Brexit could lead to thousands more deaths from heart attacks and strokes due to rising prices for fruit and vegetables, research suggests.

The new study, from Imperial College London and the University of Liverpool,  found that any deal under which the UK exits the EU will push up prices, slashing the amount of fresh produce people buy.

Given that low fruit and vegetable intake is a deemed as “major risk factor” for cardiovascular disease, this would impact heart and stroke deaths, experts warned. 

Professor Martin O’Flaherty, from the University of Liverpool, said: “Unhealthy diets are a leading driver of ill-health in the UK and a critical policy lever to tackle chronic diseases.

“Staying within the European Union appears the best option to protect public health.”

The UK is heavily reliant on imports and, in 2017, 84% of fruits and 43% of vegetables in the UK were imported.

The investigation used data from the World Health Organization and HM Revenue and Customs to measure the impact of Brexit on health.

The models explored three viable scenarios which would see the UK pay an increased rate on imported goods: a free-trading agreement with the EU and third-party countries; a free-trading agreement with the EU; and a no-deal Brexit without a new trade agreement.

A no-deal Brexit would have the worst impact, leading to more than 12,000 extra deaths between 2021 and 2030, it was revealed.

The researchers also assessed people’s average intake of fruit and vegetables using the National Diet and Nutrition Survey.

At present, only 27% of adults aged 19 to 64 and 35% of those aged over 65 achieve daily recommended fruit and veg intakes.

Under all Brexit scenarios modelled by the team, prices rose – for example, a no-deal Brexit would increase the cost of bananas by 17%, citrus fruits by 14%, and tomatoes by 15%.

These increase in prices would lead to the British public eating between 3% and 11% less fruit or vegetables, depending on the scenario.

Writing in the journal BMJ Open, the researchers said: “A no-deal Brexit scenario could be the most harmful, increasing coronary heart disease and stroke deaths by approximately 0.9% (4,110 deaths) and 2.9% (8,290 deaths) respectively between 2021 and 2030.

“The least disruptive scenario modelled, which assumes a free-trading agreement with the EU and half of non-EU fruit and veg importers, could increase coronary heart disease and stroke deaths by approximately 0.3% (1,360 deaths) and 1.0% (2,740 deaths) respectively.”

They said that, while the study focused on England, similar impacts were anticipated for Scotland, Wales and Northern Ireland.

Paraskevi Seferidi, a PhD researcher at Imperial and first author of the study, said: “The UK is highly dependent on imports, especially for fresh fruits and vegetables. These have a strong protective effect on health.

“Our paper illustrates, for the first time, the potential negative impacts of Brexit on fruit and veg prices, intake, heart disease and stroke.”

The researchers said the scenarios they modelled are not exhaustive and do not reflect all Brexit scenarios currently being debated.

But they said their study is consistent with previous research on Brexit, which estimated the cost of eating five portions of fruit and vegetables per day is likely to increase for the average family in Britain – by about £2.20 per week for a family of four.

Professor Christopher Millett, from the School of Public Health at Imperial, who jointly led the research, said: “The UK’s exit from the European Union has long been framed in terms of its political and social importance.

“But this study shows that the impact of Brexit will reach far beyond the economy and may affect people’s risk of disease.

“The UK Government must consider the public health implications of Brexit trade policy options, including changes to the price of key food groups.”

The findings are the latest in a string of concerns surrounding the impact of Brexit upon public health.

Just days ago, pharmacists warned of a shortage in many common medicines as the UK prepares to leave the EU, with some having to pay increased prices for them.

As a result, patients are complaining of delays in getting access to drugs such as painkillers, anti-depressants and blood pressure medication.

There has been a big rise in the number of drugs on the “shortage of supply” list for England, the BBC has found, leaving many experts fearing uncertainly about Brexit will make the situation worse.

In May 2018, experts argued in the British Medical Journal that Brexit is bad for public health and can be prevented.

Public health doctors, Mike Gill and Martin McKee, in addition to Mark Malloch Brown of Best for Britain and Fiona Godlee, the BMJ’s Editor in chief, said “whatever our views as individuals, or how we voted in the 2016 referendum, we can no longer escape the fact that Brexit in any form so far discussed is bad for health.”

They called upon UK health professionals to help mobilise public opinion for a ‘People’s Vote’ on the details of any deal negotiated by the government to protect public health.