Applied nutritional investigationThe potential health and economic effects of plant-based food patterns in Belgium and the United Kingdom
Introduction
Nutritional patterns and their relation to general health and well-being are receiving attention worldwide. Unhealthy food habits and insufficient physical activity are recognized as leading risk factors for the development of non-communicable diseases (NCDs) and their associated comorbidities [1], [2]. NCDs are the largest contributors to premature death caused by cardiovascular disease (CVD) and cancer in Europe [3], [4]. Moreover, these NCDs are associated with large health care expenditures, loss of productivity, and other societal costs [5].
The importance of healthy nutrition patterns is an increasing global concern [6]. In Europe, >50% of the population is overweight (according to country estimates of the World Health Organization European Region for 2008) [7] and ~23% of women and 20% of men are obese [8]. Therefore, several nutritional guidelines were developed to obtain or maintain a healthy lifestyle. A consumption of at least five portions (equivalent to 400 g) of fruit and vegetables is recommended for the adult population on a daily basis [9], [10]. However, only 12% of European adults are able to achieve this goal [11].
In this study, we chose to focus on the Mediterranean diet and a soy-containing diet, two examples of healthy, balanced, plant-based food pattern. A soy-containing diet is rich in soy protein, which can be consumed as soybeans, tofu, miso, soy drinks, soy yogurt, and so on. It is known to protect against obesity, coronary heart disease (CHD), stroke, type 2 diabetes mellitus (T2DM), and breast, colon, stomach, lung, and prostate cancers [12], [13], [14], [15], [16], [17], [18], [19], [20], [21]. The Mediterranean diet is defined by a large amount of fruit, vegetables, whole grains, nuts, seeds, high amounts of olive oil, a moderate to high consumption of fish and other seafood, and a low intake of meat and dairy products [22]. Previous studies have shown that the Mediterranean diet is able to reduce the risk for developing CHD, stroke, T2DM, and breast cancer [23], [24], [25], [26], [27], [28].
The aim of this study was to assess the health and economic consequences of a soy-containing diet and the Mediterranean diet from the societal perspective in Belgium and the United Kingdom.
Section snippets
Decision model
For the purpose of this economic evaluation, a modeling approach was applied, as is typical for this type of research question [29]. An age- and sex-dependent epidemiologic prediction model was built to predict health outcomes and related health care costs associated with a soy-containing diet and the Mediterranean diet over a 20-y period. A societal perspective was taken for the calculation of costs. The health outcomes were expressed as quality-adjusted life-years (QALYs), the most common
Soy-containing diet
In Belgium, the estimated prevalence of cancer decreases by 1.57% in women and 1.45% in men who consume a soy-containing diet compared with a “non-soy” diet. For stroke, the prevalence numbers decrease by 0.93% and 0.24% in women and men, respectively. The reduction of the estimated prevalence of CHD is less explicit (−0.01% in women and −0.03% in men). These estimated prevalence reductions are similar in the United Kingdom.
In Belgium, a soy-containing diet is estimated to lead to 202 QALYs and
Discussion
The aim of the present study was to estimate the health and economic effects of two plant-based food patterns, a soy-containing diet and the Mediterranean diet. By means of a health economic model, estimates about the societal savings and health benefits of the two diets were provided. For both food patterns, we applied clinical inputs comparing the highest and lowest levels of adherence. The lowest level, for both food patterns, corresponded to no or almost no adherence. The highest levels of
Conclusion
The result of the present analysis suggests that both a soy-containing diet and the Mediterranean diet could contribute to health promotion because they are predicted to lead to substantial health benefits and societal savings. However, these results must be interpreted with caution because no intervention costs were taken into account and, regarding a soy-containing diet, the effect on health outcomes was mostly based on Asian studies. Therefore, further studies are required to establish more
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This study was funded by the ALPRO Foundation.