Cardiovascular Healthcare Cost Savings Associated with Increased Whole Grains Consumption among Adults in the United States

Murphy, Mary M.; Schmier, Jordana K.

doi:10.3390/nu12082323

Cited by 14 publications

(12 citation statements)

References 17 publications

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“…Exchanging whole grains for refined grains to levels that meet the DTI among 5% up to 100% of Australian adults is estimated to lead to between AUD 37.5 and 750.7 million and AUD 35.9 to 717.4 million in total annual healthcare-and productivity-related costs for T2DM and CVD, respectively. A similar analysis was conducted in the US, where estimated healthcare savings related to CVD from modelled increases of 0.25 oz-eq per day (~4 g) of whole grains was USD 2.4 billion (USD 0.6 to USD 4.3) [22]. The larger valuation in the US compared to the results in this study is likely due to the larger population size and higher cardiovascular related healthcare costs.…”

Section: Discussionsupporting

confidence: 63%

“…At the time when the Aune et al [18,19] studies were published, there was no global definition of whole grain, and the weight of products was used to determine a serving of whole grains (e.g., one 30 g slice of wholemeal bread). In this analysis, 30 g of whole grain "product" was assumed to be equivalent to 16 g of whole grain "content", with three servings being in line with the recommended DTI of 48 g. This conversion was recommended by the recent work of Ross et al [21] and utilised in another analysis in the US by Murphy and Schmier [22].…”

Section: Step 2: Disease Risk Reduction (Estimates Of Reductions In Relative Risk Of T2dm and Cvd)mentioning

confidence: 99%

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Healthcare Cost Savings Associated with Increased Whole Grain Consumption among Australian Adults

Abdullah

Hughes²,

Grafenauer

2021

Nutrients

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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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Section: Discussionsupporting

confidence: 63%

Section: Step 2: Disease Risk Reduction (Estimates Of Reductions In Relative Risk Of T2dm and Cvd)mentioning

confidence: 99%

Healthcare Cost Savings Associated with Increased Whole Grain Consumption among Australian Adults

Abdullah

Hughes²,

Grafenauer

2021

Nutrients

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“…Third, our present study considers only a partial savings and QALY gain potential produced by increasing daily whole grain consumption, since there is well-established evidence for the benefits of whole grains, for example, in the prevention of cardiovascular diseases and various types of cancers [ 52 , 53 , 54 ]. For example, a recent study from the US showed substantial cardiovascular health care savings potential associated with increased whole grains consumption among the US adults [ 55 ]. However, since cardiovascular complications are common in the patients with T2D, the benefits obtained by reducing cardiovascular morbidity are partly considered also in the present study.…”

Section: Discussionmentioning

confidence: 99%

Type 2 Diabetes-Related Health Economic Impact Associated with Increased Whole Grains Consumption among Adults in Finland

et al. 2021

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The prevalence of type 2 diabetes (T2D) is increasing rapidly worldwide. A healthy diet supporting the control of energy intake and body weight has major importance in the prevention of T2D. For example, a high intake of whole grain foods (WGF) has been shown to be inversely associated with risk for T2D. The objective of the study was to estimate the expected health economic impacts of increased WGF consumption to decrease the incidence of T2D in the Finnish adult population. A health economic model utilizing data from multiple national databases and published scientific literature was constructed to estimate these population-level health economic consequences. Among the adult Finnish population, increased WGF consumption could reduce T2D-related costs between 286€ and 989€ million during the next 10-year time horizon depending on the applied scenario (i.e., a 10%-unit increase in a proportion of daily WGF users, an increased number (i.e., two or more) of WGF servings a day, or alternatively a combination of these scenarios). Over the next 20–30 years, a population-wide increase in WGF consumption could lead to much higher benefits. Furthermore, depending on the applied scenario, between 1323 and 154,094 quality-adjusted life years (QALYs) could be gained at the population level due to decreased T2D-related morbidity and mortality during the next 10 to 30 years. The results indicate that even when the current level of daily WGF consumption is already at a relatively high-level in a global context, increased WGF consumption could lead to important health gains and savings in the Finnish adult population.

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“…Another strategy to improve whole-grain intake is the inclusion of whole-grain foods in the basic food basket, and in already existing programmes, such as the National School Meal Program (Programa Nacional de Alimentação Escolar) and the Worker's Food Program (Programa de Alimantação do Trabalhador). Increased whole-grain consumption may result in health improvement resulting in reduced health system burden and concomitant healthcare cost savings, for that reason, strategies to tackle the problem should be urgently implemented (59,60) .…”

Section: Discussionmentioning

confidence: 99%

Opportunities for diet quality improvement: the potential role of staple grain foods

Fontanelli

Martínez-Arroyo

Sales

et al. 2021

Public Health Nutr.

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Objective: Given the high disease burden associated with the low intake of whole grains, modelling studies that estimate the impact of dietary strategies to increase more healthful grain foods consumption are essential to inform evidence-based and culturally-specific policies. This study investigated the potential nutritional impact of replacing staple grain foods with more healthful options. Design: Based on the 2015 Health Survey of São Paulo, a cross-sectional, population-based study, we modelled the substitution of white rice and white bread with brown rice and whole-wheat bread. Outcomes included changes in more healthful grain foods, energy, and nutrient intakes. Setting: Urban area of São Paulo, Brazil. Participants: Participants aged over 12 years who completed a semi-structured questionnaire and one 24-h recall (n=1741). Results: The substitution of all white rice and white bread with brown rice and whole-wheat bread, respectively, would result in more than 5% increases in zinc (+9.1%), calcium (+9.3%), vitamin E (+18.8%), dietary fibre (+27.0%), and magnesium (+52.9%) intake, while more than a 5% decrease would be seen for total carbohydrate (-6.1%), folate (-6.6%), available carbohydrate (-8.5%), iron (-8.6%), vitamin B6 (-12.5%), vitamin B2 (-17.4%), and vitamin B1 (-20.7%). A substantial increase in the amount of more healthful grain foods consumed would be seen (10g/d to 220g/d), or from 4% to 69% of total grain intake. Conclusions: Replacing white rice and white bread with their whole-grain versions has the potential to improve diet quality, suggesting they are prime targets for policy actions aiming at increasing intake of more healthful grain foods.

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Cardiovascular Healthcare Cost Savings Associated with Increased Whole Grains Consumption among Adults in the United States

Cited by 14 publications

References 17 publications

Healthcare Cost Savings Associated with Increased Whole Grain Consumption among Australian Adults

Healthcare Cost Savings Associated with Increased Whole Grain Consumption among Australian Adults

Type 2 Diabetes-Related Health Economic Impact Associated with Increased Whole Grains Consumption among Adults in Finland

Opportunities for diet quality improvement: the potential role of staple grain foods

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