Abstract
Non-communicable diseases (NCDs) represent not only the major driver for quality-restricted and lost life years; NCDs and their related medical treatment costs also pose a substantial economic burden on healthcare and intra-generational tax distribution systems. The main objective of this study was therefore to quantify the economic burden of unbalanced nutrition in Germany—in particular the effects of an excessive consumption of fat, salt and sugar—and to examine different reduction scenarios on this basis. In this study, the avoidable direct cost savings in the German healthcare system attributable to an adequate intake of saturated fatty acids (SFA), salt and sugar (mono- & disaccharides, MDS) were calculated. To this end, disease-specific healthcare cost data from the official Federal Health Monitoring for the years 2002–2008 and disease-related risk factors, obtained by thoroughly searching the literature, were used. A total of 22 clinical endpoints with 48 risk-outcome pairs were considered. Direct healthcare costs attributable to an unbalanced intake of fat, salt and sugar are calculated to be 16.8 billion EUR (CI95%: 6.3–24.1 billion EUR) in the year 2008, which represents 7% (CI95% 2%-10%) of the total treatment costs in Germany (254 billion EUR). This is equal to 205 EUR per person annually. The excessive consumption of sugar poses the highest burden, at 8.6 billion EUR (CI95%: 3.0–12.1); salt ranks 2nd at 5.3 billion EUR (CI95%: 3.2–7.3) and saturated fat ranks 3rd at 2.9 billion EUR (CI95%: 32 million—4.7 billion). Predicted direct healthcare cost savings by means of a balanced intake of sugars, salt and saturated fat are substantial. However, as this study solely considered direct medical treatment costs regarding an adequate consumption of fat, salt and sugars, the actual societal and economic gains, resulting both from direct and indirect cost savings, may easily exceed 16.8 billion EUR.
Highlights
Introduction and Objective of the StudyDiet-related non-communicable diseases represent in Germany and in other industrialized countries an important cost factor in healthcare systems
The unbalanced intake of saturated fatty acids was associated with 2.9 billion EUR (CI95%: 32 million—4.7 billion)—mainly due to the costs of treating diabetes mellitus, obesity, ischemic heart disease, chronic obstructive pulmonary disease and arthrosis (Fig 1)
The highest uncertainty ratio—and, the lowest validity of the risk factors considered in terms of their impacts—was observed in the case of saturated fatty acids (SFA) (1.60), followed by mono- & disaccharides (MDS) (1.06) and salt (0.76)
Summary
Diet-related non-communicable diseases represent in Germany and in other industrialized countries an important cost factor in healthcare systems. Bloom et al (2011) stated that the global costs of non-communicable diseases (e.g. obesity, diabetes, cancer, cardiovascular diseases) will rise from 6.2 trillion US$ in the year 2010 to 17 trillion US$ in the year 2030 [7]. This forecast is substantiated by the results of the Global Burden of Disease Study 2010, which confirmed a global increase of non-communicable diseases in comparison to infectious diseases (from 1990 to 2010) [8]. On a global level there are not currently available any reliable data on the extent to which healthcare expenditures on non-communicable diseases are related to dietary factors
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