The Economic Benefits of Plant-Based Diets

Written by Dr. Steve Chaney on . Posted in Benefits of Plant-Based Diets

Could Plant-Based Diets Cut Healthcare Costs?

Author: Dr. Stephen Chaney

 

Could saving the healthcare system be one of the economic benefits of plant-based diets?

economic benefits of plant-based diets healthcare system costsI don’t need to tell you that our healthcare system is in crisis. Costs are out of control. The Centers for Medicare and Medicaid Services (CMS) estimates that healthcare costs will account for 25% of the gross domestic product by 2025. They also predict that 47% of that spending will be financed by federal. State, and local governments. That is unsustainable.

Our politicians have no answer. Neither political party has a viable plan to cut costs. Perhaps it is time to take matters into our own hands. What if there were a way to improve our own health and the viability of our healthcare system? A recent study suggests there may be a way to accomplish both goals.

How Was The Study Done?

In a recent study (L. Annemans and J. Schepers, Nutrition, 48: 24-32, 2018 ) scientist at Ghent university in Belgium set out to investigate the effect on public health and healthcare costs if just 10% of the population of Belgium and England switched to a primarily plant-based diet. They started with two diets for which the health benefits have been well established by multiple studies. These diets are:

economic benefits of plant-based diets soy#1: A Soy-Containing Diet: This is defined as a diet in which soy protein foods were consumed in place of animal protein foods more than 5 times per week. The soy foods included in their study were soybeans, tofu, miso, soy protein drinks, and soy yoghurt.

The soy-containing diet was chosen because previous studies have shown it protects against obesity, heart disease, stroke, diabetes, and breast, colon, stomach, lung, and prostate cancer.  (Yes. In spite of the erroneous information you find on the internet, soy foods decrease cancer risk.)

#2: The Mediterranean Diet: This is defined as a diet rich in fruits, vegetables, whole grains, nuts, seeds and large amounts of olive oil. It includes a moderate to high consumption of fish and other seafood and a low intake of meat and dairy products.

economic benefits of plant-based diets mediterranean dietsThe Mediterranean diet was chosen because previous studies have shown it protects against heart disease, stroke, diabetes, and breast cancer. I have documented these health benefits in more detail in my book Slaying The Food Myths.”

This study did not look at the benefits of other plant-based diets. For example, as discussed in “Slaying The Food Myths,” the Seventh-Day Adventist studies have shown comparable health benefit for a variety of vegetarian diets.

This study looked at the prevalence of each of these diseases in Belgium and England and estimated what the effect would be if the prevalence of these diseases were reduced by the amounts reported in previous studies of soy-based and Mediterranean diets.

The study reported two outcomes: the increase in Quality of Life Years (QALYs) and the decrease in healthcare costs. Increased Quality of Life Years simply means the increase in disease-free years. That is the outcome most important to each of us personally. However, we should be equally interested in the decreased healthcare costs. The dollars our government spends on healthcare don’t grow on trees. They come out of our pockets.

 

Economic Benefits of Plant-Based Diets: Decreasing Healthcare Costs?

 

economic benefits of plant-based dietsWith that buildup, you are probably wondering what the outcome of the study was. The news was good:

If 10% of the population switched to a soy-based diet there would be:

  • An increase of 154 Quality of Life Years/1,000 people and a decrease in healthcare costs of $1.9 billion/20 years in Belgium.
  • An increase of 130 Quality of Life Years/1,000 people and a decrease in healthcare costs of $10.7 billion/20 years in England.

If 10% of the population switched to a Mediterranean diet there would be:

  • An increase of 166 Quality of Life Years/1,000 people and a decrease in healthcare costs of $1.6 billion/20 years in Belgium.
  • An increase of 116 Quality of Life Years/1,000 people and a decrease in healthcare costs of $7.4 billion/20 years in England.

[Note: In case you were wondering, the authors said the reason why plant-based diets had less of an effect on Quality of Life Years in England than in Belgium is because public health interventions have already significantly decreased the incidence of heart attack and stroke in England. Conversely, the reason healthcare savings are higher in England is because healthcare costs are higher there.]

Finally, if one were to extrapolate the British healthcare savings to the costs of the US healthcare system, one would predict:

  • If 10% of the US population were to switch to a soy-based diet, healthcare savings might amount to $17 billion/20 years.
  • If 10% of the US population were to switch to a Mediterranean diet, healthcare savings might amount to $12 billion/20 years.

