Cost-Effectiveness of Interventions to Promote Fruit and Vegetable Consumption

Abstract

BackgroundFruits and vegetables are an essential part of the human diet, but many people do not consume the recommended serves to prevent cardiovascular disease and cancer. In this research, we evaluate the cost-effectiveness of interventions to promote fruit and vegetable consumption to determine which interventions are good value for money, and by how much current strategies can reduce the population disease burden.Methods/Principal FindingsIn a review of published literature, we identified 23 interventions for promoting fruit and vegetable intake in the healthy adult population that have sufficient evidence for cost-effectiveness analysis. For each intervention, we model the health impacts in disability-adjusted life years (DALYs), the costs of intervention and the potential cost-savings from averting disease treatment, to determine cost-effectiveness of each intervention over the lifetime of the population, from an Australian health sector perspective. Interventions that rely on dietary counselling, telephone contact, worksite promotion or other methods to encourage change in dietary behaviour are not highly effective or cost-effective. Only five out of 23 interventions are less than an A$50,000 per disability-adjusted life year cost-effectiveness threshold, and even the most effective intervention can avert only 5% of the disease burden attributed to insufficient fruit and vegetable intake.Conclusions/SignificanceWe recommend more investment in evaluating interventions that address the whole population, such as changing policies influencing price or availability of fruits and vegetables, to see if these approaches can provide more effective and cost-effective incentives for improving fruit and vegetable intake.

The role of emotional states in fruit and vegetable consumption in Brazilian adults

“…In addition, health professionals should take into account emotional states in designing and implementing programs targeting healthy eating. To sum up, although our results suggest that mental health may play an important role in adequate FV consumption, especially among women, other aspects such as reducing production and consumer costs of FVL for the whole population are essential to shape eating habits of the whole population 44 .…”

The economic feasibility of price discounts to improve diet in Australian Aboriginal remote communities

“…A number of Australian studies suggest that price incentives and health education can be cost-effective strategies for improving health in Australia, [12][13][14] but we have little understanding of their potential health benefit or cost-effectiveness when delivered to Aboriginal and Torres Strait Islander remote communities.…”

Evaluación de las actividades de promoción de consumo de frutas y verduras en 8 países miembros de la Alianza Global de Promoción al Consumo de Frutas y Hortalizas “5 al día” – AIAM5

“…35 identificaron 23 intervenciones para la promoción y la ingesta de frutas y verduras en población adulta sana, modelando los impactos en la salud como años de vida perdidos ajustados por discapacidad (disabilityadjusted life years -DALYs) los costos de la intervención, y los potenciales ahorros al evitar el tratamiento de la enfermedad. Los autores encontraron que las intervenciones que se basan en el asesoramiento dietético, contactos telefónicos, promoción en el lugar de trabajo u otros métodos para fomentar cambios en la conducta alimentaria no son muy eficaces o rentables.…”

“…35,38 , que analizan el costo-efectividad de las políticas públicas para aumentar el consumo de frutas y verduras en poblaciones de bajos ingresos, encontrando que las campañas informativas pueden ser las más costoefectivas. Igualmente, la evaluación descrita por Stables y Cols.…”