[Cost-effectiveness analysis and diet quality index applied to the WHO Global Strategy].
OBJECTIVE
To test the use of cost-effectiveness analysis as a decision making tool in the production of meals for the inclusion of the recommendations published in the World Health Organization's Global Strategy.


METHODS
Five alternative options for breakfast menu were assessed previously to their adoption in a food service at a university in the state of Sao Paulo, Southeastern Brazil, in 2006. Costs of the different options were based on market prices of food items (direct cost). Health benefits were estimated based on adaptation of the Diet Quality Index (DQI). Cost-effectiveness ratios were estimated by dividing benefits by costs and incremental cost-effectiveness ratios were estimated as cost differential per unit of additional benefit. The meal choice was based on health benefit units associated to direct production cost as well as incremental effectiveness per unit of differential cost.


RESULTS
The analysis showed the most simple option with the addition of a fruit (DQI = 64 / cost = R$ 1.58) as the best alternative. Higher effectiveness was seen in the options with a fruit portion (DQI1=64 / DQI3=58 / DQI5=72) compared to the others (DQI2=48 / DQI4=58).


CONCLUSIONS
The estimate of cost-effectiveness ratio allowed to identifying the best breakfast option based on cost-effectiveness analysis and Diet Quality Index. These instruments allow easy application easiness and objective evaluation which are key to the process of inclusion of public or private institutions under the Global Strategy directives.
Machado
Flávia Mori Sarti
FM
Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, SP, Brasil. flamori@usp.br
Simões
Arlete Naresse
AN
D001938:Brazil; D003362:Cost-Benefit Analysis / Q000592:standards; D004032:Diet / Q000191:economics / Q000592:standards*; D017408:Guidelines as Topic; D006293:Health Promotion; D008612:Menu Planning / Q000191:economics*; D018673:Nutrition Policy; D014495:Universities; D014944:World Health Organization