Other ‘international’ health-economic studies in the field of osteoporosis followed a similar approach: in these studies, the effect of fractures on quality of life was not based on country-specific sources; whereas for the costs, country-specific data were available [56–59]. Conclusions Our study shows that, especially for France and Sweden, the societal burden of hip fractures associated with low calcium

selleckchem intake is quite substantial. Improving the dairy consumption is likely to be effective in decreasing this public health burden and the associated health care expenditures. Our findings support the use of a food-based approach to help maintain bone health or prevent age-related bone loss. This is in line with the position of the French Agency for the Safety find more of Health Products (AFSSAPS) which recommends to correct calcium and/or vitamin D deficiencies before prescribing anti-osteoporotic drugs [60]. It would be worth performing a cost-effectiveness analysis of a community-based educational health campaign. Behavioral changes, especially related to diet and exercise, form the backbone of public health recommendations for the prevention and treatment of osteoporosis [61], are supported by several RCTs [62, 63] and meta-analyses [50, 64, 65]. Yet, the cost-effectiveness of such recommendations remains largely unexplored. Our model had to rely on the existing figures that do not take into

account the long-term advantages of prevention, mainly focusing on the senior population Etofibrate where bone density is already affected and where dietary interventions will complete the clinical management of diagnosed osteoporosis [66]. Yet, it is no less important to focus on younger people as well, because eating practices established in childhood are likely to be

maintained throughout life, and an adequate calcium intake during childhood and adolescence, necessary for the development of peak bone mass, may contribute to bone strength and reduce the risk of osteoporosis and fractures later in life [67, 68]. Although the methods may be further refined, this model appears to be a solid and straightforward, easy-to-use method to assess the health, well-being and cost outcomes of food products from a health economics perspective. Acknowledgements We thank Dr. Nelly Ziadé (APEMA, Paris, France) for providing us more specific data on the mortality rates for France and Dr. Marga Ocké (RIVM, The Netherlands) who provided us detailed data on calcium intake in the general Dutch population. Furthermore, we would like to thank Dr. Östen Ljunggren (Sweden) for his constructive remarks on an earlier version of the manuscript. Funding This research was supported by an unrestricted grant from Danone Research. No information used in preparation of this manuscript was owned by the sponsor. First and second authors contributed equally to the manuscript. Conflicts of interest None.