Increased intake of fruit and vegetables: estimation of impact in terms of life expectancy and healthcare costs†

Abstract

Objectives: There is strong evidence that a high consumption of fruit and vegetables reduces the risk of developing many cancers. This study examined the economic consequences for the healthcare sector if people followed the recommendations and increased their intake of fruit and vegetables. Design: A life table was used to describe a base case population with respect to life expectancy, cancer incidence and healthcare costs. Relative risks of cancer for a high versus a low intake of fruit and vegetables were obtained from the literature and were used to simulate populations with a higher intake of fruit and vegetables. The empirical data consist of a 20% sample of the Danish population that was followed from 1993 to 1997. Civil registration numbers were used to link various computerised registers, in order to describe each individual in the sample in terms of morbidity, mortality and healthcare costs. Results: The average daily intake of fruit and vegetables was assumed to be approximately 250 g for the general Danish population. Simulated intakes of 400 g and 500 g increased the life expectancy by 0.8 and 1.3 years, respectively. In addition, it was estimated that 19% and 32% of the cancer incidence could be prevented. The aggregate healthcare costs remained stable, as the resources saved due to a lower cancer incidence were offset by healthcare costs imposed by the fact that healthy people live longer and require more healthcare. However, the variations across age groups and health sectors were substantial. Discussion: The study adopted a healthcare sector perspective. Only costs from hospitalisation and primary care were included in the calculations. The costs of changing people's dietary habits, i.e. education, information and promotion as well as other costs that would be relevant from a societal perspective, have not been taken into account. Furthermore, the transition from one level of intake to another is not the focus of the analysis, although it might take decades to observe the full effect of the dietary changes. Conclusion: Empirical evidence suggests that a considerable fraction of all cancer incidences can be prevented by a higher intake of fruit and vegetables. That may result in improved public health (gain in life years) at no additional cost to the healthcare sector.

Dietary intake and development of a quantitative FFQ for a nutritional intervention to reduce the risk of chronic disease in the Navajo Nation

“…Given that the limited resources of IHS are used mostly for treatment and that treatment costs are high, a far more cost-effective strategy would be to focus efforts on nutritional intervention programmes for prevention of obesity, diabetes and chronic diseases in this high-risk population. Substantial evidence suggests that improving diet and nutrition could reduce the risk of diabetes, cancer and CVD, which would result in decreasing the incidence, mortality and economic cost of these chronic diseases (11)(12)(13)(14)(15)(16)(17)(18) . The Navajo Healthy Store (NHS) intervention programme was designed to improve dietary quality and reduce risk for obesity by increasing the availability, purchase and consumption of healthy foods for the Navajo Nation.…”

Register-based studies of healthcare costs

“…Firstly, the universal use of the unique personal identification number, rendering register linkages straightforward and easy, allow us to follow individuals and their healthcare use over time and between institutions; as well as linking these data with other data of relevance for a specific study like income or geographical area of residence. The majority of the assessed studies have selected a group of individuals in a cohort [7,8,10], a patient register [3,13], or from a randomised study [4À6], and subsequently identified these in the national registers by means of register linkages.…”

“…In an economic evaluation of the beneficial effect of fruit and vegetables consumption on cancer incidence [3], Gundgaard et al used the Danish National Patient Register and the Danish National Health Service Register to compute the attributable costs of cancer incidence, by comparing healthcare costs for cancer patients to healthcare costs for people that were not cancer patients. The authors used the Danish Cancer Registry for identification of cancer patients.…”

Efecto de la cocción sobre la capacidad antioxidante y calidad sensorial de la coliflor mínimamente procesada

“…Several epidemiological studies have indicated that a high intake of plant products is associated with a reduced risk of some chronic diseases, such as atherosclerosis and cancer (Gosslau and Chen 2004, Gundgaard et al 2003, Linnewiel et al 2015. These beneficial effects have been partly attributed to compounds with antioxidant activity.…”