title: Health economic potential of early nutrition programming: a model calculation of long-term reduction in blood pressure and related morbidity costs by use of long-chain polyunsaturated fatty acid-supplemented formula.
abstract: BACKGROUND
  The reported effect sizes of early nutrition programming on long-term health outcomes are often small, and it has been questioned whether early interventions would be worthwhile in enhancing public health.
  
  
  OBJECTIVE
  We explored the possible health economic consequences of early nutrition programming by performing a model calculation, based on the only published study currently available for analysis, to evaluate the effects of supplementing infant formula with long-chain polyunsaturated fatty acids (LC-PUFAs) on lowering blood pressure and lowering the risk of hypertension-related diseases in later life.
  
  
  METHODS
  The costs and health effects of LC-PUFA-enriched and standard infant formulas were compared by using a Markov model, including all relevant direct and indirect costs based on German statistics. We assessed the effect size of blood pressure reduction from LC-PUFA-supplemented formula, the long-term persistence of the effect, and the effect of lowered blood pressure on hypertension-related morbidity.
  
  
  RESULTS
  The cost-effectiveness analysis showed an increased life expectancy of 1.2 quality-adjusted life-years and an incremental cost-effectiveness ratio of -630 Euros (discounted to present value) for the LC-PUFA formula in comparison with standard formula. LC-PUFA nutrition was the superior strategy even when the blood pressure-lowering effect was reduced to the lower 95% CI.
  
  
  CONCLUSIONS
  Breastfeeding is the recommended feeding practice, but infants who are not breastfed should receive an appropriate infant formula. Following this model calculation, LC-PUFA supplementation of infant formula represents an economically worthwhile prevention strategy, based on the costs derived from hypertension-linked diseases in later life. However, because our analysis was based on a single randomized controlled trial, further studies are required to verify the validity of this thesis.
authors.affiliation: Institute for Market Research, Strategy and Planning, Munich, Germany.
authors.forename: Niels
authors.initials: N
authors.lastname: Straub
authors.forename: Philipp
authors.initials: P
authors.lastname: Grunert
authors.forename: Rüdiger
authors.initials: R
authors.lastname: von Kries
authors.forename: Berthold
authors.initials: B
authors.lastname: Koletzko
mesh_terms: D001794:Blood Pressure; D001942:Breast Feeding; D003362:Cost-Benefit Analysis; D019587:Dietary Supplements; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007223:Infant; D041943:Infant Formula / Q000008:administration & dosage* / Q000737:chemistry / Q000191:economics; D007227:Infant Nutritional Physiological Phenomena; D008017:Life Expectancy; D018803:Models, Economic; D009017:Morbidity; D009752:Nutritional Status; D013995:Time
chemical_list: D005231:Fatty Acids, Unsaturated