A study published in the Journal of the Academy of Nutrition and Dietetics suggests that 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 is the first to comprehensively analyze the potential cost implications of improved adherence to healthy dietary patterns among U.S. adults across major chronic disease types.

The researchers estimated the cost savings under two scenarios. The more conservative scenario looks at the savings that could be realized if U.S. adults increased their adherence to a healthy dietary pattern by 20%, as measured by two metrics of diet quality: the Healthy Eating Index (HEI) and the Mediterranean-style diet (MED) score. The more ambitious scenario projects savings that could result if U.S. adults achieved an 80% score on those same metrics.

Both the HEI and the MED are markers of what are considered healthy dietary patterns. The HEI is used frequently in the United States to evaluate a U.S.-style diet and reflects adherence with the 2015–2020 Dietary Guidelines for Americans while 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 U.S. adult currently shows about 60% adherence to the HEI. If this were increased to 72% adherence (a relative increase of 20%), the analysis shows the United States could save $30–$47 billion in health-related costs annually. Under the more ambitious scenario, if the average U.S. adult increased their adherence to 80% 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 reductions in costs associated with cancer and type 2 diabetes.

The average U.S. 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%, 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% by incorporating more components of the Mediterranean-style diet.


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