The potential health and economic effects of plant-based food patterns in Belgium and the United Kingdom

Highlights

• Plant-based food patterns, such as a soy-containing diet and the Mediterranean diet, reduce the risk for non-communicable diseases such as type 2 diabetes mellitus, coronary heart disease, stroke, and certain cancers.

• If 10% of the total population commit to a high adherence of the Mediterranean diet, societal cost savings in Belgium and the United Kingdom over 20 y are estimated at €1.55 billion and £7.53 billion, respectively.

• If 10% of the total population commit to a high adherence of a soy-containing diet, societal cost savings in Belgium and the United Kingdom over 20 y are estimated at €1.90 billion and £10.91 billion, respectively.

Abstract

Objective

Policymakers increasingly require scientific evidence on both health and economic consequences of different nutritional patterns. The aim of this study was to assess health and economic effects of Mediterranean and soy-containing diets. Selected countries were Belgium and the United Kingdom.

Methods

Cost-effectiveness of these plant-based food patterns was assessed in comparison with a “conventional” diet using an age- and sex-dependent prediction model. The model allowed the prediction of health outcomes and related health care costs for the food patterns over 20 y. A societal perspective was applied for cost calculation and health outcomes were expressed in quality-adjusted life-years (QALYs).

Results

For Belgium, a soy-containing diet is estimated to lead to 202 QALYs and 107 QALYs per 1000 women and men, respectively, whereas societal savings of €2 146 000 and €1 653 000 are predicted. For the United Kingdom, a gain of 159 QALYs and 100 QALYs per 1000 women and men, respectively, is estimated, as are a prediction of savings of £1 580 000 and £1 606 000. For the Mediterranean diet in the corresponding estimates for Belgium are 184 QALYs and 148 QALYs per 1000 women and men, respectively, and savings of €1 618 000 and €1 595 000. For the United Kingdom, these are 122 QALYs and 110 QALYs per 1000 women and men, respectively, and savings of £1 155 000 and £1 046 000, respectively.

Conclusion

A wider implementation of plant-based eating would lead to large net economic gains for society and improved health outcomes for the population.

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.