Coronary heart disease and stroke disease burden attributable to fruit and vegetable intake in Japan: projected DALYS to 2060

Abstract

Background Fruit and vegetable consumption was considered a protective effect against cardiovascular and cerebrovascular diseases (CVDs). This study aimed to project the reduction in the CVD burden under different scenarios of increased fruit and vegetable intake in Japan by 2060. Methods Population attributable fractions (PAF) were calculated by gender and age in 2015. The projection considered five scenarios for 2015, 2030, 2045, and 2060: 1) a baseline of no changes in intake; 2) a moderate increase in fruit intake (extra 50 g/day or 1/2 serving); 3) an high increase in fruit intake (extra 100 g/day or 1 serving); 4) a moderate increase in vegetable intake (extra 70 g/day or 1 serving); and 5) an high increase in vegetable intake (extra 140 g/day or 2 servings). Potentially preventable disability-adjusted life years (DALYs) for CVDs were estimated for each scenario. Monte Carlo simulations were performed to calculate the 95% confidence intervals of the estimates. Results Across all age groups, men had a higher daily vegetable intake than women (292.7 g/d > 279.3 g/d) but a lower daily fruit intake (99.3 g/d < 121.0 g/d). Comparing with recommended intake level (350 g/d of vegetable and 200 g/d of fruit), the total CVD burden was estimated to be 302,055 DALYs attributable to inadequate fruit consumption in 2015, which accounted for 12.6% of the total CVD burden (vegetable: 202,651 DALYs; 8.5%). In 2060, the percentage of the CVD burden due to insufficient intake of fruit is estimated to decrease to 7.9% under the moderate increase scenario and to decrease to 4.5% under the high increase scenario (vegetable: 5.4%; 2.4%). Conclusions The study suggested that a relevantly large percentage of the CVD burden can be alleviated by promoting even modest increases in fruit and vegetable consumption in Japan. Electronic supplementary material The online version of this article (10.1186/s12889-019-7047-z) contains supplementary material, which is available to authorized users.

Projections of disability-adjusted life years for major diseases due to a change in vegetable intake in 2017–2040 in Japan

“…In accordance with previous studies, our study showed the benefits against CVDs by increased vegetable intake among younger female (20–49 years) and 50–69 years old age group [ 20 , 21 ]. Various nutrients in vegetables also demonstrate to protect against CVDs through a variety of mechanisms; a decrease of atherosclerosis in the blood vessel and blood pressure, and a lowering of the risk of oxidative damage [ 22 ].…”

Reduced burden from major diseases due to an increase in vegetable intake in Japan: projections of disability-adjusted life years, 2017-2040

“…In accordance with previous studies, our study showed the benefits against CVDs by increased vegetable intake among younger female (20-49 years) and 50-69 year old age group (21,22). Various nutrients in vegetables also demonstrate to protect against CVDs through a variety of mechanisms; a decrease of atherosclerosis in the blood vessel and blood pressure, and a lowering of the risk of oxidative damage (23).…”

“…49 years) and 50-69 year old age group(21,22). Various nutrients in vegetables also demonstrate to protect against CVDs through a variety of mechanisms; a decrease of atherosclerosis in the blood vessel and blood pressure, and a lowering of the risk of oxidative damage(23).…”

Prediction of disability-adjusted life years for diseases due to low fruit intake in 2017–2040 in Japan

“…The national health promotion policy guideline 'Health Japan 21 (second phase)', which was established in 2012 to improve lifestyle and extend healthy life expectancy, has set a target of having <30 % of the population consuming <100 g of fruit/d (7) . However, even among those who consumed the most fruit, identified as those in their 70s, only 32 % met the recommended level (6) . This target, defined on the population level, is not comparable with the individual-level goal defined in the World Health Organisation (WHO)'s guideline that recommends eating at least 400 g of fruit and vegetables per day (excluding potatoes and other starchy tubers) (8) .…”

“…Since then, the intake has been declining and, for the first time in the past 40 years, has dropped below 100 g to reach 98•9 g in 2016 (5) . In Japan, fruit intake increased with age, and women consumed more fruit than men in all 10-year-old age groups in 2015 (6) . The national health promotion policy guideline 'Health Japan 21 (second phase)', which was established in 2012 to improve lifestyle and extend healthy life expectancy, has set a target of having <30 % of the population consuming <100 g of fruit/d (7) .…”