The authors concluded: “The result of the present analysis suggests that both a soy-containing diet and the Mediterranean diet could contribute to health promotion because they are predicted to lead to substantial health benefits and societal savings.”

How Accurate Are These Estimates?

The benefits of soy-based and Mediterranean diets on which these estimates are based are very solid. The benefits are based on association studies, but the studies are very well done and are remarkably consistent.

The major weakness of these estimates is the benefits of these diets have been demonstrated in other parts of the world and are being extrapolated to a region of the world where neither of those diets are commonly followed. The authors tried very hard to control for all confounding variables, but the possibility remains that lifestyle differences unique to those geographic regions also contributed to the health benefits of soy-based and Mediterranean diets.

The authors acknowledged that some of the foods that are normally part of soy-based and Mediterranean diets were not as readily available in Belgium and England. They raised the possibility that something like the “New Nordic Diet”, which is also primarily plant-based but incorporates more familiar foods, might be equally effective. The equivalent diet in the US might be the DASH diet.

The economic benefits of plant-based diets may not depend so much on the diet, as long as it is plant-based and those foods are readily available.

 

The Bottom Line:

 

A recent study looked at the effect of a plant-based diet on Quality Of Life Years (disease free years) and healthcare costs in Belgium and England. The study estimated:

If 10% of the population switched to a soy-based diet there would be:

  • An increase of 154 Quality of Life Years/1,000 people and a decrease in healthcare costs of $1.9 billion/20 years in Belgium.
  • An increase of 130 Quality of Life Years/1,000 people and a decrease in healthcare costs of $10.7 billion/20 years in England.

If 10% of the population switched to a Mediterranean diet there would be:

  • An increase of 166 Quality of Life Years/1,000 people and a decrease in healthcare costs of $1.6 billion/20 years in Belgium.
  • An increase of 116 Quality of Life Years/1,000 people and a decrease in healthcare costs of $7.4 billion/20 years in England.

If one were to extrapolate the British healthcare savings to the costs of the US healthcare system, one would predict:

  • If 10% of the US population were to switch to a soy-based diet, healthcare savings might amount to $17 billion/20 years.
  • If 10% of the US population were to switch to a Mediterranean diet, healthcare savings might amount to $12 billion/20 years.

The authors concluded: “The result of the present analysis suggests that both a soy-containing diet and the Mediterranean diet could contribute to health promotion because they are predicted to lead to substantial health benefits and societal savings.”

For more details, read the article above:

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Can Plant-based Diets Be Unhealthy?

Posted September 10, 2019 by Dr. Steve Chaney

Do Plant-Based Diets Reduce Heart Disease Deaths?

Author: Dr. Stephen Chaney

 

plant-based diets vegetablesPlant-based diets have become the “Golden Boys” of the diet world. They are the diets most often recommended by knowledgeable health and nutrition professionals. I’m not talking about all the “Dr. Strangeloves” who pitch weird diets in books and the internet. I am talking legitimate experts who have spent their life studying the impact of nutrition on our health.

Certainly, there is an overwhelming body of evidence supporting the claim that plant-based diets are healthy. Going on a plant-based diet can help you lower blood pressure, inflammation, cholesterol and triglycerides. People who consume a plant-based diet for a lifetime weigh less and have decreased risk of heart disease, diabetes, and cancer.

But, can a plant-based diet be unhealthy? Some people consider a plant-based diet to simply be the absence of meat and other animal foods. Is just replacing animal foods with plant-based foods enough to make a diet healthy?

Maybe not. After all, sugar and white flour are plant-based food ingredients. Fake meats of all kinds abound in our grocery stores. Some are very wholesome, but others are little more than vegetarian junk food. If you replace animal foods with plant-based sweets, desserts, and junk food, is your diet really healthier?

While the answer to that question seems obvious, very few studies have asked that question. Most studies on the benefits of plant-based diets have compared population groups that eat a strictly plant-based diet (Seventh-Day Adventists, vegans, or vegetarians) with the general public. They have not looked at variations in plant food consumption within the general public. Nor have they compared people who consume healthy and unhealthy plant foods.

This study (H Kim et al, Journal of the American Heart Association, 8:e012865, 2019) was designed to fill that void.

