January 2013, Volume 24, Issue 1, pp 139-150,
Open Access This content is freely available online to anyone, anywhere at any time.
Date: 16 Jun 2012
Dairy foods and osteoporosis: an example of assessing the health-economic impact of food products
Osteoporosis has become a major health concern, carrying a substantial burden in terms of health outcomes and costs. We constructed a model to quantify the potential effect of an additional intake of calcium from dairy foods on the risk of osteoporotic fracture, taking a health economics perspective.
This study seeks, first, to estimate the impact of an increased dairy consumption on reducing the burden of osteoporosis in terms of health outcomes and costs, and, second, to contribute to a generic methodology for assessing the health-economic outcomes of food products.
We constructed a model that generated the number of hip fractures that potentially can be prevented with dairy foods intakes, and then calculated costs avoided, considering the healthcare costs of hip fractures and the costs of additional dairy foods, as well as the number of disability-adjusted life years (DALYs) lost due to hip fractures associated with low nutritional calcium intake. Separate analyses were done for The Netherlands, France, and Sweden, three countries with different levels of dairy products consumption.
The number of hip fractures that may potentially be prevented each year with additional dairy products was highest in France (2,023), followed by Sweden (455) and The Netherlands (132). The yearly number of DALYs lost was 6,263 for France, 1,246 for Sweden, and 374 for The Netherlands. The corresponding total costs that might potentially be avoided are about 129 million, 34 million, and 6 million Euros, in these countries, respectively.
This study quantified the potential nutrition economic impact of increased dairy consumption on osteoporotic fractures, building connections between the fields of nutrition and health economics. Future research should further collect longitudinal population data for documenting the net benefits of increasing dairy consumption on bone health and on the related utilization of healthcare resources.
Steijns JM (2008) Dairy products and health: focus on their constituents or on the matrix? Int Dairy J 18:425–435CrossRef
Gracia A, Albisu LM (2001) Food consumption in the European Union: main determinants and country differences. Agribusiness 17:469–488CrossRef
Hjartåker A, Lagiou A, Slimani N, Lund E, Chirlaque MD, Vasilopoulou E, Zavitsanos X, Berrino F, Sacerdote C, Ocke MC, Peeters PH, Engeset D, Skeie G, Aller A, Amiano P, Berglund G, Nilsson S, McTaggart A, Spencer EA, Overvad K, Tjonneland A, Clavel-Chapelon F, Linseisen J, Schulz M, Hemon B, Riboli E (2002) Consumption of dairy products in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort: data from 35955 24-hour dietary recalls in 10 European countries. Public Health Nutr 5:1259–1271PubMedCrossRef
Elwood PC, Givens DI, Beswick AD, Fehily AM, Pickering JE, Gallacher J (2008) The survival advantage of milk and dairy consumption: an overview of evidence from cohort studies of vascular diseases, diabetes and cancer. J Am Coll Nutr 27:723S–734SPubMed
Tremblay A, Gilbert JA (2009) Milk products, insulin resistance syndrome and type 2 diabetes. J Am Coll Nutr 28(Suppl 1):91S–102SPubMed
Heaney RP (2000) Calcium, dairy products and osteoporosis. J Am Coll Nutr 19:83S–99SPubMed
Kalkwarf HJ, Khoury JC, Lanphear BP (2003) Milk intake during childhood and adolescence, adult bone density, and osteoporotic fractures in US women. Am J Clin Nutr 77:257–265PubMed
Shea B, Wells G, Cranney A, Zytaruk N, Robinson V, Griffith L, Ortiz Z, Peterson J, Adachi J, Tugwell P, Guyatt G (2002) Meta-analyses of therapies for postmenopausal osteoporosis. VII. Meta-analysis of calcium supplementation for the prevention of postmenopausal osteoporosis. Endocr Rev 23:552–559PubMedCrossRef
World Health Organization (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis, WHO Technical report series no. 843. World Health Organization, Geneva
Papaioannou A, Kennedy CC, Ioannidis G, Sawka A, Hopman WM, Pickard L, Brown JP, Josse RG, Kaiser S, Anastassiades T, Goltzman D, Papadimitropoulos M, Tenenhouse A, Prior JC, Olszynski WP, Adachi JD (2009) The impact of incident fractures on health-related quality of life: 5 years of data from the Canadian multicentre osteoporosis study. Osteoporos Int 20:703–714PubMedCrossRef
