity analysis indicated that reducing food waste, particularly cereal, livestock, and poultry waste, would have significant effects on reducing GD, offsetting the higher demand due to rising urbanization and higher incomes. These results underscore the significance of simultaneous consideration of multiple factors, particularly the dietary structure and demographic composition, resulting in a more accurate prediction of GD. Our findings should be useful for policymakers concerning grain security, health, and environmental protection.
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Affiliation(s)
- Xiuli Liu
- Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing 100190, China
- University of Chinese Academy of Sciences, Beijing 100049, China
- Center for Forecasting Science, Chinese Academy of Sciences, Beijing 100190, China
- Harvard China Project on Energy, Economy and Environment, School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
| | - Mun S Ho
- Harvard China Project on Energy, Economy and Environment, School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
| | - Geoffrey J D Hewings
- Regional Economics Applications Laboratory, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Yuxing Dou
- Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing 100190, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Shouyang Wang
- Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing 100190, China
- University of Chinese Academy of Sciences, Beijing 100049, China
- Center for Forecasting Science, Chinese Academy of Sciences, Beijing 100190, China
| | - Guangzhou Wang
- Institute of Population and Labor Economics, Chinese Academy of Social Sciences, Beijing 100006, China
| | - Dabo Guan
- Department of Earth System Science, Tsinghua University, Beijing 100084, China
| | - Shantong Li
- Development Research Center of the State Council, Beijing 100010, China
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Blair SA, Edwards G, Yu K, Jovel E, Powell LJ, Renwick K, Conklin AI. What Is a School Farm? Results of a Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5332. [PMID: 37047947 PMCID: PMC10094287 DOI: 10.3390/ijerph20075332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
As school farms become more prominent programs to teach food education, research is needed to support school farms' implementation and sustainability. This scoping review included 94 articles on school farms from three bibliometric databases covering broad international literature. Vocational agricultural training, animal husbandry, and crop production were common characteristics of school farms across 103 years of publications. Themes of sustainability, healthy eating, and food systems were more prominent in recent literature. Peer-reviewed studies (1985-2019) provided some empirical research showing school farms' impact on students. This review discusses school farms' structures and objectives as promising food education and production programming.
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Affiliation(s)
- Sammy A. Blair
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Gabrielle Edwards
- Faculty of Education, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Katharine Yu
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Eduardo Jovel
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Lisa Jordan Powell
- Center for Human and Environmental Sustainability, Sweet Briar College, Sweet Briar, VA 24595, USA
| | - Kerry Renwick
- Faculty of Education, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Annalijn I. Conklin
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Centre for Health Evaluation and Outcome Sciences, Providence Healthcare Research Institute, St. Paul’s Hospital, Vancouver, BC V6Z 1Y6, Canada
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Modelling the health and economic impact of sugary sweetened beverage tax in Canada. PLoS One 2022; 17:e0277306. [DOI: 10.1371/journal.pone.0277306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 10/23/2022] [Indexed: 11/12/2022] Open
Abstract
Background
With the increasing concerns about the health and economic burden attributed to sugar-sweetened beverages (SSBs) consumption, SSB taxation has been proposed and implemented in many countries. Many previous economic evaluations of SSB taxation have shown that this kind of policy is cost-effective. However, the magnitude of impact varies. This study aims to design a comprehensive model to estimate the impact and cost-effectiveness of the SSB tax in Canada.
Methods
A proportional multi-state life table-based Markov model was chosen to estimate the impacts of SSB tax in Canada. The health-related quality of life (including disability-adjusted life years (DALYs) and quality-adjusted life years (QALYs)), the costs (including health care costs and intervention costs), and the tax revenue were the main health and economic outcomes. We compared the simulated SSB tax with the current practice from the public health care payer perspective, and the tax was applied to the 2015 adult Canadian population up to 100 years. The economic model was built following guidelines from the Canadian Agency for Drugs and Technologies in Health.
Results
After implementing a CAD$0.015/oz SSB tax, 282,104 cases of overweight and obesity, 210,542 cases of diseases, and 2,189 deaths could be prevented. The simulated SSB tax has the potential to avert 2.3 million DALYs, gain 1.5 million QALYs, and save CAD$32,583 million in health care costs in a lifetime period. The incremental cost-effectiveness ratio for the SSB tax was CAD$ -24,933/QALY. The SSB tax with different tax levels (CAD$0.01/oz and CAD$0.02/oz) remained cost-effective.
