Change in USA food policies could prevent 230,000 heart disease deaths by 2030

Increased discounts on fruit and vegetables, and higher taxes on sugary drinks, could prevent heart disease deaths, says a new study.

Changes in USA food policies such as increased subsidies on fruit and vegetables, higher taxes on sugar sweetened drinks, and more mass media campaigns to change dietary habits, could avert hundreds of thousands of deaths from cardiovascular disease (CVD), according to a new study from Imperial College London.

Despite declining numbers of cases, CVD remains the leading cause of mortality in the USA, causing around 800,000 deaths and six million hospital admissions every year. Those with lower incomes are particularly susceptible to these effects.

Diets high in sugar and low in fruit and vegetable intake are a leading cause of CVD and early death in the USA. Researchers know that policies targeting fruit, vegetables, and sugary drinks can improve public health, but the specific potential benefits of different policies are unclear, in particular the impact on people with differing income levels.

Now, based on the health results from previous food taxes and subsidies, researchers from Imperial, the University of Liverpool, and Tufts University in the USA have modelled and compared the potential benefits of fruit and vegetable subsidies for those who are using the Supplemental Nutrition Assistance Program (SNAP), where the government helps families with lower incomes to buy healthy food, and for those who are not. They also looked at benefits of taxes on sugary drinks, and of media campaigns encouraging healthy eating.

The team of researchers, led by Dr Jonathan Pearson-Stuttard at Imperial’s School of Public Health, combined the existing USA IMPACT Food Policy Model and data on CVD deaths to determine how different food policy scenarios might impact those deaths.

They modelled their data from 2015-2030, and measured previous and projected cases of CVD related conditions such as coronary heart disease and stroke in the USA.

Based on their analyses, the researchers predicted that introducing subsidies for fruit and vegetables targeted according to different income levels, higher tax on sugary drinks, and mass media campaigns, could potentially prevent around 230,000 heart disease deaths by 2030.

Dr Pearson-Stuttard said: “Our findings suggest making fruit and vegetables more easily available, particularly for lower income individuals, and reducing sugary drinks consumption, could massively help to reduce heart disease deaths in the USA.”

Robust recommendations

The authors estimated that a national 10% subsidy for fruit and vegetables was likely to be the most beneficial policy, potentially resulting in 150,500 fewer CVD deaths. For SNAP recipients, who have lower incomes and are more vulnerable to the effects of inadequate diet or limited availability of healthy food, the authors argue that a 30% fruit and vegetable subsidy could avert 35,100 CVD deaths.

The researchers also examined the effect of mass media campaigns to change dietary habits, which, they suggest, could help to prevent 25,800 CVD deaths

Finally, they argue that a 10% tax on sugar sweetened beverages for the general population would likely avert 31,000 CVD deaths.

The authors explained that an approach combining all these policies could have an especially large impact, saving around 230,000 lives from CVD by 2030, as well as reducing the inequality in CVD cases between individuals of different income levels. The authors did not calculate the effects of other causes of dietary change on CVD death risk.

The researchers also note that, although CVD is a health risk in many countries, their study is particularly specific to the USA, and they cannot assume that the same interventions would have the same effects in other countries.

Dr Pearson-Stuttard added: “Enshrining our suggestions in health policy could drastically reduce deaths from heart disease in the US. Combining the policies of increasing tax on sugary drinks and subsidising fruit and vegetables could also cancel each other out in terms of cost to the government. The next steps should be to investigate how these policies could be better targeted to those populations who need them the most.”

“Reducing US cardiovascular disease burden and disparities through national and targeted dietary policies: A modelling study” by Jonathan Pearson-Stuttard, Piotr Bandosz, Colin D. Rehm, Jose Penalvo, Laurie Whitsel, Tom Gaziano, Zach Conrad, Parke Wilde, Renata Micha, Ffion Lloyd-Williams, Simon Capewell, Dariush Mozaffarian, Martin O'Flaherty. Published 6 June 2017 in PLOS Medicine.

See the press release of this article