scholarly journals Cardiovascular Healthcare Cost Savings Associated with Increased Whole Grains Consumption among Adults in the United States

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2323
Author(s):  
Mary M. Murphy ◽  
Jordana K. Schmier
Keyword(s):  
Health Economic ◽  
Direct Medical Cost ◽  
Healthcare Cost ◽  
Medical Cost ◽  
Cost Savings ◽  
The United States ◽  
Whole Grains ◽  
Dietary Guidelines ◽  
Potential Health ◽  
One Year

Little is known about the potential health economic impact of increasing the proportion of total grains consumed as whole grains to align with Dietary Guidelines for Americans (DGA) recommendations. Health economic analysis estimating difference in costs developed using (1) relative risk (RR) estimates between whole grains consumption and outcomes of cardiovascular disease (CVD) and a selected component (coronary heart disease, CHD); (2) estimates of total and whole grains consumption among US adults; and (3) annual direct and indirect medical costs associated with CVD. Using reported RR estimates and assuming a linear relationship, risk reductions per serving of whole grains were calculated and cost savings were estimated from proportional reductions by health outcome. With a 4% reduction in CVD incidence per serving and a daily increase of 2.24 oz-eq of whole grains, one-year direct medical cost savings were estimated at US$21.9 billion (B) (range, US$5.5B to US$38.4B). With this same increase in whole grains and a 5% reduction in CHD incidence per serving, one-year direct medical cost savings were estimated at US$14.0B (US$8.4B to US$22.4B). A modest increase in whole grains of 0.25 oz-eq per day was associated with one-year CVD-related savings of $2.4B (US$0.6B to US$4.3B) and CHD-related savings of US$1.6B (US$0.9B to US$2.5B). Increasing whole grains consumption among US adults to align more closely with DGA recommendations has the potential for substantial healthcare cost savings.

scholarly journals Healthcare Cost Savings Associated with Increased Whole Grain Consumption among Australian Adults

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1855
Author(s):  
Mohammad M. H. Abdullah ◽  
Jaimee Hughes ◽  
Sara Grafenauer
Keyword(s):  
Healthcare Cost ◽  
Adult Population ◽  
Productivity Loss ◽  
Cost Savings ◽  
Economic Benefits ◽  
Whole Grains ◽  
Dietary Guidelines ◽  
Whole Grain ◽  
Eating Pattern ◽  
Lost Productivity

Many dietary guidelines emphasise “mostly” whole grain food choices as part of an overall healthy eating pattern based on evidence for enhancing nutritional status and reducing chronic disease. Still, countries including Australia fall short of their consumption targets. Furthermore, healthcare cost savings associated with increasing the consumption of whole grains in alignment with the Daily Target Intake (DTI) recommendation of 48 g are unknown. The aim of this study was to assess the potential savings in costs of healthcare and lost productivity associated with a reduction in the incidence of Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease (CVD) through meeting the 48 g DTI recommendation for whole grains among the Australian adult population (>20 years). A three-step cost-of-illness analysis was conducted using input parameters from: 1) estimates of proportions of consumers (5%, 15%, 50%, and 100%) who would increase their current intake of whole grains to meet the recommended DTI in Australia; 2) relative reductions in risk of T2DM and CVD associated with specific whole grain consumption, as reported in meta-analysis studies; and 3) data on costs of healthcare and productivity loss based on monetary figures by national healthcare authorities. A very pessimistic (5% of the population) through to universal (100% of the population) adoption of the recommended DTI was shown to potentially yield AUD 37.5 (95% CI 22.3–49.3) to AUD 750.7 (95% CI 445.7–985.2) million, and AUD 35.9 (95% CI 8.3–60.7) to AUD 717.4 (95% CI 165.5–1214.1) million in savings on annual healthcare and lost productivity costs for T2DM and CVD, respectively. Given such economic benefits of the recommended consumption of whole grains, in exchange for refined grains, there is a real opportunity to facilitate relevant socioeconomic cost-savings for Australia and reductions in disease. These results are suggestive of a much greater opportunity to communicate the need for dietary change at all levels, but particularly through food-based dietary guidelines and front-of-pack labelling initiatives.

