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Providing perspectives on recent research into vitamins and nutritionals


Eating to Reduce Prescription and Health Care Costs

By Michael McBurney

A new report finds that the USA has the highest total and public health expenditure per person compared to 5 countries (Canada, France, Germany, Netherlands, and Switzerland). The average health expenditure per person was $7,212 in 2011. The US spent 17% of GDP on health spending whereas the other 5 nations ranged between 10.6 to 11%. Out-of-pocket health expenditure per person is the highest except for Switzerland. Probably attributable to higher spending on hospital costs ($2,408 vs $909 to $1,501) and pharmaceutical and other medical non-durables ($878 vs $408 to $664). Generally, private insurer models (Netherlands, Switzerland, USA) had weaker cost control whereas national government or social insurance administration (Canada, France, Germany) had lower administrative costs than multiple-payer systems.

While death and taxes may be inescapable, long prosperous lives with minimal chronic disease require adequate amounts of vitamins, minerals, and omega-3 fatty acids. As Werner Schultink, UNICEF said, “We know for sure that, unless you provide good nutrition, something goes terribly wrong in later life.” Nutrition during the first 1,000 days of life affects lifetime productivity and health. Children who are stunted are predicted to earn nearly a quarter less income during adulthood than their well-nourished peers. Globally, 1 in 4 children under the age of 5 is stunted.

Abizari and colleagues compared nutrient intake adequacy and nutritional status of 383 children (5-13y) attending schools with and without schoollunch programs in Ghana. At home, the 3 main meals consisted of maize porridge, sometimes with sugar, groundnut flour/paste, okra, or vegetable soups added. The school lunch used a multiple-micronutrient-fortified corn soya blend from the World Food Programme which significantly increased median intakes of energy, protein, fat, iron, zinc, calcium, vitamin C, vitamin A, vitamin B12, and folate. The proportion of children below the estimated average requirement (EAR) was significantly reduced for all vitamins and minerals except calcium. The authors conclude that micronutrient-dense foods are important to achieve micronutrient adequacy.

Micronutrient density is also important in developed nations. Malnutrition  co-exists with obesity and overweight.  Millions of Americans suffer nutritional deficiencies. Nutrient density should be our guiding principle (Miller et al, 2009). Micronutrients are essential for growth and development. Maintaining a healthy body weight involves more than balancing caloric consumption with energy expenditure. Making nutrient-dense food choices is the only way to obtain essential nutrients in a set number of calories without dietary supplementation.

Nutrition matters. After all, our health and health care costs depend upon consuming the right balance of essential nutrients and calories from the beginning of life until the end.

Main Citations

Lorenzoni L, Belloni A, Sassi F. Health-care expenditure and health policy in the USA and other high-spending OECD countries. 2014 Lancet doi: 10.1016/S0140-6736(14)60571-7

Abizari A-R, Buxton C, Kwara L, Mensah-Homiah J, Armar-Klemesu M, Brouwer ID. School feeding contributes to micronutrient adequacy of Ghanian schoolchildren. 2014 Br J Nutr doI: 10.1017/S0007114514001585

Other Citation

Miller GD, Drewnowski A, Fulgoni V, Heaney RP, King J, Kennedy E. It is time for a positive approach to dietary guidance using nutrient density as a basic principle. 2009 J Nutr doi: 10.3945/jn.108.100842