How healthy diet can save $50 billion of healthcare costs

A study examining 10 dietary factors finds that unhealthy diets account for almost 20% of heart disease, stroke and diabetes costs in the US. Investigators from Brigham and Women’s Hospital, and those from Friedman School of Nutrition Science and Policy at Tufts University have found that suboptimal diet costs approximately $50 billion of healthcare expenditure nationally.According to the instigators, unhealthy diet, which national economic burden remains unknown, accounts for 18 percent of all cardiometabolic diseases, such as heart disease, stroke and type 2 diabetes costs in the country, and up to 45 percent of all deaths.

The team in its findings published in PLOS Medicine, analysed the impact of 10 dietary factors, including consumption of fruits, vegetables, nuts, seeds, processed meats and estimated the annual cardiometabolic diseases cost of suboptimal diet habits.They reported that suboptimal diet costs approximately $300 per person, or $50 billion nationally.“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, 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.”To conduct their study, Gaziano and colleagues, including co-senior author Renata Micha, PhD, an associate research professor at Tufts, focused on the impact of 10 food groups, which include, fruits, vegetables, nuts/seeds, whole grains, unprocessed red meats, processed meats, sugar-sweetened beverages, polyunsaturated fats, seafood omega-3 fats and sodium).

The team, which used data from the National Health and Nutrition Examination Survey (NHANES), created a representative United States population sample of individuals aged 35-85 years. The team used a model they developed and termed the CVD PREDICT model, to analyse individual risk of cardiometabolic disease and associated costs for the sample population based on respondents’ current dietary patterns. They then re-calculated the costs for cardiometabolic disease if everyone’s diet was optimised to the healthiest amounts of the 10 foods and nutrients.

The team found that suboptimal diets account for $301 per person in terms of cardiometabolic disease -related costs. This translates to more than $50 billion nationally, 84 percent of which is due to acute care. Costs were highest for those with Medicare ($481/person) and those who were eligible for both Medicare and Medicaid ($536/person).

“We have accumulating evidence from the Food-PRICE collaborative research work 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.

“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,” said co-senior author Renata Micha of the Friedman School of Nutrition Science and Policy at Tufts.

Their findings showed that three dietary factors contributed most to these costs: consumption of processed meats, low consumption of nuts/seeds, and low consumption of seafoods containing omega-3 fats. The team noted that the current study might underestimate the cost of unhealthy diet habits as dietary factors may contribute to risk of diseases beyond heart disease, stroke and diabetes, such as cancer.

While the study focuses on 10 dietary factors for which there were robust data, others may influence risk and cost as well. In addition, the study relied on dietary intake data collected from food questionnaires that asked respondents to recall what foods they had consumed in the past 24 hours. Respondents may have underreported unhealthy food choices or inaccurately recalled what they had consumed.“Our work illustrates the need for interventions or policies that incentivize healthier dietary behavior as these changes have the potential to have a big impact and reduce the health and financial burden of cardiometabolic disease,” said Gaziano.