A cost effective approach to combating the diabesity epidemic with an integrated diet and lifestyle approach

Professor Catherine Itsiopoulos, BSc(Hons) Grad Dip Diet MPH PhD APD1

1 Head of School of Allied Health, Professor of Dietetics and Human Nutrition, La Trobe University

Cardiovascular Disease is a major cause of disease burden and death in the Australian population, accounting for 29% of all deaths. Furthermore, with the increasing prevalence of obesity and type 2 diabetes, premature CVD as a complication of type 2 diabetes is also rising. Because of this increasing prevalence, CVD-related health-care expenditure has been estimated at $8 billion, higher than for any other disease. Although there are long-standing public health strategies targeting primary prevention of CVD, the dominant treatment for people with established CVD is pharmacotherapy, with $3 billion spent on non-hospital prescription CVD medications alone in 2009-10. Dietary interventions have demonstrated benefits in both primary and secondary prevention of CVD. For example, the INTERHEART case-control study identified diet as one of nine modifiable risk factors that account for more than 90% of the population attributable risk for acute myocardial ischemia worldwide.

However, while there has been significant attention to the primary prevention of CVD, there has been less attention given to improving secondary or tertiary prevention, where the risks of an imminent CVD event are considerably higher and where benefits from a reduction in risk are considerably greater and will accrue almost immediately. The traditional Mediterranean diet and lifestyle has been established as cardioprotective and cost effective in European trials however there are knowledge gaps that prevent the clear translation of those recommendations into the Australian healthcare setting. The AUSMED Heart Trial aims to address these knowledge gaps.