Abstract P285: Potential Direct Medical Cost-Savings Attributable to Physical Activity in Major Disease Categories

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Zachary Rourk ◽  
Ivo Abraham ◽  
Thomas Olson ◽  
Eric Snyder
Keyword(s):  
Physical Activity ◽  
Direct Medical Cost ◽  
Medical Cost ◽  
Population Attributable Risk ◽  
Cost Savings ◽  
Cost Effective ◽  
The United States ◽  
Medical Intervention ◽  
Physically Active ◽  
Meta Analyses

Introduction: Physical activity (PA) is known to be effective in treating and preventing many lifestyle diseases including CVD, stroke, depression, type II diabetes, Alzheimer’s disease, as well as breast and colon cancer. To date the direct medical cost-savings of PA as a medical intervention are poorly understood. Hypothesis: We hypothesized that a 10% increase in the proportion of US citizens who meet the minimum weekly exercise requirements of 150 minutes per week would lead to savings in direct medical costs (DMC) and cases prevented, as related to the above diseases. Methods: Population Attributable Risk (PAR) was calculated as PAR= (1+Prf x (RR-1))/(Prf x(RR-1)), where Prf is the percentage of the U.S. population not meeting minimum exercise requirements and RR is the relative risk of disease for sedentary versus physically active individuals. Prf and RR data were retrieved from the most recent and comprehensive meta-analyses and systematic reviews. PAR was calculated for each disease under two conditions; first, Prf was equal to the current percent (9.6%) of the population estimated to achieve the minimum weekly PA requirements. Second, Prf was equal to the initial Prf plus 10 percent (19.6%). For each condition the following were calculated: Attributable DMC=(PAR x DMC), preventable cases=(PAR x Prevalence) and Savings=(Condition 2- Condition 1). Results: The Prevalence, RR, PAR and DMC are provided in Table 1. This table also describes the potential savings in DMC and new cases by improving the Prf by 10%. A 10% increase in US citizens who meet the minimum weekly exercise requirements could lead to a total savings of 10.78 billion USD in DMC and 2.1 million cases prevented related to the studied diseases. Conclusion: A healthcare system directed PA intervention that effectively leads to a 10% increase in US citizens that meet minimum weekly exercise requirements and costs less than 10.78 billion dollars has the potential to be cost-effective, and prevent and treat, millions of cases in the United States.

scholarly journals Dietary intakes of whole grains, health benefits but do contaminants pose a major risk?

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Anne Nugent ◽  
Frank Thielecke
Keyword(s):  
Heavy Metals ◽  
Whole Grains ◽  
Dietary Guidelines ◽  
Food Storage ◽  
Dietary Intakes ◽  
Whole Grain ◽  
Food Category ◽  
Carbohydrate Source ◽  
Potential Health ◽  
The Impact

AbstractIntroductionThere is a long history of use for whole grain cereals as part of human dietary intakes with records of dietary grain consumption from the Middle Stone Ages. Whole grains are nutrient dense and research demonstrates that the healthiest diets (those associated with reduced risk of non-communicable diseases e.g. cardiovascular disease or cancer) are characterised by higher intake of fruit, vegetables, nuts and legumes and whole grains and lower intakes of red and processed meats. Currently, grains are a main energy and carbohydrate source and as such form a cornerstone of food based dietary guidelines and dietary guidance globally. However, grains also naturally contain contaminants and as a food category can represent a significant dietary source of foodborne contaminants.Materials and MethodsThe outcomes of a narrative review on the major contaminants present in whole grains, their potential health risks and suggested strategies to mitigate any risk are described. Contaminants are limited to mycotoxins (aflatoxinB1, ochratoxin A, Fumonisin B1, deoxynivalenol, zearalenone), heavy metals (e.g. arsenic, cadmium, lead) and the process contaminant acrylamide.ResultsWhole grains can contain more contaminants than refined versions e.g. whole grain rice with bran intact can have up to 80% more arsenic than white rice. However, whole grains also provide more nutrients which may mitigate against the impact of these contaminants. For example, for heavy metals, there is some evidence that dietary fibres (e.g. wheat bran) may bind to them and reduce their absorption, as can nutrients naturally found in whole grains e.g. zinc, magnesium or copper. Minerals such as iron, calcium, magnesium and zinc may also impede heavy metal absorption by down-regulating or competing for attachment to transporters that facilitate intestinal absorption. Although, strict regulatory thresholds and monitoring processes by competent authorities minimise any risk to public health, the consumer may further lessen any risk through their own dietary choices and food storage and preparation practicesDiscussionThere are a number of potential health-protective properties inherent to whole grains. Given that complete elimination of contaminants from grains is unlikely to be achieved, their presence merits continued monitoring with evidence to date suggesting any such risk does not outweigh the known benefits of wholegrain consumption.

