title: The European Common Agricultural Policy on fruits and vegetables: exploring potential health gain from reform.
abstract: BACKGROUND
  Consumption of fruits and vegetables is associated with a reduced risk of cardiovascular disease and cancer. The European Union Common Agricultural Policy keeps prices high by limiting the availability of fruits and vegetables. This policy is at odds with public health interests. We assess the potential health gain for the Dutch population of discontinuing EU withdrawal support for fruits and vegetables.
  
  
  METHODS
  The maximum effect of the reform was estimated by assuming that a quantity equivalent to the amount of produce withdrawn in recent years would be brought onto the market. For the calculation of the effect of consumption change on health we constructed a multi-state life table model in which consumption of fruits and vegetables is linked to ischaemic heart disease, stroke, and cancer of the oesophagus, stomach, colorectum, lung and breast. Uncertainty is quantified using Monte Carlo simulation.
  
  
  RESULTS
  The reform would maximally increase the average consumption of fruits and vegetables by 1.80% (95% uncertainty interval 1.12-2.73), with an ensuing increase in life expectancy of 3.8 (2.2-5.9) days for men and 2.6 (1.5-4.2) days for women. The reform is also likely to decrease socio-economic inequalities in health.
  
  
  CONCLUSIONS
  Ending EU withdrawal support for fruits and vegetables could result in a modest health gain for the Dutch population, though uncertainty in the estimates is high. A more comprehensive examination of the health effects of the EU agricultural policy could help to ensure health is duly considered in decision-making.
authors.affiliation: Department of Public Health, Erasmus MC--University Medical Centre Rotterdam, The Netherlands. j.veerman@erasmusmc.nl
authors.forename: J Lennert
authors.initials: JL
authors.lastname: Veerman
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Barendregt
authors.forename: Johan P
authors.initials: JP
authors.lastname: Mackenbach
mesh_terms: D000383:Agriculture / Q000191:economics / Q000331:legislation & jurisprudence*; D002318:Cardiovascular Diseases / Q000517:prevention & control; D004032:Diet; D005060:Europe; D005062:European Union; D005260:Female; D005638:Fruit / Q000600:supply & distribution*; D006304:Health Status; D006801:Humans; D015993:Life Tables; D008297:Male; D009369:Neoplasms / Q000517:prevention & control; D009426:Netherlands; D011050:Policy Making; D011634:Public Health; D014675:Vegetables / Q000600:supply & distribution*