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Temporal changes in diet quality and the associated economic burden in Canada

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  • Léon Nshimyumukiza
  • Jessica R L Lieffers
  • John Paul Ekwaru
  • Arto Ohinmaa
  • Paul J Veugelers

Abstract

A high-quality diet is associated with a reduced of risk of chronic disease and all-cause mortality. In this study, we assessed changes in diet quality and the associated economic burden in the Canadian population between 2004 and 2015. We used a prevalence-based cost-of-illness approach. We first calculated the diet quality using the Healthy Eating Index-Canada-2010 (HEI-C-2010) and 24-hour recall data from the Canadian Community Health Surveys (CCHS) on nutrition (CCHS 2004 cycle 2.2 and the CCHS-NU 2015). We then retrieved relative risks of HEI-2010 quintiles for chronic diseases from meta-analyses. Based on the proportions of the population following diets of varying qualities and these relative risks, we computed the population-attributable fractions and attributable costs (direct health care and indirect costs) by survey year (2004 and 2015) as well as by age and sex group. Costs were estimated in 2017 Canadian dollars for comparison purposes. We observed that on average the diet quality of Canadians improved between 2004 and 2015: the proportion of the Canadian population that did not eat a diet of high quality decreased from 83% to 76%. This improvement in diet quality translated in a decrease in economic burden of $133 million, down from $13.21 billion in 2004 to $13.08 billion in 2015. The economic burden decreased by $219 million among males but increased by $86 million among females. It also decreased among people under the age of 65 years ($333 million) but increased among those over 65 years ($ 200 million). Our findings suggest that, despite some temporal improvements, the diet of the majority of Canadians is of poor quality resulting in a high attributable economic burden. Policy and decision makers are encouraged to expand nutrition programs and policies and to specifically target the elderly in order to prevent chronic diseases and reduce health care costs.

Suggested Citation

  • Léon Nshimyumukiza & Jessica R L Lieffers & John Paul Ekwaru & Arto Ohinmaa & Paul J Veugelers, 2018. "Temporal changes in diet quality and the associated economic burden in Canada," PLOS ONE, Public Library of Science, vol. 13(11), pages 1-15, November.
  • Handle: RePEc:plo:pone00:0206877
    DOI: 10.1371/journal.pone.0206877
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    References listed on IDEAS

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    1. Tarricone, Rosanna, 2006. "Cost-of-illness analysis: What room in health economics?," Health Policy, Elsevier, vol. 77(1), pages 51-63, June.
    2. Center for Nutrition Policy and Promotion, 1995. "The Healthy Eating index," CNPP Reports 311249, United States Department of Agriculture, Center for Nutrition Policy and Promotion.
    3. Jessica R L Lieffers & John Paul Ekwaru & Arto Ohinmaa & Paul J Veugelers, 2018. "The economic burden of not meeting food recommendations in Canada: The cost of doing nothing," PLOS ONE, Public Library of Science, vol. 13(4), pages 1-17, April.
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