Better diets could save billions in U.S. health care costs

Healthier diets could save the US around $50 billion in healthcare costs annually, according to a new study.

Image credits Ylanite Koppens.

Unhealthy diets are a leading cause of poor health, as they promote the development of cardiometabolic diseases (CMDs) such as heart disease, stroke, and type 2 diabetes. A new study led by Brigham and Women’s Hospital researchers estimates that unhealthy diets can account for 45% of all CMD-related deaths in the US, leading to a national healthcare burden of around $50 billion nationally.

Fooding the bill

“There is a lot to be gained in terms of reducing risk and cost associated with heart disease, stroke, and diabetes by making relatively simple changes to one’s diet,” said corresponding author Thomas Gaziano, MD, MSc, of the Division of Cardiovascular Medicine at the Brigham. “Our study indicates that the foods we purchase at the grocery store can have a big impact. I was surprised to see a reduction of as much as 20 percent of the costs associated with these cardiometabolic diseases.”

In collaboration with researchers at the Friedman School of Nutrition Science and Policy at Tufts University, the team looked at the impact of 10 dietary factors — fruits, vegetables, nuts/seeds, whole grains, unprocessed red meats, processed meats, sugar-sweetened beverages, polyunsaturated fats, seafood omega-3 fats, and sodium — on one’s diet on annual CMD-related health costs.

Towards this end, they used data from the National Health and Nutrition Examination Survey (NHANES), to create a representative U.S. population sample of individuals aged between 35 and 85 years old. Then, using a model they developed, the team analyzed how the individual risk of CMDs shift based on the dietary patterns of respondents to the NHANES study. Finally, they calculated what the overall CMD-related costs would be if everyone followed an optimal diet in relation to the 10 factors.

They conclude that suboptimal diets cost around $301 per person per year, for a total of over $50 billion nationally. The team explains that this sum represents 18% of all heart disease, stroke and type 2 diabetes costs in the United States. Costs were highest for those with Medicare ($481/person) and those who were eligible for both Medicare and Medicaid ($536/person).

The consumption of processed meats and low consumption of nuts, seeds, and omega-3 fat foodstuffs (such as seafood) were the highest drivers of CMD risks and additional costs, the team explains.

“We have accumulating evidence […] to support policy changes focused on improving health at a population level. One driver for those changes is identifying the exorbitant economic burden associated with chronic disease caused by our poor diets,” said co-senior author Renata Micha of the Friedman School of Nutrition Science and Policy at Tufts.

“This study provides additional evidence that those costs are unacceptable. While individuals can and do make changes, we need innovative new solutions — incorporating policy makers, the agricultural and food industry, healthcare organizations, and advocacy/non-profit organizations — to implement changes to improve the health of all Americans.”

The results of this study may underestimate the total cost of unhealthy diets, the team explains, as it can contribute to other health complications aside from CMDs. Additionally, other factors beyond the 10 used in this study could drive health risks and costs, they add. Finally, the NHANES study relied on self-reported data — participants were asked to recall what they ate in the past 24 hours — which isn’t very reliable.

The paper “Cardiometabolic disease costs associated with suboptimal diet in the United States: A cost analysis based on a microsimulation model” has been published in the journal PLOS Medicine.

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