Modelling the impact of compliance fruit and vegetable intake recommendations on mortality in Russia

Abstract

Abstract Background Low fruit and vegetable intake is among the top ten selected risk factors for global mortality. The World Health Organization recommended daily fruit and vegetable intake is known to be 400 g/day. Despite strong evidence indicating that low fruit and vegetable intake relates to chronic diseases and mortality, most adults do not comply with dietary recommendations. According to the ESSE-RF epidemiological study, the prevalence of low fruit and vegetable consumption was 41.9%. The purpose of this study is to model the impact of following the national fruit and vegetables intake recommendations in decreasing N of death attributable to low fruit and vegetable intake. Methods A validated and transparent macrosimulation model, the PRIME (Preventable Risk Integrated ModEl) was used to estimate the cardiovascular and diet-related cancer death toll that could be prevented or delayed for the populations of Russia in a year. Data included in the model are a baseline scenario (actual F&V intake), a counterfactual scenario (recommended intake), and age-and sex-specific mortality for cardiovascular and diet-related cancer diseases, together with the total population risk of a specific year. Monte Carlo analyses with 5000 iterations were performed to produce the 95% uncertainty intervals. Results In 2018, an estimated 52 725 deaths (95% CI: 33 474, 69 837) could be averted or delayed if Russians adhered to dietary recommendations on fruit and vegetable intake. Cardiovascular disease accounted for 97.8% of these deaths. The modelled reduction in deaths for coronary heart disease was 43 530 (95%CI: 24 782, 60 168), for stroke 8 063 (95%CI: 5 252, 10 715). The modelled reduction in deaths for lung cancer was 1132 (95%CI: 484, 1731). Conclusions The modelling illustrates the potentially large social benefits of compliance with national fruit and vegetable intake recommendations. Key messages Despite strong evidence indicating that low fruit and vegetable intake relates to chronic diseases and mortality, most adults do not comply with dietary recommendations. The modelling illustrates the potentially large social benefits of compliance with national fruit and vegetable intake recommendations.