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To save billions in health-related costs, it's worth looking at Americans' diets

The study touts itself as the first to comprehensively analyze the potential cost implications of improved adherence to healthy dietary patterns.

Jeff Lagasse, Associate Editor

What people eat has important implications for their health, and ultimately for what gets spent on healthcare. New research suggests improving the quality of the average American's diet could substantially reduce costs associated with heart disease, diabetes, cancer and other major health problems.

The study touts itself as the first to comprehensively analyze the potential cost implications of improved adherence to healthy dietary patterns -- as measured by the Healthy Eating Index and the Mediterranean-style diet score -- among U.S. adults across major chronic disease types. Previous research has focused on specific populations or specific conditions, such as heart disease.

Increasing adherence to those dietary patterns even by 20 percent could save more than $20 billion in direct and indirect costs, according to the research. What's more, the authors think it's attainable.

And it's not the first time food has been viewed as a means of achieving potential cost savings. Prior research has shown that meal delivery programs, such as Meals on Wheels, reduce the cost of healthcare in dually eligible Medicare and Medicaid beneficiaries. Food has also been proposed as a possible means of cutting treatment costs for diabetes patients.

The team estimated cost savings under two scenarios, with the 20 percent increase in health dietary patterns representing the more more conservative scenario. The more ambitious scenario projects savings that could result if adults achieved an 80 percent adherence score on the same metrics.

Both the HEI, the healthy eating index, and the MED, the Mediterranean-style diet score, are markers of what are considered healthy dietary patterns. The HEI is used frequently to evaluate a U.S.-style diet and reflects adherence with the 2015-2020 Dietary Guidelines for Americans. The MED was first used to describe the diet of countries in the Mediterranean region and emphasizes components such as fish, nuts and fruits, along with olive oil as a healthy fat source.

The average American adult currently shows about 60 percent adherence to the HEI. If this were increased to 72 percent adherence (a relative increase of 20 percent), the analysis shows the U.S. could save $30-47 billion in health-related costs annually. Under the more ambitious scenario, if the average adult increased their adherence to 80 percent of the HEI, the researchers project an annual savings of $52-82 billion.

Close to half of these savings result from a reduction in costs associated with heart disease alone, with additional savings from cost reductions associated with cancer and type 2 diabetes. Because heart disease in the U.S. is so prevalent, so costly and so heavily influenced by diet, a small improvement in diet quality can result in meaningful cost savings, researchers said.

The average American adult currently scores a 3.5 out of 9 possible points on the MED score used to assess adherence to the Mediterranean-style diet. If this adherence were raised by 20 percent, the researchers project an annual savings of about $21-26 billion. The lower estimate includes only breast, colorectal and prostate cancer along with five other health outcomes (coronary heart disease, stroke, type 2 diabetes, hip fractures and Alzheimer's disease) while the higher estimate includes savings related to all cancer types along with the same five other health outcomes. Annual savings could reach $112-135 billion if Americans increased their MED adherence to 80 percent by incorporating more components of the Mediterranean-style diet.

The research was driven by the increasing understanding of the importance of overall dietary patterns rather than individual nutrients or foods. While it's unlikely that Americans could change their dietary patterns overnight or that the projected health improvements would immediately reduce health-related costs, the numbers provide a reference point for understanding the potential benefits of adopting a healthier diet, authors said.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com

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