Impacts of Brexit on fruit and vegetable intake and cardiovascular disease in England: a modelling study.



Seferidi, Paraskevi, Laverty, Anthony A, Pearson-Stuttard, Jonathan, Bandosz, Piotr ORCID: 0000-0002-6395-6216, Collins, Brendan ORCID: 0000-0002-3023-8189, Guzman-Castillo, Maria, Capewell, Simon ORCID: 0000-0003-3960-8999, O'Flaherty, Martin ORCID: 0000-0001-8944-4131 and Millett, Christopher
(2019) Impacts of Brexit on fruit and vegetable intake and cardiovascular disease in England: a modelling study. BMJ open, 9 (1). e026966 - e026966.

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Abstract

OBJECTIVES:To estimate the potential impacts of different Brexit trade policy scenarios on the price and intake of fruits and vegetables (F&V) and consequent cardiovascular disease (CVD) deaths in England between 2021 and 2030. DESIGN:Economic and epidemiological modelling study with probabilistic sensitivity analysis. SETTING:The model combined publicly available data on F&V trade, published estimates of UK-specific price elasticities, national survey data on F&V intake, estimates on the relationship between F&V intake and CVD from published meta-analyses and CVD mortality projections for 2021-2030. PARTICIPANTS:English adults aged 25 years and older. INTERVENTIONS:We modelled four potential post-Brexit trade scenarios: (1) free trading agreement with the EU and maintaining half of non-EU free trade partners; (2) free trading agreement with the EU but no trade deal with any non-EU countries; (3) no-deal Brexit; and (4) liberalised trade regime that eliminates all import tariffs. OUTCOME MEASURES:Cumulative coronary heart disease and stroke deaths attributed to the different Brexit scenarios modelled between 2021 and 2030. RESULTS:Under all Brexit scenarios modelled, prices of F&V would increase, especially for those highly dependent on imports. This would decrease intake of F&V between 2.5% (95% uncertainty interval: 1.9% to 3.1%) and 11.4% (9.5% to 14.2%) under the different scenarios. Our model suggests that a no-deal Brexit scenario would be the most harmful, generating approximately 12 400 (6690 to 23 390) extra CVD deaths between 2021 and 2030, whereas establishing a free trading agreement with the EU would have a lower impact on mortality, contributing approximately 5740 (2860 to 11 910) extra CVD deaths. CONCLUSIONS:Trade policy under all modelled Brexit scenarios could increase price and decrease intake of F&V, generating substantial additional CVD mortality in England. The UK government should consider the population health implications of Brexit trade policy options, including changes to food systems.

Item Type: Article
Depositing User: Symplectic Admin
Date Deposited: 08 Feb 2019 08:56
Last Modified: 25 Feb 2020 09:53
DOI: 10.1136/bmjopen-2018-026966
Open Access URL: https://bmjopen.bmj.com/content/9/1/e026966
URI: http://livrepository.liverpool.ac.uk/id/eprint/3032460