Conclusion
Implementing the SSB tax in Canada is a potential cost-effective policy option for reducing obesity and related chronic diseases. The model built in this study provides a more accurate estimate of health and economic impact of SSB tax and could be used to estimate other sugar tax options.
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Liu S, Munasinghe LL, Maximova K, Taylor JP, Ohinmaa A, Veugelers PJ. The economic burden of excessive sugar consumption in Canada: should the scope of preventive action be broadened? CANADIAN JOURNAL OF PUBLIC HEALTH 2022; 113:331-340. [PMID: 35292938 PMCID: PMC8923742 DOI: 10.17269/s41997-022-00615-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 01/28/2022] [Indexed: 12/11/2022]
Abstract
Objective Excessive sugar consumption is an established risk factor for various chronic diseases (CDs). No earlier study has quantified its economic burden in terms of health care costs for treatment and management of CDs, and costs associated with lost productivity and premature mortality. This information, however, is essential to public health decision-makers when planning and prioritizing interventions. The present study aimed to estimate the economic burden of excessive free sugar consumption in Canada. Methods Free sugars refer to all monosaccharides and disaccharides added to foods plus sugars naturally present in honey, syrups, and fruit juice. Based on free sugar consumption reported in the 2015 Canadian Community Health Survey–Nutrition and established risk estimates for 16 main CDs, we calculated the avoidable direct health care costs and indirect costs. Results If Canadians were to comply with the free sugar recommendation (consumption below 10% of total energy intake (TEI)), an estimated $2.5 billion (95% CI: 1.5, 3.6) in direct health care and indirect costs could have been avoided in 2019. For the stricter recommendation (consumption below 5% of TEI), this was $5.0 billion (95% CI: 3.1, 6.9). Conclusion Excessive free sugar in our diet has an enormous economic burden that is larger than that of any food group and 3 to 6 times that of sugar-sweetened beverages (SSBs). Public health interventions to reduce sugar consumption should therefore consider going beyond taxation of SSBs to target a broader set of products, in order to more effectively reduce the public health and economic burden of CDs.
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Affiliation(s)
- Siyuan Liu
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Lalani L Munasinghe
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Katerina Maximova
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer P Taylor
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Arto Ohinmaa
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Paul J Veugelers
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
- School of Public Health, University of Alberta, 3-50 University Terrace, Edmonton, AB, T6G 2T4, Canada.
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Miller KB, Grafenauer SJ, Martikainen J. Nutrition economics: Four analyses supporting the case for whole grain consumption. J Cereal Sci 2022. [DOI: 10.1016/j.jcs.2022.103455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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8
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Liu D, Lu M, Lakshmanan P, Hu Z, Chen X. Increased Provision of Bioavailable Mg through Vegetables Could Significantly Reduce the Growing Health and Economic Burden Caused by Mg Malnutrition. Foods 2021; 10:foods10112513. [PMID: 34828794 PMCID: PMC8620491 DOI: 10.3390/foods10112513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 12/05/2022] Open
Abstract
Magnesium (Mg) is an essential mineral nutrient for human health and its deficiency associated with many diseases, including stroke, heart failure, and type 2 diabetes. Vegetables are an important source of dietary Mg for humans. In this study, we quantified vegetable Mg content by a global meat analysis, analyzed human health, and economic impact caused by Mg deficiency. Results revealed that vegetable Mg content showed a large variation with an average value of 19.3 mg 100 g−1 FW. Variation in per capita vegetable-Mg supply in different continents is largely ascribed to continental difference in the amount and the type of vegetables produced. The health and economic loss attributed to Mg deficiency are estimated to be 1.91 million disability-adjusted life years (DALYs) and 15.8 billion dollars (0.14% of GDP), respectively. A scenario analysis indicated that the increasing vegetable production (increased by 8.9% and 20.7% relative to 2017 in 2030 and 2050) and vegetable Mg content (increased by 22% through biofortification) could significantly reduce DALYs (1.24 million years) and economic burden (0.09% of GDP). This study could guide a major re-balance of production practices, species cultivated, and Mg biofortification to provide sufficient vegetable Mg for better human Mg nutrition.
