As health care costs surge globally due to an ever increasing burden of disease, the role that healthy foods such as flaxseed can play in disease reduction and even therapeutically is of great interest. Although research is sparse and somewhat dated, there is evidence to suggest that healthy components such as flaxseed can provide reductions in health care costs.
Manitoba researchers Rodriguez-Leyva, McCullough and Pierce present a compelling case for implementing novel nutritional interventions that can positively affect the incidence of heart disease in the general population (1). Strong arguments are made as to the influence that nutrition can make in terms of the treatment of cardiovascular disease (CVD). The researchers – who are also global leaders in the study of the health benefits of flaxseed – identify a number of foods and their bioactives that have been associated with clinically significant reductions in CVD markers. The authors cite recommendations in the National Cholesterol Education Program of the U.S. National Institutes of Health that include unsaturated fats (such as alpha-linolenic acid, ALA) and dietary fibre as part of primary preventive measures (2).
The potential health care cost reductions that could be attributed to flaxseed consumption for cardiovascular disease and type-2 diabetes has been estimated (3). For cardiovascular diseases, these reductions ranged from a low of $1.2 million, when base case estimates are used, to a high of $3.6 million, when best case estimates of consumption are employed. In the case of type 2 diabetes, estimates ranged from $ 0.48 million, when base case estimates are used, to $1.4 million, when the best case estimates are employed. In total, these health economic benefits range from $1.3 million to $3.8 million.
A very early study assessed the cost savings to the Canadian government with the introduction of functional foods and natural health products (NHP) into the diet. Holub identified that such nutritional constituents could reduce the costs of health care by $19 billion per annum, representing almost 20% of the health care budget for several disease states (4).
Another good example of such benefits is that of folic acid which has been the subject of mandatory supplementation of grain products in the US and Canada to prevent neural tube defects since 1998. Hornburger estimated that since folic acid also decreases homocysteine levels – a risk factor for CVD – $11 billion USD reductions in health care costs result in North America yearly (5).
Even more compelling to this argument is the observation that omega-3 deficiency is the sixth largest cause of premature death of Americans and more deadly than excess trans fat intake (6). Twelve dietary, lifestyle and metabolic risk factors such as high blood pressure were used to determine how many fatalities could have been prevented if better practices had been observed. It was determined that in the US there are 72,000-96,000 preventable deaths each year due to omega-3 deficiency, compared to 63,000-97,000 for high trans fat intake. Tobacco smoking ranked as the highest risk factor with 436,000 to 500,000 attributed preventable deaths, followed by high blood pressure (372,000 to 414,000), obesity (188,000 to 237,000), physical inactivity (164,000 to 222,000) and high salt intake (97,000-107,000). The other risk factors were high blood glucose; low-density lipoprotein (LDL) cholesterol and low fruits and vegetables intake.
Canola oil, which contains about 10% of its fatty acids as ALA, may reduce health care costs in Canada due to its positive effect on CVD (7). It is estimated that an additional 100,000 tonnes of canola oil being consumed in Canada would result in a reduction in health care costs of $167 million per year. This is a very conservative estimate, as the increase in canola oil consumption could be well over 100,000 tonnes, and the reduction in health care costs includes only those related to CVD, and not to diabetes or other disease states that may be positively affected by canola oil.
These intriguing publications support the premise that advances in human health could be derived from the nutritional effects of food and their bioactives. Such observations would translate into reductions in the trajectory of health service costs and enhancements to the productivity of the population. More research is required to confirm and expand these results. Communications as to the role that a healthy diet – including flaxseed – can play in reducing overall disease risk as well as health care costs is indeed warranted.
References
- Rodriguez-Leyva, D., McCullough, R. and Pierce, G.N. 2009. Nutrition as a vehicle for cardiovascular translational research. J. Cardiovasc. Translational Res., 2: 328-334.
- Retelny, V. S., Neuendorf, A., and Roth, J. L. 2008. Nutrition protocols for the prevention of cardiovascular disease. Nutr Clinical Prac. 23:468–476.
- Coyte, Peter, C. 2005. Health Economic Impact Assessment of the Nutritional Effects of Flax, Report to Flax Canada 2015. November.
- Holub, B. J. 2002. Potential benefits of functional foods and nutraceuticals to reduce the risk and costs of disease in Canada. Ottawa, ON: Agriculture and Agri-Food Canada.
- Hornburger, J. 1998. A cost-benefit analysis of a cardiovascular disease prevention trial, using folate supplementation as an example. Amer. J Public Health. 88:61–66.
- Danaei, G., Ding, EL, Mozaffarian, D, et al. 2009. The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors. Public Library Sci Med J. Vol. 6, April.
- Stavroula Malla, S., Hobbs, J. and Perger, O. 2007. Valuing the Health Benefits of a Novel Functional Food. Can J Agric Econ. 55:115–136.