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The economic burden of inadequate consumption of vegetables and fruit in Canada

  • John Paul Ekwaru (a1), Arto Ohinmaa (a1), Sarah Loehr (a1), Solmaz Setayeshgar (a1), Nguyen Xuan Thanh (a2) and Paul J Veugelers (a1)...
Abstract
Objective

Public health decision makers not only consider health benefits but also economic implications when articulating and issuing lifestyle recommendations. Whereas various estimates exist for the economic burden of physical inactivity, excess body weight and smoking, estimates of the economic burden associated with our diet are rare. In the present study, we estimated the economic burden attributable to the inadequate consumption of vegetables and fruit in Canada.

Design

We accessed the Canadian Community Health Survey to assess the inadequacy in the consumption of vegetables and fruit and published meta-analyses to assemble risk estimates for chronic diseases. Based on these inadequacy and risk estimates, we calculated the population-attributable fraction and avoidable direct and indirect costs to society. Direct costs include those for hospital care, physician services and drugs in 2015.

Results

About 80 % of women and 89 % of men consume inadequate amounts of vegetables and fruit. We estimated this to result in an economic burden of $CAN 3·3 billion per year, of which 30·5 % is direct health-care costs and 69·5 % is indirect costs due to productivity losses. A modest 1 percentage point annual reduction in the prevalence of inadequate vegetables and fruit consumption over the next 20 years would avoid approximately $CAN 10·8 billion, and an increase of one serving of vegetables and fruit per day would avoid approximately $CAN 9·2 billion.

