Hostname: page-component-848d4c4894-tn8tq Total loading time: 0 Render date: 2024-06-23T11:07:04.507Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  16 October 2007

Jens Gundgaard ,
Jørgen Nørskov Nielsen ,
Jens Olsen  and
Jan Sørensen
Jens Gundgaard*
Affiliation:
Centre for Applied Health Services Research and Technology Assessment (CAST), University of Southern Denmark, Winsløwparken 19, 3, DK-5000 Odense C, Denmark
Jørgen Nørskov Nielsen
Affiliation:
Centre for Applied Health Services Research and Technology Assessment (CAST), University of Southern Denmark, Winsløwparken 19, 3, DK-5000 Odense C, Denmark
Jens Olsen
Affiliation:
Centre for Applied Health Services Research and Technology Assessment (CAST), University of Southern Denmark, Winsløwparken 19, 3, DK-5000 Odense C, Denmark
Jan Sørensen
Affiliation:
Centre for Applied Health Services Research and Technology Assessment (CAST), University of Southern Denmark, Winsløwparken 19, 3, DK-5000 Odense C, Denmark
*
*Corresponding author: Email jgu@cast.sdu.dk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
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 250g for the general Danish population. Simulated intakes of 400g and 500g 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.

Keywords

FruitVegetablesCancerHealthcareCosts
Type
Research Article
Information
Public Health Nutrition , Volume 6 , Issue 1 , February 2003 , pp. 25 - 30
Copyright
Copyright © CABI Publishing 2003

References

1Doll, R, Peto, R. The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. J. Natl. Cancer Inst. 1981; 66: 1191–308CrossRefGoogle ScholarPubMed
2van't Veer, P, Jansen, MCJF, Klerk, M, Kok, FJ. Fruits and vegetables in the prevention of cancer and cardiovascular disease. Public Health Nutr. 2000; 3: 103–7.CrossRefGoogle ScholarPubMed
3 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR). Food, Nutrition and the Prevention of Cancer: a Global Perspective. Washington, DC: World Cancer Research Fund/American Institute for Cancer Research, 1997.Google Scholar
4 Statens Ernæringsråd. Kostnad-nytte vurderinger av tiltak for å øke forbruket av frukt og grønnsaker, for å redusere forekomsten av kreft [Cost-effectiveness Evaluations of Initiatives to Increase the Consumption of Fruit and Vegetables to Reduce Cancer Incidence]. Report No. 4/98. Oslo: Statens Ernæringsråd, 1998.Google Scholar
5Trolle, E, Fagt, S, Ovesen, L. Frugt og grøntsager – anbefalinger for indtagelse [Fruit and Vegetables – Recommendations for Intake]. Veterinær- og Fødevaredirektoratet. Copenhagen, Denmark: Statens Publikationer, 1998.Google Scholar
6Bonneux, L, Barendregt, JJ, Nusselder, WJ, Van der Maas, PJ. Preventing fatal diseases increases healthcare costs: cause elimination life table approach. Br. Med. J. 1998; 316: 26–9.CrossRefGoogle ScholarPubMed
7Nusselder, WJ, van der Velden, K, van Sonsbeek, JLA, Lenior, ME, van den Bos, GAM. The elimination of selected chronic diseases in a population: the compression and expansion of morbidity. Am. J. Public Health 1999; 86: 187–94.CrossRefGoogle Scholar
8 Statistics Denmark. Befolkningens bevægelser [Vital Statistics]. Copenhagen: Statistics Denmark, 1998.Google Scholar
9Breslow, RA, Graubard, BI, Sinha, R, Subar, AF. Diet and lung cancer mortality: a 1987 national health interview survey cohort study. Cancer Causes Control. 2000; 11: 419–31.CrossRefGoogle ScholarPubMed
10Feskanich, D, Ziegler, RG, Michaud, DS, Giovanucci, EL, Speizer, FE, Willet, WC, Colditz, GA. Prospective study of fruit and vegetable consumption and risk of lung cancer among men and women. J. Natl. Cancer Inst. 2000; 92: 1812–23.CrossRefGoogle ScholarPubMed
11Voorrips, LE, Goldbohm, RA, van Poppel, G, Sturmans, F, Hermus, RJJ, van den Brandt, PA. Vegetable and fruit consumption and risks of colon and rectal cancer in a prospective cohort study. Am. J. Epidemiol. 2000; 152: 1081–92.CrossRefGoogle ScholarPubMed
12Drummond, MF, O'Brien, B, Stoddard, GL, Torrance, GW. Methods for the Economic Evaluation of Health Care Programmes, 2nd ed. Oxford: Oxford Medical Publications, 1997.Google Scholar
13Meltzer, D. Accounting for future costs in medical cost-effectiveness analysis. J. Health Econ. 1997; 16: 31–64.CrossRefGoogle ScholarPubMed