Accounting for consumers' preferences in the analysis of dietary recommendations

Abstract

Background/objectives: The goal of this article is to present and demonstrate the applicability of an original method to assess the economic and health impacts of compliance with food-based recommendations. The method takes account of consumers' preferences and the associated adoption cost in the assessment of various recommendations.

Subjects/methods: We combine an economic model of diet choice with an epidemiological model to compute the health impacts of dietary changes. To demonstrate the use of the method, we analyse the impacts of a 5% variation in the consumption of seven food groups taken separately: a 5% increase in consumption of fruits and vegetables (F&V) and milk products; and a 5% decrease in consumption of red meat, all meats, salty/sweet products, ready meals and butter/cream/cheese.

Results: A recommendation, when adopted by consumers, generates important changes in the whole diet due to substitutions and complementarities among foods. All simulated recommendations have a positive impact on health. The F&V recommendation has the largest impact on the number of DALYs averted, but the highest adoption cost for consumers, especially for low-income consumers. Alone, the change in energy intake explains from 71% to 98% of the DALYs averted induced by a recommendation.

Conclusions: Small increases in recommended foods have the potential of generating relatively significant health gains. Preference-driven substitutions among foods have a major effect on simulated health outcomes and should be included in the assessment of dietary recommendations, together with the adoption cost borne by consumers.

Fig. 1

Impact of dietary risks factor, considered in the PrimeTime model, on net health gains induced by the adoption of food-based recommendations over the life cycle Note: The values reflect the change in total DALYs if the risk factor is eliminated from the analyses. A negative value indicates that the change in risk factor is leading to a loss of health. For example, in the case of the recommendation on salty/sweet products, the change in F&V consumption negatively impacts the health. This is because the adoption of the recommendation leads to a decrease in F&V consumption. The sum of DALYs across all risk factors does not equal the total DALYs from the modelling combining all risk factors because the potentially avertable disease burden diminishes with each additional risk factor. In the orange area, the % refers to the contribution of the reduction of energy intake to the net gain

Fig. 2

Incident cases averted in first ten years thanks to the adoption of food-based recommendations in the French population. Note: in the green area, the % refers to the share of incident cases averted due to reduction in diabetes