Food policies have potential to lower US cardiovascular disease rates

Food policies, such as fruit and vegetable subsidies, taxes on sugar sweetened drinks, and mass media campaigns to change dietary habits, could avert hundreds of thousands of deaths from cardiovascular disease (CVD) in the United States, researchers project in a study published in PLOS Medicine by Jonathan Pearson-Stuttard from the University of Liverpool, UK and Imperial College London, UK, and colleagues at the Friedman School of Nutrition Science and Policy at Tufts University, US.

Efforts to improve dietary choices through economic incentives have been successful in the past, but the impact of such changes on CVD--the leading cause of mortality in the US--has not been clear. In the new work, researchers used the existing US IMPACT Food Policy Model, coupled with data on CVD mortality, to determine how different food policy scenarios might impact CVD deaths.

The researchers estimated that a national 10% subsidy for fruit and vegetables was likely to be the most beneficial, potentially resulting in 150,500 fewer CVD deaths by 2030. A 30% fruit and vegetable subsidy targeting only SNAP (or food stamp) recipients was estimated to avert 35,100 CVD deaths; a mass media campaign to change dietary habits might avert 25,800 CVD deaths, and a 10% tax on sugar sweetened beverages might avert 31,000 deaths from CVD. The targeted SNAP only subsidy would reduce disparities the most. An approach combining these policies, they calculated, could have an especially large impact, saving around 230,000 lives and also reducing the disparity between CVD in SNAP recipients and non-SNAP recipients. The study didn't calculate effects on mortality through other causes that dietary changes would likely have at the same time as CVD.

"The findings of this study have important implications for crafting specific price and incentive policy approaches to optimize access to fruits and vegetables and reduce consumption of sugar sweetened beverages," the authors say. "Policies effectively increasing fruit and vegetable consumption or reducing sugar sweetened beverage consumption might powerfully reduce cardiovascular disease mortality and disparities. Furthermore, a combination of these policies could be even more powerful."

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This project was funded by a National Institutes of Health grant, number R01HL115189. No funding bodies had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

I have read the journal's policy and the authors of this manuscript have the following competing interests: LW serves as the Director of Policy Research for the American Heart Association. CDR has consulted for the Almond Board of California and the Bell Institute of Health and Nutrition. DM has received honoraria for one-time scientific presentations/reviews on diet from Haas Avocado Board, and Pollock Communications; has done ad-hoc consulting for Life Sciences Research Organization, Astra Zeneca, Boston Heart Diagnostics, GOED, and DSM; was on the scientific advisory board for Unilever North America until 2014; has received royalties from UpToDate for online chapters on fish oil and dietary fat; is listed on Patent US8889739 B2 to Harvard University as a co-inventor, for use of trans-palmitoleic acid in identifying and treating metabolic disease.

Pearson-Stuttard J, Bandosz P, Rehm CD, Penalvo J, Whitsel L, Gaziano T, et al. (2017) Reducing US cardiovascular disease burden and disparities through national and targeted dietary policies: A modelling study. PLoS Med 14(6): e1002311. https://doi.org/10.1371/journal.pmed.1002311

Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom

School of Public Health, Imperial College London, London, United Kingdom

Department of Preventive Medicine and Education, Medical University of Gda?sk, Gda?sk, Poland

Office of Community and Population Health, Montefiore Medical Center, New York, New York, United States of America

Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, United States of America

American Heart Association, Washington, District of Columbia, United States of America

Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America

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