English diet could save 4,000 Scottish, Welsh and Irish lives

Scots eating more fruit and veg would reduce the health gap with England.

Around 4,000 deaths could be prevented every year if the Scots, Welsh and Northern Irish adopted the average diet eaten in England, Oxford University researchers have calculated.

The chief factor that is driving the ‘mortality gap’ between the home nations is fruit and vegetables, the researchers say.

Consumption of fruit and vegetables in Scotland is around 12% lower than in England, and it is about 20% lower in Northern Ireland. The Welsh eat about the same amount as the English.

Other important factors are salt and saturated fat, which feature more in Scottish, Welsh and Irish diets than English diets.

The study was funded by the British Heart Foundation and published in the medical journal BMJ Open.

Peter Scarborough of the Department of Public Health at Oxford University, who led the study, said: ‘Small improvements in dietary quality in Scotland and Northern Ireland (and, to a lesser degree, Wales) could result in substantial narrowing of health inequalities within the United Kingdom.

‘If dietary quality within Northern Ireland, Scotland and Wales were equivalent to England, then we would expect there to be around 3700 fewer deaths in these countries annually.’

Scarborough says that the study did not consider the effectiveness of policies or interventions aimed at improving people’s diets. ‘However, from other work that has been conducted in this area, we believe that taxes on salt and saturated fat, coupled with subsidies for fruit and vegetables, should be considered,’ he says.

"We believe that taxes on salt and saturated fat, coupled with subsidies for fruit and vegetables, should be considered."

Peter Scarborough

Death rates for heart disease, stroke and cancer are higher in Scotland, Wales, and Northern Ireland than they are in England. These diseases are known to be associated with a poor diet that is high in saturated fats and salt, and low in fibre, fruits and vegetables.

‘The objective of this paper was to explore the nature of the health inequalities between the four countries of the United Kingdom,’ explains Scarborough. ‘The English diet was not chosen as an example of a healthy diet, which it most certainly is not! At present in England we do not meet government recommendations for average consumption of salt, saturated fat and fruit and vegetables.

‘However, selecting the English diet as a “comparison” diet for Wales, Scotland and Northern Ireland is useful as it allows for comparisons with a diet that is similar and – crucially – achievable,’ he adds.

The researchers from the Department of Public Health at Oxford looked at mortality data for coronary heart disease, stroke, and 10 cancers associated with diet in each of the four home nations over three years from 2007 to 2009.

And they estimated average diets in Scotland, England, Wales and Northern Ireland, using representative data from the Family Food Survey for the same period.

The team then used a mathematical model to calculate the impact of diets on death rates.

They found that inequalities in death rates between England, Northern Ireland and Wales can largely be explained by differences in their diets.

The poorer diets seen in Scotland, however, only accounted for around 40% of the difference in mortality rate compared with England.

‘There are many other factors that could account for the remaining health inequalities between the four countries, after diet has been taken into account,’ notes Scarborough. ‘The prevalence of smoking, alcohol consumption and physical activity levels, which are not uniform across the UK, could have an impact on incidence rates.’