Type 2 Diabetes-Related Health Economic Impact Associated with Increased Whole Grains Consumption among Adults in Finland

Abstract

The prevalence of type 2 diabetes (T2D) is increasing rapidly worldwide. A healthy diet supporting the control of energy intake and body weight has major importance in the prevention of T2D. For example, a high intake of whole grain foods (WGF) has been shown to be inversely associated with risk for T2D. The objective of the study was to estimate the expected health economic impacts of increased WGF consumption to decrease the incidence of T2D in the Finnish adult population. A health economic model utilizing data from multiple national databases and published scientific literature was constructed to estimate these population-level health economic consequences. Among the adult Finnish population, increased WGF consumption could reduce T2D-related costs between 286€ and 989€ million during the next 10-year time horizon depending on the applied scenario (i.e., a 10%-unit increase in a proportion of daily WGF users, an increased number (i.e., two or more) of WGF servings a day, or alternatively a combination of these scenarios). Over the next 20–30 years, a population-wide increase in WGF consumption could lead to much higher benefits. Furthermore, depending on the applied scenario, between 1323 and 154,094 quality-adjusted life years (QALYs) could be gained at the population level due to decreased T2D-related morbidity and mortality during the next 10 to 30 years. The results indicate that even when the current level of daily WGF consumption is already at a relatively high-level in a global context, increased WGF consumption could lead to important health gains and savings in the Finnish adult population.

Opportunities to increase whole grain intake within the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

“…While the expert roundtable acknowledged the higher cost of whole grain foods, they also noted this must be balanced by the potential public health benefit and cost savings in health care and quality of life that could be realized through increased whole grain intake. Several modeling studies in the United States, Europe, and Australia have consistently reported health care costs savings if individuals met the recommended intakes for whole grain (Abdullah et al, 2021; Martikainen et al, 2021; Murphy & Schmier, 2020). In the United States, if the population consumed the recommended amount of whole grain each day, the direct medical cost savings for cardiovascular disease alone was estimated to be $21.9 billion (Murphy & Schmier, 2020).…”

Economic evaluation of using polygenic risk score to guide risk screening and interventions for the prevention of type 2 diabetes in individuals with high overall baseline risk

“…In the present study, the societal perspective (excluding direct non-medical costs, such as travel costs associated with the utilization of health care services) was applied in the study. The excess primary health care cost estimates of T2D were obtained from a recent Finnish study ( Martikainen et al, 2021 ). The excess secondary health care costs of T2D, its complications and T2D-related productivity losses for persons under the age of 65 were based on previous Finnish studies ( Koski et al, 2017 ; Koski et al, 2018a ; Koski et al, 2018b ).…”

“…To model the risk of T2D-related micro- and macrovascular complications in persons with newly diagnosed T2D, a previously developed Weibull survival regression model was applied ( Martikainen et al, 2021 ). The coefficients of the Weibull regression for the incidence of T2D-related complications is shown in Supplementary Material S4 .…”

The relation of whole grain surrogate estimates and food definition to total whole grain intake in the Finnish adult population

“…Several surrogate estimates have been applied worldwide to approximate whole grain intake instead of calculating total whole grain intake from the whole diet as recommended [6]. The estimates have mainly been based on the consumption of certain whole grain-containing foods, such as whole grain bread or breakfast cereals [7][8][9][10][11]. However, the accuracy of these estimates in relation to total whole grain intake has not been assessed.…”