Prediction of disability-adjusted life years for diseases due to low fruit intake in 2017-2040 in Japan

Abstract

Objective: The current study aimed to predict disability-adjusted life years (DALY) rate in Japan through 2040 with plausible future scenarios of fruit intake for neoplasms, cardiovascular diseases (CVD) and diabetes and kidney diseases (DKD).

Design: Data from National Health and Nutrition Surveys and the Global Burden of Diseases study in 2017 were used. We developed an autoregressive integrated moving average model with four future scenarios. Reference scenario maintains the current trend. Best scenario assumes that the goal defined in Health Japan 21 is achieved in 2023 and is kept constant afterwards. Moderate scenario assumes that the goal is achieved in 2040. Constant scenario applies the same proportion of 2016 for the period between 2017 and 2040.

Setting: DALY rates in Japan were predicted for the period between 2017 and 2040.

Participants: Population aged more than than 20 years old.

Results: In our reference forecast, the DALY rates in all-ages group were projected to be stable for CVD and continue increasing for neoplasms and DKD. Age group-specific DALY rates for these three disease groups were forecasted to decrease, with some exceptions. Among men aged 20-49 years, DALY attributable to CVD differed substantially between the scenarios, implying that there is a significant potential for reducing the burden of CVD by increasing fruit intake at the population level.

Conclusions: Our scenario analysis shows that higher fruit intake is associated with lower disease burden in Japan. Further research is required to assess which policies and interventions can be used to achieve an increase in fruit intake as modelled in the scenarios of the current study.

Keywords: Cardiovascular diseases; DALY rate; Diabetes; Japan; Kidney diseases; Low fruit intake; Neoplasms.

Fig. 1

Observed and projected all ages disability-adjusted life years (DALY) rate (per 100 000) for neoplasms for reference forecast and three alternative scenarios, 1990–2040: male, female and both sexes combined. 1: best scenario, 2: moderate scenario, 3: constant scenario. It is important to note that the y-axis scales are different for each panel in order to make the differences between scenarios easier to understand. Detailed values are shown in online Supplemental Table 3. , Observed; , Reference; , Scenario 1; , Scenario 2; , Scenario 3

Fig. 2

Observed and projected all ages disability-adjusted life years (DALY) rate (per 100 000) for cardiovascular diseases for reference forecast and three alternative scenarios, 1990–2040: male, female and both sexes combined. 1: best scenario, 2: moderate scenario, 3: constant scenario. It is important to note that the y-axis scales are different for each panel in order to make the differences between scenarios easier to understand. Detailed values are shown in Supplemental Table 4. , Observed; , Reference; , Scenario 1; , Scenario 2; , Scenario 3

Fig. 3

Observed and projected all ages disability-adjusted life years (DALY) rate (per 100 000) for diabetes and kidney disease for reference forecast and three alternative scenarios, 1990–2040: male, female and both sexes combined. 1: best scenario, 2: moderate scenario, 3: constant scenario. It is important to note that the y-axis scales are different for each panel in order to make the differences between scenarios easier to understand. Detailed values are shown in online Supplemental Table 5. , Observed; , Reference; , Scenario 1; , Scenario 2; , Scenario 3