Subsidies on healthy eats, taxes on sugary drinks may lead to better cardiovascular outcomes

A microsimulation cardiovascular disease risk prediction model found that a 10 percent subsidy on the price of fruits and vegetables would lead to reductions in cardiovascular disease deaths, non-fatal MI and non-fatal stroke.

In addition, a 10 percent tax on sugar-sweetened beverages would reduce cardiovascular disease deaths, MI, stroke and diabetes, while a 10 percent subsidy on the price of whole grains would reduce cardiovascular disease deaths and MI.

Lead researcher Thomas A. Gaziano, MD, MSc, an assistant professor at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health in Boston, and colleagues presented their results on March 1 at the American Heart Association’s Epidemiology/Lifestyle 2016 Scientific meeting in Phoenix.

“A change in your diet can be challenging, but if achieved through personal choice or changes in the market place, it can have a profound effect on your cardiovascular health,” Gaziano said in a news release.

The model included a million adults who were at least 35 years old and were part of the National Health and Nutrition Examination Survey. Inputs for the model included patient risk factors, cardiovascular disease risk equations and intervention effectiveness data. The researchers also added groups of 35 year olds each year to determine outcomes for 2015 through 2035.

Based on the model, the researchers estimated a 10 percent subsidy on the price of fruits and vegetables would lead to an 8 percent reduction in 5-year cardiovascular disease deaths, a 10 percent reduction in 20-year cardiovascular disease deaths, a 16 percent reduction in 5-year non-fatal MI, an 18 percent reduction in 20-year non-fatal MI, a 25 percent reduction in 5-year non-fatal stroke and a 24 percent reduction in 20-year non-fatal stroke.

Meanwhile, a 10 percent subsidy on the price of whole grains would lead to a 2.5 percent reduction in 5-year cardiovascular disease deaths, a 3 percent reduction in 20-year cardiovascular disease deaths, a 9.1 percent reduction in 5-year MI and a 9.7 percent reduction in 20-year MI.

Further, a 10 percent tax on sugar-sweetened beverages would lead to a 0.8 percent reduction in 5-year cardiovascular disease deaths, a 1.3 percent reduction in 20-year cardiovascular disease deaths, a 2.5 percent reduction in 5-year MI, an 2.5 percent reduction in 20-year MI, a 1.8 percent reduction in 5-year stroke, a 2.3 percent reduction in 20-year stroke, a 2.6 reduction in 5-year diabetes and a 9.8 percent reduction in 20-year diabetes.

Taken together, if all three scenarios existed, there would be more than 3.5 million fewer cardiovascular disease deaths and more than 4 million fewer cardiovascular disease events by 2035.

The AHA said in a news release that the Navajo Nation eliminated taxes on fruits and vegetables and increased taxes on sugary drinks last year. It is using the revenue created through the initiative to launch education campaigns and programs promoting healthy behaviors. Mexico has also implemented a peso per liter tax on sugary drinks, which the AHA said has led to fewer purchases.

“These novel findings support the need to combine modest taxes and subsidies to better represent the real costs of food to health and society,” senior author Dariush Mozaffarian, MD, DrPH, said in a news release.