Conclusions

Further investments in the promotion of vegetables and fruit will prevent chronic disease and substantially reduce direct and indirect health-care costs.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
* Corresponding author: Email arto.ohinmaa@ualberta.ca
References
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1. World Health Organization (2005) Preventing chronic diseases: a vital investment. http://www.who.int/chp/chronic_disease_report/en/ (accessed April 2015).
2. World Health Organization (2005) Facing the facts: the impact of chronic disease in Canada. http://www.who.int/chp/chronic_disease_report/media/CANADA.pdf (accessed April 2015).
3. Mirolla, M (2004) The Cost of Chronic Disease in Canada. The Chronic Disease Prevention Alliance of Canada; available at http://www.gpiatlantic.org/pdf/health/chroniccanada.pdf
4. Ezzati, M, Lopez, AD, Rodgers, A et al. (editors) (2004) Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors, vol. 1. Geneva: WHO.
5. Black, JL & Billette, J-M (2013) Do Canadians meet Canada’s Food Guide’s recommendations for fruits and vegetables? Appl Physiol Nutr Metab 38, 234242.
6. Colley, RC, Garriguet, D, Janssen, I et al. (2011) Physical activity of Canadian adults: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey. Health Rep 22, 714.
7. Statistics Canada (2015) Body composition of adults, 2012 to 2013. Health Fact Sheet 82-625-X. http://www.statcan.gc.ca/pub/82-625-x/2014001/article/14104-eng.htm (accessed March 2016).
8. Krueger, H, Turner, D, Krueger, J et al. (2014) The economic benefits of risk factor reduction in Canada: tobacco smoking, excess weight and physical inactivity. Can J Public Health 105, e69e78.
9. Anis, AH, Zhang, W, Bansback, N et al. (2010) Obesity and overweight in Canada: an updated cost-of-illness study. Obes Rev 11, 3140.
10. Birmingham, CL, Muller, JL, Palepu, A et al. (1999) The cost of obesity in Canada. CMAJ 160, 483488.
11. Finkelstein, MM (2001) Obesity, cigarette smoking and the cost of physicians’ services in Ontario. Can J Public Health 92, 437440.
12. Katzmarzyk, PT & Janssen, I (2004) The economic costs associated with physical inactivity and obesity in Canada: an update. Can J Appl Physiol 29, 90115.
13. Moffatt, E, Shack, LG, Petz, GJ et al. (2011) The cost of obesity and overweight in 2005: a case study of Alberta, Canada. Can J Public Health 102, 144148.
14. Kuhle, S, Kirk, S, Ohinmaa, A et al. (2011) Use and cost of health services among overweight and obese Canadian children. Int J Pediatr Obes 6, 142148.
15. Cadilhac, DA, Magnus, A, Sheppard, L et al. (2011) The societal benefits of reducing six behavioural risk factors: an economic modelling study from Australia. BMC Public Health 11, 483.
16. Scarborough, P, Bhatnagar, P, Wickramasinghe, KK et al. (2011) The economic burden of ill health due to diet, physical inactivity, smoking, alcohol and obesity in the UK: an update to 2006–07 NHS costs. J Public Health (Oxf) 33, 527535.
17. Krueger, H, Krueger, J & Koot, J (2015) Variation across Canada in the economic burden attributable to excess weight, tobacco smoking and physical inactivity. Can J Public Health 106, e171e177.
18. Krueger, H, Williams, D, Ready, AE et al. (2013) Improved estimation of the health and economic burden of chronic disease risk factors in Manitoba. Chronic Dis Inj Can 33, 236246.
19. Statistics Canada (2014) Canadian Community Health Survey – Annual Component (CCHS). http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=3226 (accessed March 2016).
20. World Cancer Research Fund/American Institute for Cancer Research (2007) Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective. Washington, DC: American Institute for Cancer Research.
21. Li, M, Fan, Y, Zhang, X et al. (2014) Fruit and vegetable intake and risk of type 2 diabetes mellitus: meta-analysis of prospective cohort studies. BMJ Open 4, e005497.
22. Vieira, AR, Abar, L, Vingeliene, S et al. (2016) Fruits, vegetables and lung cancer risk: a systematic review and meta-analysis. Ann Oncol 27, 8196.
23. Aune, D, Chan, DS, Vieira, AR et al. (2012) Fruits, vegetables and breast cancer risk: a systematic review and meta-analysis of prospective studies. Breast Cancer Res Treat 134, 479493.
24. Vieira, AR, Vingeliene, S, Chan, DS et al. (2015) Fruits, vegetables, and bladder cancer risk: a systematic review and meta-analysis. Cancer Med 4, 136146.
25. World Cancer Research Fund/American Institute for Cancer Research (2010) WCRF/AICR Systematic Literature Review Continuous Update Project Report. The Associations between Food, Nutrition and Physical Activity and the Risk of Colorectal Cancer. http://www.wcrf.org/sites/default/files/SLR_colorectal_cancer_2010.pdf (accessed October 2016).
26. Murray, CJ, Ezzati, M, Lopez, AD et al. (2003) Comparative quantification of health risks conceptual framework and methodological issues. Popul Health Metr 1, 1.
27. Public Health Agency of Canada (2015) Economic Burden of Illness in Canada (EBIC) online tool. http://ebic-femc.phac-aspc.gc.ca/index.php (accessed October 2016).
28. Johnson, JA, Pohar, SL & Majumdar, SR (2006) Health care use and costs in the decade after identification of type 1 and type 2 diabetes: a population-based study. Diabetes Care 29, 24032408.
29. Canadian Institute for Health Information (2015) National Health Expenditure Trends, 1975 to 2015. Ottawa, ON: Canadian Institute for Health Information.
30. Health Canada (2002) Economic Burden of Illness in Canada, 1998. Ottawa, ON: Health Canada.
31. Statistics Canada (2014) CANSIM Table 052-0005 – Projected population, by projection scenario, age and sex, as of July 1, Canada, provinces and territories. http://www5.statcan.gc.ca/cansim/a26?lang=eng&id=520005 (accessed October 2016).
32. Health Canada (2007) Canada’s Food Guide. http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/basics-base/quantit-eng.php (accessed March 2016).
33. World Health Organization (2003) Population nutrient intake goals for preventing diet-related chronic diseases. In Diet, Nutrition and the Prevention of Chronic Diseases. Report of a Joint WHO/FAO Expert Consultation. WHO Technical Report Series no. 916. http://www.fao.org/docrep/005/AC911E/ac911e07.htm#bm07.1.2 (accessed October 2016).
34. Key, TJ (2011) Fruit and vegetables and cancer risk. Br J Cancer 104, 611.
35. Manitoba Association for Home Economics (2016) The Cost of Eating Fruits and Vegetables. http://www.homefamily.net/the-cost-of-eating-fruits-and-vegetables/ (accessed April 2016).
36. Joshipura, KJ, Ascherio, A, Manson, JE et al. (1999) Fruit and vegetable intake in relation to risk of ischemic stroke. JAMA 282, 12331239.
37. Hu, FB (2003) Plant-based foods and prevention of cardiovascular disease: an overview. Am J Clin Nutr 78, 3 Suppl., 544S551S.
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Public Health Nutrition
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