Abstract
Objective Nutritional patterns and their relation to general health are receiving broad attention worldwide. Policymakers increasingly require scientific evidence on both the health and economic consequences of different nutritional patterns. The purpose of this study is to assess the health and economic effects of a Mediterranean diet and soy containing diet. Selected countries were Belgium and the UK. Methods The cost-effectiveness of these plant-based food patterns was assessed in comparison with a u2018conventionalu2019 diet using an age- and gender dependent prediction model. The model allowed to predict health outcomes and related health care costs for the food patterns over a time horizon of 20 years. A societal perspective was applied for the costs calculation and health outcomes were expressed in QALYs. Results For Belgium, a soy-containing diet is estimated to lead to 202 QALYs and 107 QALYs per 1000 women and men, respectively, while societal savings of 2,146,000u20ac and 1,653,000u20ac are predicted. For the UK, a gain 159 QALYs and 100 QALYs per 1000 women and men is estimated, while predicting savings of u00a31,580,000 and u00a31,606,000. For the Mediterranean diet in the corresponding estimates for Belgium are 184 QALYs and 148 QALYs per 1000 women and men, and savings 1,618,000u20ac and 1,595,000u20ac. For the UK, these are 122 QALYs and 110 QALYs per 1000 women and men, and savings of u00a31,155,000 and u00a31,046,000 respectively. Conclusion If these food patterns would be more widely implemented, this would lead to large net economic gains to society and improved health outcomes in the population.
Generated Summary
This economic evaluation employed a modeling approach to assess the health and economic impacts of plant-based food patterns, specifically soy-containing and Mediterranean diets, in Belgium and the United Kingdom. The study used an age- and gender-dependent epidemiological prediction model to forecast health outcomes and healthcare costs over a 20-year period. The research adopted a societal perspective for cost calculations, expressing health outcomes in Quality-Adjusted Life Years (QALYs). The model incorporated data on disease transition probabilities and mortality probabilities for various health states, including diabetes, cardiovascular diseases, and cancers. The study compared the plant-based diets with a ‘conventional’ diet to evaluate their cost-effectiveness. Data inputs included relative risk reductions from literature on the effects of the diets. Sensitivity analyses were conducted to assess the impact of parameter uncertainty.
Key Findings & Statistics
- In Belgium, a soy-containing diet is estimated to lead to 202 QALYs and 107 QALYs per 1000 women and men, respectively, with societal savings of u20ac2,146,000 and u20ac1,653,000.
- For the UK, a soy-containing diet is estimated to yield 159 QALYs and 100 QALYs per 1000 women and men, with societal savings of u00a31,580,000 and u00a31,606,000.
- For the Mediterranean diet in Belgium, the estimates are 184 QALYs and 148 QALYs per 1000 women and men, with savings of u20ac1,618,000 and u20ac1,595,000.
- In the UK, the Mediterranean diet is estimated to lead to 122 QALYs and 110 QALYs per 1000 women and men, with societal savings of u00a31,155,000 and u00a31,046,000.
- For Belgium, the estimated prevalence of cancer decreases with 1.57% in women and 1.45% in men in a soy-containing diet compared to a ‘non-soy’ diet. The prevalence of stroke decreases with 0.93% and 0.24% in women and men, respectively.
- For the UK, the estimated prevalence of T2DM decreases with 1.36% in women and 1.62% in men in a Mediterranean diet compared to a Western diet. For stroke, the prevalence numbers decreases with 1.13% and 0.88% in women and men respectively and for CHD the prevalence numbers decreases with 0.07% in women and 0.32% in men.
- If 10% of the total population would commit to a high adherence of the Mediterranean diet, societal cost savings of u20ac1.30 billion in Belgium and u00a35.21 billion in the UK are estimated over a time horizon of 20 years.
- If 10% of the total population would commit to a high adherence of a soy-containing diet, societal cost savings of u20ac1.53 billion in Belgium and u00a37.54 billion in the UK are estimated over a time horizon of 20 years.
Other Important Findings
- Plant-based food patterns, like soy-containing and Mediterranean diets, reduce the risk of non-communicable diseases such as T2DM, CHD, stroke, and certain cancers.
- The Mediterranean diet is associated with a decreased risk of breast cancer.
- A soy-containing diet is linked to a significant reduction of 2.27 mmHg systolic blood pressure (BP) and 1.21 mmHg diastolic BP in normotensive individuals.
- The highest quintile of soy intake (5 or more times per week) was compared to the lowest quintile of soy intake (0-2 times per week).
- The intake of the highest levels of soy compared to the lowest levels of soy intake decreases the risk of developing T2DM by 28%, the risk of developing lung cancer by 23% (men) and 25% (women).
Limitations Noted in the Document
- The study’s reliance on mainly Asian studies regarding soy-containing diets may limit the generalizability to Western populations due to differing soy consumption levels.
- The lack of a clear ‘intervention’ definition for promoting soy-containing or Mediterranean diets could lead to overestimated net savings.
- The study’s assumption of equal adherence levels to the diets over a 20-year period and the absence of Belgian incidence rates for stroke and T2DM are limitations.
- The model does not explicitly incorporate the potential for these diets to reduce the risk of overweight/obesity.
- All input data are based on evidence from literature, which can introduce variability.
Conclusion
The study suggests that soy-containing and Mediterranean diets could promote health and lead to substantial benefits and savings. However, the results should be viewed with caution due to the reliance on Asian studies for soy-related data and the absence of intervention costs. Further research is necessary to solidify the evidence on the current topic. The cost-effectiveness analyses could inform policy decisions regarding healthcare budget allocation. The study highlights that adopting plant-based diets, such as soy-containing and Mediterranean diets, can lead to substantial health benefits and societal savings, reducing the risk of major non-communicable diseases. The research also emphasizes the importance of a clear intervention strategy and the need for more Western-focused studies to fully understand the impact of these diets. These diets are associated with a reduced risk of various diseases, including diabetes, cardiovascular diseases, and certain cancers. Implementing these dietary patterns could significantly improve public health outcomes and generate economic gains, underscoring the value of plant-based diets for both individual and societal well-being. Therefore, encouraging the adoption of these diets could have a positive impact on healthcare expenditures, productivity, and overall public health. The findings underscore the potential of plant-based diets as a tool for health promotion and offer insights for policymakers aiming to improve population health through dietary changes. Despite some limitations, the research provides valuable evidence to support the benefits of plant-based diets, particularly in the context of chronic disease prevention and healthcare cost reduction.