Health and economic impact of a food substitution in the Portuguese diet: methodology overview

Abstract

Abstract The Portuguese Food Based Dietary Guidelines (FBDG), namely Food Wheel Guide, as well as the National Food, Nutrition and Physical Activity Survey 2015-2016, advise the Portuguese population to substitute animal protein for vegetable protein. At the same time, 10,1% of the Portuguese families suffered from food insecurity issues, mainly due to lack of financial resources. This study will be the first to investigate the possibilities of associating the health impacts of different risks and benefits through a Risk-Benefit Assessment (RBA) with different methodologies that estimate the economic sustainability of substituting unprocessed red meat by legumes produced in Portugal, e.g. beans and chickpeas in the Portuguese population. An overview of the current Portuguese diet as well as a literature review of the RBA methodology was performed, with specific reference to substitution studies, as means of promoting healthy and sustainable diets. For a socio-economic analysis, relevant literature of specific authorities (FAO, EFSA, ECDC), and published studies (Public Health and Environment institutes), was evaluated and the different methodologies, such as the Willingness To Pay (WTP), behavioral economics and a cost analysis were compared amongst them as to their advantages and disadvantages. From the literature review it can be concluded that not only income or food prices are the only factors that explain food choices. However, if healthier diets are proved to be unaffordable for many people's households, especially the Portuguese families, then nutrient adequate consumption dietary patterns will not improve, even in their lowest prices form, with nutrition education and behavioral change. This way, associating a RBA with a cost analysis is a valuable approach to evaluate the health impact in relation to the cost of substituting red meat for legumes in a household, giving estimates that support policies that promote nutritious foods for all. Key messages Advocate for the substitution of red meat for legumes in the Portuguese population, expected to be both more environmentally-friendly and healthier. Investigate the costs (affordability) of this substitution in the Portuguese households while advocating for healthier foods: methodological overview.