AHA Analysis: 30% Price Decrease on Fruit and Veg Saves Lives

Dietary patterns that reduce fruit and vegetable prices by 10 percent through 2030 could lower the death rate from heart disease and stroke about 1 percent, saving about 64,000 to 69,000 lives over a 15–year period.

This price decrease, together with increasing the price of sugary drinks by ten percent, could prevent 515,000 deaths over 20 years.

 

For the estimates, US researchers from the Friedman School of Nutrition Science & Policy at Tufts University, Boston and the University of Liverpool, UK created a model called the US IMPACT Food Policy Model. The model includes projections of US demographics and cardiovascular death rates to 2030, plus current and projected fruit and vegetable intake. It allowed the team to simulate the effects of various policies on dietary habits, and the impact of change in those habits on heart disease and stroke risk. The researchers then compared how many people would be expected to die over 15 years if nothing changed, versus the expected numbers if each policy had been launched, to see how many lives would be saved.

 

Researchers from Tufts and Harvard Medical School used computer modeling to predict how price changes might impact eating habits over time and whether this could reduce cardiovascular diseases. A 30 percent price drop was modeled to be the most effective in saving lives – diminishing the death rate by almost 3 percent, saving between 191,000 and 205,000 lives over 15 years.
 
In comparison, researchers reported that a year–long mass media campaign promoting fruits and vegetables could reduce the cardiovascular death rate by about 0.1 percent, or 7,500 to 8,300 lives. A media campaign lasting 15 years, reduced the rate by 0.3 percent, or 22,800 to 24,800 deaths over 15 years, the study found.
 
They estimated:
Reducing the price of fruits and vegetables: Within five years of a ten percent price reduction on fruits and vegetables, deaths from cardiovascular diseases overall could decrease by 1.2 percent and within 20 years by almost 2 percent. Specifically, heart attacks could decrease by 2.6 percent and strokes by 4 percent over the 20 years.
Reducing the price of grains: Within five years of a ten percent price reduction on grains, deaths from cardiovascular diseases overall could decrease by 0.2 percent and within 20 years by 0.3 percent. Specifically, heart attacks could decrease by 0.83 and 0.77 percent respectively.
Increasing the price of sugary drinks: Within 5 years of a price increase of ten percent on sugary drinks, deaths from cardiovascular diseases overall could decrease by nearly 0.1 percent and within 20 years by 0.12 percent. Specifically, heart attacks could decrease by 0.25 percent in both timeframes and strokes could decrease by 0.17 percent in 20 years. Diabetes could decrease by 0.2 percent in five years and 0.7 percent in 20 years.

 

Combined, the model shows that by 2035 it would be possible to prevent 515,000 deaths from cardiovascular disease and nearly 675,000 events, such as heart attacks and strokes, across the nation with these small changes in price.

 

If a change by one serving occurred daily, for example one more piece of fruit (100 gm), one full serving of a vegetable (100 gm), one serving of whole grains (50 gm), and one less 8 oz sugar sweetened beverage were consumed then up to 3.5 million deaths and 4 million cardiovascular events could be averted over a two-year period. The SNAP program, also known as food stamps, in Massachusetts achieved a 30 percent change in prices.

 

While improving heart health is clearly driven by what people eat and drink, determining how to create broad population shifts in eating habits could seem overwhelming without such predictive models. State and community leaders who want to improve the health of their communities can use these data to make impactful change.
 
“Poor diet is a large contributor to cardiovascular disease, which is the biggest killer in the United States. Governments must therefore implement effective dietary policies to tackle this growing burden,” said Jonathan Pearson–Stuttard, lead researcher and academic clinical fellow and public health registrar at Imperial College London, UK. “Both mass media campaigns and achieving price reductions of fruits and vegetables are important tools in achieving this.”
 
“A change in your diet can be challenging, but if achieved through personal choice or changes in the market place, it can have a profound effect on your cardiovascular health,” said Thomas A Gaziano, M.D., M.Sc., lead author and assistant professor at Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health in Boston, Massachusetts.
 
“These novel findings support the need to combine modest taxes and subsidies to better represent the real costs of food to health and society,” said senior author Dariush Mozaffarian, M.D. Dr.PH, the principal investigator of the overall NHLBI grant and dean of the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University.

“Population–level policies are powerful tools for reducing cardiovascular disease,” said Martin O’Flaherty, M.D., Ph.D., senior author, University of Liverpool. But the relative effectiveness of a health campaign aimed at improving people’s diet compared with a financial incentive — a strategy never tested nationally — has been unclear.”
 
“Strategies that increase the awareness, availability and affordability of healthy foods such as fruits and vegetables should be harnessed and adopted by the US,” added Mozaffarian.

 

Price reduction policies would affect non–Hispanic whites and blacks equally. In comparison, a mass media campaign would be about 35 percent less effective in preventing deaths from cardiovascular disease in non–Hispanic blacks.

 

“Further, policies aimed at subsidizing fruits and vegetables could have more equitable effects upon health across race and ethnic groups. And crucially, this can be achieved quickly,” Mozaffarian concluded.

 

Several states, cities and Native American tribes have considered leveraging excise taxes on sugary drinks and eliminating taxes on fruits and vegetables with mixed success. The Navajo Nation successfully did both last year – eliminating taxes on fruits and vegetables while increasing taxes on junk foods including sugary drinks – and is beginning to use the revenue for promoting healthy behaviors through education campaigns and programs.

 

Mexico implemented a peso per liter tax on sugary drinks across the country and a recent study showed decreased purchases, reinforcing what this research shows is possible if purchases carry over to health outcomes.