Abstract 16853: Dietary Improvements and the Preventable Cost of Cardiovascular Disease: Evidence From the Literature

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Donglan Zhang ◽  
Mary E Cogswell ◽  
Guijing Wang
Keyword(s):  
United States ◽  
Healthcare Cost ◽  
Healthcare Costs ◽  
Fruits And Vegetables ◽  
Sodium Intake ◽  
Saturated Fat ◽  
Cost Savings ◽  
The United States ◽  
Dietary Component ◽  
Dietary Components

Introduction: Cardiovascular diseases (CVD) risk has been linked to dietary components in many studies, but the associated reduction in CVD healthcare costs with dietary improvements has not been systematically evaluated. Hypothesis: CVD healthcare cost savings associated with an improvement in dietary metrics are substantial. Methods: We searched PubMed, Embase, CINAHL and ABI/Inform to identify population-based studies published between January 1990 and December 2014 on CVD healthcare costs related to a dietary component. The selected dietary components, in accordance with those identified by the American Heart Association in their 2010 Strategic Impact goals, included salt/sodium, sugar-sweetened beverages, fruits and vegetables, fish/omega-3 fatty acids, whole grains/fiber. Other selected dietary components, based on AHA’s secondary dietary metrics, were nuts, processed meat and saturated fat. For each dietary component, we evaluated the CVD healthcare cost savings if the current consumption level were to be changed. Results: In 329 articles obtained, 15 studies evaluated the healthcare costs associated with one or more of dietary components: salt/sodium (n=12); fruit and vegetables (n=1); meat (n=1); saturated fat (n=3). The majority of studies (n=11) used an incidence-based approach, and the remaining were prevalence-based analyses. Adjusting the costs to 2013 US dollar values using consumer price index and purchasing power parity exchange rate, reducing average sodium intake by 1.2 g/day could save $1794 per person per year in the United Kingdom. Reducing individual sodium intake to 2.3 g/day could save $1955 per person in the United States. Increasing consumption of fruits and vegetables from <0.5 cup / day to more than 1.5 cups / day could save $1481 per person in the United States. Conclusions: In conclusion, reducing sodium intake and increasing consumption of fruits and vegetables could substantially reduce CVD costs. Few studies were available on the cost savings associated with dietary components for cardiovascular health. These results suggest a need for economic studies using high-quality cost information and the most recent evidence to predict long-term cost savings.

Health Impact and Cost-Effectiveness of Achieving the National Salt and Sugar Reduction Initiative Voluntary Sugar Reduction Targets in the United States: A Micro-Simulation Study

Circulation ◽  
2021 ◽  
Author(s):  
Siyi Shangguan ◽  
Dariush Mozaffarian ◽  
Stephen Sy ◽  
Yujin Lee ◽  
Junxiu Liu ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Savings ◽  
Cost Effective ◽  
The United States ◽  
Sensitivity Analyses ◽  
Potential Health ◽  
Added Sugar ◽  
Health Gains ◽  
Life Years ◽  
Sugar Reduction

