Journal Article

Cardiometabolic disease costs associated with suboptimal diet in the United States: A cost analysis based on a microsimulation model

Rehm, Colin, Wilde, Parke, Micha, Renata, Gaziano, Thomas A., Jardim, Thiago Veiga, Huang, Yue, Abrahams-Gessel, Shafika, Mozaffarian, Dariush, Sy, Stephen, Liu, Junxiu, Lee, Yujin

2019

Overview

Poor diet is a leading risk factor for cardiometabolic disease (CMD) in the United States, but its economic costs are unknown. We sought to estimate the cost associated with suboptimal diet in the US. A validated microsimulation model (Cardiovascular Disease Policy Model for Risk, Events, Detection, Interventions, Costs, and Trends [CVD PREDICT]) was used to estimate annual cardiovascular disease (fatal and nonfatal myocardial infarction, angina, and stroke) and type 2 diabetes costs associated with suboptimal intake of 10 food groups (fruits, vegetables, nuts/seeds, whole grains, unprocessed red meats, processed meats, sugar-sweetened beverages, polyunsaturated fats, seafood omega-3 fats, sodium). A representative US population sample of individuals aged 35-85 years was created using weighted sampling from National Health And Nutrition Examination Surveys (NHANES) 2009-2012 cycles. Estimates were stratified by cost type (acute, chronic, drug), sex, age, race, education, BMI, and health insurance. Annual diet-related CMD costs were $301/person (95% CI $287-$316). This translates to $50.4 billion in CMD costs (18.2% of total) for the whole population, of which 84.3% are attributed to acute care ($42.6 billion). The largest annual per capita costs are attributed to low consumption of nuts/seeds ($81; 95% CI $74-$86) and seafood omega-3 fats ($76; 95% CI $70-$83), and the lowest are attributed to high consumption of red meat ($3; 95% CI $2.8-$3.5) and polyunsaturated fats ($20; 95% CI $19-$22). Individual costs are highest for men ($380), those aged ≥65 years ($408), blacks ($320), the less educated ($392), and those with Medicare ($481) or dual-eligible ($536) insurance coverage. A limitation of our study is that dietary intake data were assessed from 24-hour dietary recall, which may not fully capture a diet over a person's life span and is subject to measurement errors. Suboptimal diet of 10 dietary factors accounts for 18.2% of all ischemic heart disease, stroke, and type 2 diabetes costs in the US, highlighting that timely implementation of diet policies could address these health and economic burdens.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Age / Aged / Aged, 80 and over / Analysis / Angina / Angina pectoris / Authorship / Beverages / Biology and Life Sciences / Blood pressure / Cardiovascular disease / Cardiovascular diseases / Cardiovascular Diseases - epidemiology / Cerebral infarction / Cholesterol / Coronary artery disease / Cost estimates / Cost of Illness / Diabetes / Diabetes mellitus (non-insulin dependent) / Diabetes Mellitus, Type 2 - complications / Diabetes Mellitus, Type 2 - epidemiology / Diet / Diet - economics / Dietary intake / Economic aspects / Fats / Fatty acids / Female / Food / Food intake / Fruits (Food) / Government programs / Health care expenditures / Health risk assessment / Health risks / Health surveys / Heart attack / Heart diseases / Humans / Insurance / Ischemia / Life span / Male / Meat / Medical research / Medicare / Medicare - economics / Medicine and Health Sciences / Middle Aged / Mortality / Myocardial infarction / Myocardial ischemia / Nutrition / Nutrition Surveys - statistics & numerical data / Nuts / Population / Public health / Risk factors / Seafood / Seeds / Social Sciences / Software / Stroke / Type 2 diabetes / United States / Unsaturated fatty acids / Vegetables