Moderate low-cost modifications in diet prevent a substantial number of deaths and mitigate environmental impacts in Brazil.

Abstract

This study aimed to estimate the health, economic, and environmental impacts of moderate simulated interventions on dietary intake in Brazil. Data on food price and consumption were obtained from three nationwide surveys. Baseline dietary intake was estimated for 33,859 individuals aged 25years and older. Counterfactual intakes were based on six hypothetical intervention scenarios, by changing the weekly frequency and serving size in low or high consumers of fruit and vegetables (FV), milk, whole grains, red and processed meats, and sugar-sweetened beverages. For each scenario, we estimated the attributable number of deaths and disability-adjusted life years (DALY), monetary cost, environmental impacts (14 midpoint indicators), and environmentally-mediated health impacts. Compared with the baseline intake and cost, the most expensive intervention (+ 8.3%) was to increase FV intake (+ 125g), resulting in a 1.2% reduction in all-cause mortality (16,307 deaths/year). The cheapest (- 9.9%) was to reduce red and processed meat intake (- 40g), resulting in a 1.1% reduction in all-cause mortality (14,272 deaths/year). The combined intervention was, on average, 3.7% cheaper than the baseline cost, resulting in an increase in diet cost for 30% of the population (45-22% in the lower- and higher-income groups); all-cause mortality would be reduced by 3.8% (49,488 deaths/year). Interventions targeting red and processed meats would reduce emissions and resource use by 35-55%, in addition to reducing 2300 DALYs/year. A meaningful number of deaths can be avoided and environmental impacts reduced through moderate and potentially affordable diet modifications.