Background: High intake of added sugar is linked to weight gain and cardiometabolic risk. In 2018, the US National Salt and Sugar Reduction Initiative (NSSRI) proposed government supported voluntary national sugar reduction targets. This intervention's potential health and equity impacts, and cost-effectiveness are unclear. Methods: A validated microsimulation model, CVD-PREDICT, coded in C++, was used to estimate incremental changes in type 2 diabetes, cardiovascular disease (CVD), quality-adjusted life-years (QALYs), costs and cost-effectiveness of the NSSRI policy. The model was run at the individual-level, incorporating the annual probability of each person's transition between health status based on their risk factors. The model incorporated national demographic and dietary data from the National Health and Nutrition Examination Survey across 3 cycles (2011-2016), added sugar-related diseases from meta-analyses, and policy costs and health-related costs from established sources. A simulated nationally representative US population was created and followed until age 100 years or death, with 2019 as the year of intervention start. Findings were evaluated over 10 years and a lifetime from healthcare and societal perspectives. Uncertainty was evaluated in a one-way analysis by assuming 50% industry compliance, and probabilistic sensitivity analyses via a second-order Monte Carlo approach. Model outputs included averted diabetes cases, CVD events and CVD deaths, QALYs gained, and formal healthcare cost savings, stratified by age, race, income and education. Results: Achieving the NSSRI sugar reduction targets could prevent 2.48 million CVD events, 0.49 million CVD deaths, and 0.75 million diabetes cases; gain 6.67 million QALYs; and save $160.88 billion net costs from a societal perspective over a lifetime. The policy became cost-effective (<150K/QALYs) at 6 years, highly cost-effective (< 50K/QALYs) at 7 years, and cost-saving at 9 years. Results were robust from a healthcare perspective, with lower (50%) industry compliance, and in probabilistic sensitivity analyses. The policy could also reduce disparities, with greatest estimated health gains per million adults among Black and Hispanic, lower income, and less educated Americans. Conclusions: Implementing and achieving the NSSRI sugar reformation targets could generate substantial health gains, equity gains and cost-savings.

scholarly journals Association between plant-based diets and blood pressure in the INTERMAP study

2020 ◽  
pp. bmjnph-2020-000077
Author(s):  
Ghadeer Aljuraiban ◽  
Queenie Chan ◽  
Rachel Gibson ◽  
Jeremiah Stamler ◽  
Martha L Daviglus ◽  
...  
Keyword(s):  
Blood Pressure ◽  
International Study ◽  
The United States ◽  
Whole Grains ◽  
Dietary Guidelines ◽  
Sugar Sweetened Beverages ◽  
Cross Sectional ◽  
Refined Grains ◽  
Sweetened Beverages ◽  
Registration Number

BackgroundPlant-based diets are associated with a lower risk of cardiovascular diseases; however, little is known how the healthiness of the diet may be associated with blood pressure (BP). We aimed to modify three plant -based diet indices: overall plant-based diet index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI) according to country-specific dietary guidelines to enable use across populations with diverse dietary patterns – and assessed their associations with BP.DesignWe used cross-sectional data including 4,680 men and women ages 40–59y in Japan, China, the United Kingdom, and the United States from the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP). During four visits, eight BP measurements, and four 24-h dietary recalls were collected. Multivariable regression coefficients were estimated, pooled, weighted, and adjusted extensively for lifestyle/dietary confounders.ResultsModified PDI was not associated with BP. Consumption of hPDI higher by 1SD was inversely associated with systolic (-0.82 mm Hg;95% CI:-1.32,-0.49) and diastolic BP (-0.49 mm Hg; 95% CI:-0.91, -0.28). In contrast, consumption of an uPDI was directly associated with systolic (0.77 mm Hg;95% CI:0.30,1.20). Significant associations between hPDI with BP were attenuated with separate adjustment for vegetables and whole grains; associations between uPDI and BP were attenuated after adjustment for refined grains, sugar-sweetened beverages, and meat.ConclusionAn hPDI is associated with lower BP while a uPDI is adversely related to BP. Plant-based diets rich in vegetables and whole grains and limited in refined grains, sugar-sweetened beverages, and total meat may contribute to these associations. In addition to current guidelines, the nutritional quality of consumed plant foods is as important as limiting animal-based components.Trial registration numberThe observational INTERMAP study was registered at www.clinicaltrials.gov as NCT00005271.

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