Seferidi Paraskevi, Laverty Anthony A, Collins Brendan, Bandosz Piotr, Capewell Simon, O'Flaherty Martin, Millett Christopher, Pearson-Stuttard Jonathan
Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK.
Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
BMJ Nutr Prev Health. 2020 Jan 14;3(1):3-10. doi: 10.1136/bmjnph-2019-000057. eCollection 2020.
Current proposals for post-Brexit agricultural policy do not explicitly incorporate public health goals. The revised agricultural policy may be an opportunity to improve population health by supporting domestic production and consumption of fruits and vegetables (F&V). This study aims to quantify the potential impacts of a post-Brexit agricultural policy that increases land allocated to F&V on cardiovascular disease (CVD) mortality and inequalities in England, between 2021 to 2030.
We used the previously validated IMPACT Food Policy model and probabilistic sensitivity analysis to translate changes in land allocated to F&V into changes in F&V intake and associated CVD deaths, stratified by age, sex and Index of Multiple Deprivation. The model combined data on F&V agriculture, waste, purchases and intake, CVD mortality projections and appropriate relative risks. We modelled two scenarios, assuming that land allocated to F&V would gradually increase to 10% and 20% of land suitable for F&V production.
We found that increasing land use for F&V production to 10% and 20% of suitable land would increase fruit intake by approximately 3.7% (95% uncertainty interval: 1.6% to 8.6%) and 17.4% (9.1% to 36.9%), and vegetable intake by approximately 7.8% (4.2% to 13.7%) and 37% (24.3% to 55.7%), respectively, in 2030. This would prevent or postpone approximately 3890 (1950 to 7080) and 18 010 (9840 to 28 870) CVD deaths between 2021 and 2030, under the first and second scenario, respectively. Both scenarios would reduce inequalities, with 16% of prevented or postponed deaths occurring among the least deprived compared with 22% among the most deprived.
Post-Brexit agricultural policy presents an important opportunity to improve dietary intake and associated cardiovascular mortality by supporting domestic production of F&V as part of a comprehensive strategy that intervenes across the supply chain.
当前脱欧后农业政策的提议未明确纳入公共卫生目标。修订后的农业政策可能是一个通过支持国内水果和蔬菜(F&V)生产与消费来改善人口健康的契机。本研究旨在量化2021年至2030年间脱欧后增加用于F&V种植土地的农业政策对英格兰心血管疾病(CVD)死亡率及不平等状况的潜在影响。
我们使用先前验证过的IMPACT食品政策模型和概率敏感性分析,将用于F&V种植土地的变化转化为F&V摄入量的变化以及相关的CVD死亡人数变化,并按年龄、性别和多重贫困指数进行分层。该模型整合了F&V农业、浪费、购买和摄入量的数据、CVD死亡率预测以及适当的相对风险。我们模拟了两种情景,假设用于F&V种植的土地将逐渐增加到适合F&V生产土地的10%和20%。
我们发现,到2030年,将用于F&V生产的土地使用量增加到适合土地的10%和20%,水果摄入量将分别增加约3.7%(95%不确定区间:1.6%至8.6%)和17.4%(9.1%至36.9%),蔬菜摄入量将分别增加约7.8%(4.2%至13.7%)和37%(24.3%至55.7%)。在第一种和第二种情景下,这将分别在2021年至2030年间预防或推迟约3890例(1950至7080例)和18010例(9840至28870例)CVD死亡。两种情景都将减少不平等,在最不贫困人群中,预防或推迟死亡的比例为16%,而在最贫困人群中为22%。
脱欧后的农业政策提供了一个重要机会,通过支持国内F&V生产作为跨供应链干预的综合战略的一部分,来改善饮食摄入和相关的心血管死亡率。