An unhealthy diet is one of the leading factors of poor health, accounting for up to 45 percent of all deaths from cardio-metabolic diseases (CMD), such as heart disease, stroke, and type 2 diabetes. But the national economic burden of unhealthy diet habits remains unknown. A new study by investigators from Brigham and Women’s Hospital, in collaboration with investigators at the Friedman School of Nutrition Science and Policy oat Tufts University, analyzed the impact of 10 dietary factors, including consumption of fruits and vegetables, nuts and seeds, processed meat and more, and estimated the annual CMD costs of suboptimal diet habits. The team concludes that the suboptimal diet costs approximately USD 300 per person, or USD 50 billion nationally, accounting for 18 percent of all heart disease, stroke and type 2 diabetes costs in the country. The findings are published in PLOS Medicine.
The study was led by the corresponding author Thomas Gaziano, MD, MSc, of the Division of Cardiovascular Medicine at the Brigham. He explained that 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. The study indicates that the food people purchase at the grocery store can have a significant impact. Surprisingly, there was a reduction of as much as 20 percent of the costs associated with these cardio-metabolic diseases.
To conduct this study, the team, including co-senior author Renata Micha, Ph.D., and an associate research professor at Tufts. They focused on the impact of 10 food groups, fruits, vegetables, nuts/seeds, whole grains, unprocessed red meats, processed meats, sugar-sweetened beverages, polyunsaturated fats, seafood omega-3 fats and sodium).
Using data from the National Health and Nutrition Examination Survey (NHANES), the team created a representative U.S. population sample of individuals aged 35-85 years. The team developed a model known as CVD PREDICT. Using this model, the team analyzed the individual risk of cardio-metabolic disease and associated costs for the sample population based on respondents’ current dietary patterns. They then re-calculated costs for CMD if everyone’s diet was optimized to the healthiest amounts of the ten foods and nutrients.
The team also found that suboptimal diets account for USD 301 per person in terms of CMD-related costs. This translates to more than USD 50 billion nationally, 84 percent of which is due to acute care. Costs were highest for those with Medicare (USD 481/per person) and those who were eligible for both Medicare and Medicaid (USD 536/per person).
The team has accumulated 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 excessive economic burden associated with chronic diseases caused by poor diets. The study provides additional evidence that those costs are unacceptable. While individuals can and do make changes, more innovative and new solutions are needed. Incorporating policymakers, the agricultural and food industry, healthcare organizations, and advocacy/non-profit organizations will help to implement changes to improve the health of all Americans.
The three dietary factors that contributed most to these costs are consumption of processed meats, low consumption of nut/seeds, and low consumption of seafood containing omega-3 fats.
The team notes that the current study may underestimate the cost of unhealthy diet habits as dietary factors may contribute to the risk of diseases beyond heart disease, stroke and diabetes, such as cancer. While the study focuses on ten nutritional factors for which there were robust data, others may influence risk and cost as well. Additionally, 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 under-reported unhealthy food choices or inaccurately recalled what they had consumed.
The team’s work illustrates the need for interventions or policies that incentivize healthier dietary behavior as these changes have the potential to have a significant impact and reduce the health and financial burden of cardio-metabolic disease.