De Laet CE, Van Hout BA, Hofman A, Pols HA (1996) Costs of osteoporosis-related fractures in The Netherlands, 1993; possibilities of cost control [in Dutch]. Ned Tijdschr Geneeskd 140:1684–1688PubMed
Geusens P (2011) Long term treatment for fracture prevention: adherence versus evidence [abstract]. Ann Rheum Dis 70:41
Gyles CL, Lenoir-Wijnkoop I, Carlberg JG, Senanayake V, Gutierrez-Ibarluzea I, Poley MJ, Dubois D, Jones PJ (2012) Health economics and nutrition: a review of published evidence. Nutrition Reviews (in press)
Elixhauser A, Halpern M, Schmier J, Luce BR (1998) Health care CBA and CEA from 1991 to 1996: an updated bibliography. Medical Care 36:MS1, MS9, MS18–MS147
Ocké MC, Hulshof KFAM, Bakker MI, Stafleu A, Streppel MT (2005) Towards a new system of dietary monitoring in the Netherlands [in Dutch]. National Institute for Public Health and the Environment (RIVM), Bilthoven
International Osteoporosis Foundation (2011) Calcium. http://www.iofbonehealth.org/patients-public/about-osteoporosis/prevention/nutrition/calcium.html. Accessed August 9, 2011
Ross AC, Taylor CL, Yaktine AL, Del Valle HB (2010) Dietary reference intakes for calcium and vitamin D. Institute of Medicine of the National Academy of Sciences (IOM), Washington
Health Insurance Board (2006) Guidelines for pharmacoeconomic research. Updated version. Health Insurance Board, Diemen
Rothmann KJ, Greenland S (2008) Modern epidemiology. Lippincott, Philadelphia
RIVM (2010) Nederlands voedingstoffenbestand (NEVO); http://nevo-online.rivm.nl/
Heaney RP (2008) Nutrients, endpoints, and the problem of proof. J Nutr 138:1591–1595PubMed
Fransen HP, Waijers PMCM, Jansen EHJM, Ocké MC (2007) Assessment of nutritional status in the new system of dietary monitoring in the Netherlands. RIVM, Zeist/Bilthoven
Leslie WD, O'Donnell S, Jean S, Lagace C, Walsh P, Bancej C, Morin S, Hanley DA, Papaioannou A, Osteoporosis Surveillance Expert Working Group (2009) Trends in hip fracture rates in Canada. JAMA 302:883–889CrossRef
Commission E (2002) Price differences for supermarket goods in Europe. Internal working document of the Internal Market Directorate General. European Commission, Brussels
Bischoff-Ferrari HA, Dawson-Hughes B, Baron JA, Kanis JA, Orav EJ, Staehelin HB, Kiel DP, Burckhardt P, Henschkowski J, Spiegelman D, Li R, Wong JB, Feskanich D, Willett WC (2011) Milk intake and risk of hip fracture in men and women: a meta-analysis of prospective cohort studies. J Bone Miner Res 26:833–839PubMedCrossRef
Avenell A, Gillespie WJ, Gillespie LD, O’Connell D (2009) Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis. Cochrane Database Syst Rev (2):CD000227
Dawson-Hughes B, Harris SS (2002) Calcium intake influences the association of protein intake with rates of bone loss in elderly men and women. Am J Clin Nutr 75:773–779PubMed
Agence Française de Sécurité Sanitaire des Produits de Santé (2006) Traitement médicamenteux de l'ostéoporose post-ménopausique. Recommendations. Actualisation 2006. Agence Française de Sécurité Sanitaire des Produits de Santé. Saint-Denis Cedex, France
Bischoff-Ferrari HA, Rees JR, Grau MV, Barry E, Gui J, Baron JA (2008) Effect of calcium supplementation on fracture risk: a double-blind randomized controlled trial. Am J Clin Nutr 87:1945–1951PubMed
Shea B, Wells G, Cranney A, Zytaruk N, Robinson V, Griffith L, Hamel C, Ortiz Z, Peterson J, Adachi J, Tugwell P, Guyatt G (2004) Calcium supplementation on bone loss in postmenopausal women. Cochrane Database Syst Rev 1:CD004526
- Dairy foods and osteoporosis: an example of assessing the health-economic impact of food products
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Volume 24, Issue 1 , pp 139-150
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Dairy products
- Hip fractures
- Nutrition economics
- Industry Sectors
- Author Affiliations
- 1. Institute of Health Policy and Management (iBMG), Erasmus University Rotterdam, Rotterdam, The Netherlands
- 2. Departement of Pharmaceutical Sciences, University of Utrecht, Sorbonnelaan 16, 3508TB, Utrecht, The Netherlands
- 3. Danone Research, Route Départementale 128, 91767, Palaiseau, France
- 4. Service de Rhumatologie, Centre Hospitalier Universitaire Amiens, INSERM ERI 12, Amiens, France
- 5. University Hospital Geneva, Bone Diseases, Geneva, Switzerland
- 6. Institute for Medical Technology Assessment (iMTA), Erasmus University Rotterdam, Rotterdam, The Netherlands