 

How Was The Study Done?

plant-based diets studyThis study used data collected from 12,168 middle aged adults in the ARIC (Atherosclerosis Risk in Communities) study between 1987 and 2016.

The participant’s usual intake of foods and beverages was assessed by trained interviewers using a food frequency questionnaire at the time of entry into the study and again 6 years later.

Participants were asked to indicate the frequency with which they consumed 66 foods and beverages of a defined serving size in the previous year. Visual guides were provided to help participants estimate portion sizes.

The participant’s adherence to a plant-based diet was assessed using four different well-established plant-based diet scores. For the sake of simplicity, I will include 3 of them in this review.

  • The PDI (Plant-Based Diet Index) categorizes foods as either plant foods or animal foods. A high PDI score means that the participant’s diet contains more plant foods than animal foods. A low PDI score means the participant’s diet contains more animal foods than plant foods.
  • The hPDI (healthy plant-based diet index) is based on the PDI but emphasizes “healthy” plant foods. A high hPDI score means that the participant’s diet is high in healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) and low in animal foods.
  • The uPDI (unhealthy plant-based diet index) is based on the PDI but emphasizes “unhealthy” plant foods. A high uPDI score means that the participant’s diet is high in unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) and low in animal foods.

For statistical analysis the scores from the various plant-based diet indices were divided into 5 equal groups. In each case, the group with the highest score consumed the most plant foods and least animal foods. The group with the lowest score consumed the least plant foods and the most animal foods.

The health outcomes measured in this study were heart disease events, heart disease deaths, and all-cause deaths. Again, for the sake of simplicity, I will only include 2 of these outcomes (heart disease deaths and all-cause deaths) in this review. The data on deaths were obtained from state death records and the National Death Index. (Yes, your personal information is available on the web even after you die.)

 

Do Plant-Based Diets Reduce Heart Disease Deaths?

plant-based diets reduce heart deathsThe participants in this study were followed for an average of 25 years.

The investigators looked at heart disease deaths over the 25 years and compared people with the highest intake of plant foods to people with the highest intake of red meat and other animal foods. The results were:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

What Else Did The Study Show?

The investigators made a couple of other interesting observations:

  • The association of the overall diet with heart disease and all-cause deaths was stronger than the association of individual food components. This underscores the importance of looking at the effect of the whole diet on health outcomes rather than the “magic” foods you hear about on Dr. Strangelove’s Health Blog.
  • Diets with the highest amount of healthy plant foods were associated with higher intake of carbohydrates, plant protein, fiber, and micronutrients, including potassium, magnesium, iron, vitamin A, vitamin C, folate, and lower intake of saturated fat and cholesterol.
  • Diets with the highest amount of unhealthy plant foods were associated with higher intake of calories and carbohydrates and lower intake of fiber and micronutrients.

The last two observations may help explain some of the health benefits of plant-based diets.

 

Can Plant-Based Diets Be Unhealthy?

plant-based diets unhealthy cookiesNow, let’s return to the question I asked at the beginning of this article: “Can plant-based diets be unhealthy?” Although some previous studies have suggested that unhealthy plant-based diets might increase the risk of heart disease, this study did not show that.

What this study did show was that an unhealthy plant-based diet was no better for you than a diet containing lots of red meat and other animal foods.

If this were the only conclusion from this study, it might be considered a neutral result. However, this result clearly contrasts with the data from this study and many others showing that both plant-based diets in general and healthy plant-based diets reduce the risk of heart disease deaths and all-cause deaths compared to animal-based diets.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

There is one other subtle message from this study. This study did not compare vegans with the general public. Everyone in the study was the general public. Nobody in the study was consuming a 100% plant-based diet.

For example:

  • The group with the highest intake of plant foods consumed 9 servings per day of plant foods and 3.6 servings per day of animal foods.
  • The group with the lowest intake of plant foods consumed 5.4 servings per day of plant foods and 5.6 servings per day of animal foods.

In other words, you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet.

 

The Bottom Line

A recent study analyzed the effect of consuming plant foods on heart disease deaths and all-cause deaths over a 25-year period.

When the investigators looked at heart disease deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

A more subtle message from the study is that you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet. The people in this study were not following some special diet. The only difference was that some of the people in this study ate more plant foods and others more animal foods.

For more details on the study, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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