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Affiliation(s)
- Dunyi Liu
- Key Laboratory of Efficient Utilization of Soil and Fertilizer Resources, College of Resources and Environment, Southwest University, Chongqing 400715, China; (D.L.); (M.L.); (Z.H.)
- Interdisciplinary Research Center for Agriculture Green Development in Yangtze River Basin, Southwest University, Chongqing 400715, China;
| | - Ming Lu
- Key Laboratory of Efficient Utilization of Soil and Fertilizer Resources, College of Resources and Environment, Southwest University, Chongqing 400715, China; (D.L.); (M.L.); (Z.H.)
| | - Prakash Lakshmanan
- Interdisciplinary Research Center for Agriculture Green Development in Yangtze River Basin, Southwest University, Chongqing 400715, China;
- Sugarcane Research Institute, Guangxi Academy of Agricultural Sciences, Nanning 530007, China
- Queensland Alliance for Agriculture and Food Innovation, University of Queensland, St. Lucia, QLD 4067, Australia
| | - Ziyi Hu
- Key Laboratory of Efficient Utilization of Soil and Fertilizer Resources, College of Resources and Environment, Southwest University, Chongqing 400715, China; (D.L.); (M.L.); (Z.H.)
| | - Xinping Chen
- Key Laboratory of Efficient Utilization of Soil and Fertilizer Resources, College of Resources and Environment, Southwest University, Chongqing 400715, China; (D.L.); (M.L.); (Z.H.)
- Interdisciplinary Research Center for Agriculture Green Development in Yangtze River Basin, Southwest University, Chongqing 400715, China;
- Correspondence: ; Tel.: +86-23-6825-1082
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Abdullah MMH, Hughes J, Grafenauer S. Healthcare Cost Savings Associated with Increased Whole Grain Consumption among Australian Adults. Nutrients 2021; 13:1855. [PMID: 34072326 PMCID: PMC8228843 DOI: 10.3390/nu13061855] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 12/12/2022] Open
Abstract
Many dietary guidelines emphasise "mostly" whole grain food choices as part of an overall healthy eating pattern based on evidence for enhancing nutritional status and reducing chronic disease. Still, countries including Australia fall short of their consumption targets. Furthermore, healthcare cost savings associated with increasing the consumption of whole grains in alignment with the Daily Target Intake (DTI) recommendation of 48 g are unknown. The aim of this study was to assess the potential savings in costs of healthcare and lost productivity associated with a reduction in the incidence of Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease (CVD) through meeting the 48 g DTI recommendation for whole grains among the Australian adult population (>20 years). A three-step cost-of-illness analysis was conducted using input parameters from: 1) estimates of proportions of consumers (5%, 15%, 50%, and 100%) who would increase their current intake of whole grains to meet the recommended DTI in Australia; 2) relative reductions in risk of T2DM and CVD associated with specific whole grain consumption, as reported in meta-analysis studies; and 3) data on costs of healthcare and productivity loss based on monetary figures by national healthcare authorities. A very pessimistic (5% of the population) through to universal (100% of the population) adoption of the recommended DTI was shown to potentially yield AUD 37.5 (95% CI 22.3-49.3) to AUD 750.7 (95% CI 445.7-985.2) million, and AUD 35.9 (95% CI 8.3-60.7) to AUD 717.4 (95% CI 165.5-1214.1) million in savings on annual healthcare and lost productivity costs for T2DM and CVD, respectively. Given such economic benefits of the recommended consumption of whole grains, in exchange for refined grains, there is a real opportunity to facilitate relevant socioeconomic cost-savings for Australia and reductions in disease. These results are suggestive of a much greater opportunity to communicate the need for dietary change at all levels, but particularly through food-based dietary guidelines and front-of-pack labelling initiatives.
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Affiliation(s)
| | - Jaimee Hughes
- Grains & Legumes Nutrition Council, 1 Rivett Rd, North Ryde 2113, Australia; (J.H.); (S.G.)
| | - Sara Grafenauer
- Grains & Legumes Nutrition Council, 1 Rivett Rd, North Ryde 2113, Australia; (J.H.); (S.G.)
