Diet and Health: Diseases and Food 295It estimated that costs for the health service will rise alarmingly if targets are not
met to reduce CHD and cancers. CHD treatment costs (drugs like statins and
surgical techniques like revascularization) would add an additional £2.4 billion per
annum by 2010–2011, doubling CHD expenditure. Such calculations remind us
of the multi-headed nature of ill health. Smoking, diet, physical activity, genetics,
environment and socioeconomic background all have direct health outcomes.
Wanless and his team were convinced by US scientific work that high cholesterol –
‘which is mainly due to diet’ – accounts for 43 per cent of CHD incidence, com-
pared to 20 per cent for smoking. This sort of evidence shows that the poor diet
has such far-reaching financial implications that it warrants higher political atten-
tion. This case was confirmed by a second Wanless study arguing for the economic
value of facing the public health costs of poor diet, life-style and education.^81 How-
ever, for the last quarter of a century policy attention has been directed to cutting
costs, not by altering the food supply chain, but by such policies as contracting out
services and by privatization. In the UK, less than £5 million a year is spent on
food-related health education. Meanwhile, drug companies and surgeons only
offer expensive but highly sophisticated solutions when the patient is already
sick.
Indeed, drug treatments can be hugely expensive. A trial on over 20,000 UK
people with high risks for heart disease showed that giving patients a type of drug
known as statins reduced the risk of a first coronary attack by 25 per cent but
would cost £1 ($1.5) per patient per day.^82 Currently, 1.8 million people are pre-
scribed statins, costing UK£750 million a year. Taking statins for three years can
reduce the risk of a heart attack by up to a third.
Coronary Heart Disease (CHD)
Since 1999, the WHO has attributed 30 per cent of all annual global deaths – that
is, of 15 million people – to cardiovascular disease.83,84 The majority of those deaths
are in low- and middle-income countries. In 1998, 86 per cent of DALYs were lost
to cardiovascular disease (CVD) worldwide.
The main risk factors for heart disease are high blood pressure, smoking and
lipid concentrations (cholesterol levels). Others include age, sex, family history
and the presence of diabetes. WHO recommendations for reducing CVD
include:^85
- regular physical activity;
- linoleic acid;
- fish and fish oils;
- vegetables and fruits, including berries;
- potassium;
- low to moderate alcohol intake.