- School of Medicine, University of Wollongong, Northfields Avenue, Wollongong 2522, Australia
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Basnet TB, G. C. S, Basnet R, Neupane B. Dietary nutrients of relative importance associated with coronary artery disease: Public health implication from random forest analysis. PLoS One 2020; 15:e0243063. [PMID: 33301496 PMCID: PMC7728256 DOI: 10.1371/journal.pone.0243063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 11/14/2020] [Indexed: 01/09/2023] Open
Abstract
Dietary nutrients have significant effects on the risk of cardiovascular diseases. However, the results were not uniform across different countries. The study aims to determine the relative importance of dietary nutrients associated with coronary artery disease (CAD) among the Nepalese population. A hospital-based matched case-control study was carried out at Shahid Gangalal National Heart Center in Nepal. In the present study, patients with more than seventy percent stenosis in any main coronary artery branch in angiography were defined as cases, while those presenting normal coronary angiography or negative for stressed exercise test were considered controls. Dietary intakes of 612 respondents over the past 12 months were evaluated using a semi-quantitative customized food frequency questionnaire. In conditional regression model, the daily average dietary intake of β-carotene (OR: 0.54; 95%CI: 0.34, 0.87), and vitamin C (OR: 0.96; 95%CI: 0.93, 0.99) were inversely, whereas dietary carbohydrate (OR: 1.16; 95%CI: 1.1, 1.24), total fat/oil (OR: 1.47; 95%CI: 1.27, 1.69), saturated fatty acid (SFA) (OR: 1.2; 95%CI: 1.11, 1.3), cholesterol (OR: 1.01; 95%CI: 1.001, 1.014), and iron intakes (OR: 1.11; 95%CI: 1.03, 1.19) were positively linked with CAD. Moreover, in random forest analysis, the daily average dietary intakes of SFA, vitamin A, total fat/oil, β-carotene, and cholesterol were among the top five nutrients (out of 12 nutrients variables) of relative importance associated with CAD. The nutrients of relative importance imply a reasonable preventive measure in public health nutrients specific intervention to prevent CAD in a resource-poor country like Nepal. The findings are at best suggestive of a possible relationship between these nutrients and the development of CAD, but prospective cohort studies and randomized control trials will need to be performed in the Nepalese population.
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Affiliation(s)
- Til Bahadur Basnet
- Little Buddha College of Health Sciences, Prubanchal University, Kathmandu, Nepal
- * E-mail:
| | - Srijana G. C.
- Maharajgunj Nursing Campus, Tribhuvan University, Kathmandu, Nepal
| | - Rajesh Basnet
- Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Bidusha Neupane
- Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
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Murphy MM, Schmier JK. Cardiovascular Healthcare Cost Savings Associated with Increased Whole Grains Consumption among Adults in the United States. Nutrients 2020; 12:nu12082323. [PMID: 32756452 PMCID: PMC7469007 DOI: 10.3390/nu12082323] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 01/07/2023] Open
Abstract
Little is known about the potential health economic impact of increasing the proportion of total grains consumed as whole grains to align with Dietary Guidelines for Americans (DGA) recommendations. Health economic analysis estimating difference in costs developed using (1) relative risk (RR) estimates between whole grains consumption and outcomes of cardiovascular disease (CVD) and a selected component (coronary heart disease, CHD); (2) estimates of total and whole grains consumption among US adults; and (3) annual direct and indirect medical costs associated with CVD. Using reported RR estimates and assuming a linear relationship, risk reductions per serving of whole grains were calculated and cost savings were estimated from proportional reductions by health outcome. With a 4% reduction in CVD incidence per serving and a daily increase of 2.24 oz-eq of whole grains, one-year direct medical cost savings were estimated at US$21.9 billion (B) (range, US$5.5B to US$38.4B). With this same increase in whole grains and a 5% reduction in CHD incidence per serving, one-year direct medical cost savings were estimated at US$14.0B (US$8.4B to US$22.4B). A modest increase in whole grains of 0.25 oz-eq per day was associated with one-year CVD-related savings of $2.4B (US$0.6B to US$4.3B) and CHD-related savings of US$1.6B (US$0.9B to US$2.5B). Increasing whole grains consumption among US adults to align more closely with DGA recommendations has the potential for substantial healthcare cost savings.
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Affiliation(s)
- Mary M. Murphy
- Exponent, Inc., Center for Chemical Regulation and Food Safety, Washington, DC 20036, USA
- Correspondence: ; Tel.: +1-202-772-4953
| | - Jordana K. Schmier
- Pharmerit—An Open Health Company, Real-World Evidence and Data Analytics Center of Excellence, Bethesda, MD 20814, USA;
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