Potential Health Benefits and Medical Cost Savings from Calorie, Sodium, and Saturated Fat Reductions in the American Diet

• Published in: American journal of health promotion Vol. 23; no. 6; pp. 412 - 422
• Main Authors: Doll, Timothy M., Fulgoni, Victor L., Zhang, Yiduo, Reimers, Kristin J., Packard, Patricia T., Astwood, James D.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.07.2009
• Subjects: Body fat; Caloric Restriction - economics; Diet; Diet - economics; Dietary Fats - economics; Health; Health Policy; Humans; Hypercholesterolemia - complications; Hypercholesterolemia - economics; Hypercholesterolemia - prevention & control; Hypertension - complications; Hypertension - economics; Hypertension - prevention & control; Models, Econometric; Obesity; Overweight - complications; Overweight - economics; Overweight - prevention & control; Risk Factors; Savings; Sodium; Sodium, Dietary - economics; United States; United States; Obesity; High Cholesterol; Setting: united States; Uncontrolled Hypertension; Chronic Conditions; disease; Manuscript format: research; Cost of Illness; Prevention Research; Target population circumstances: overweight; Strategy: improved diet; Health Promotion; Outcome measure: overweight/obesity; Health focus: obesity; Diet; medical costs; Target population: adults; cholesterol; hypertension; Research purpose: intervention testing/program evaluation; Study design: nonexperimental
• DOI: 10.4278/ajhp.080930-QUAN-226
• ISSN: 0890-1171

Purpose. Model the potential national health benefits and medical savings from reduced daily intake of calories, sodium, and saturated fat among the U.S. adult population. Design. Simulation based on secondary data analysis; quantitative research. Measures include the prevalence of overweight/obesity, uncontrolled hypertension, elevated cholesterol, and related chronic conditions under various hypothetical dietary changes. Setting. United States. Subjects. Two hundred twenty-four million adults. Measures. Findings come from a Nutrition Impact Model that combines information from national surveys, peer-reviewed studies, and government reports. Analysis. The simulation model predicts disease prevalence and medical expenditures under hypothetical dietary change scenarios. Results. We estimate that permanent 100-kcal reductions in daily intake would eliminate approximately 71.2 million cases of overweight/obesity and save $58 billion annually. Long-term sodium intake reductions of 400 mg/d in those with uncontrolled hypertension would eliminate about 1.5 million cases, saving $2.3 billion annually. Decreasing 5 g/d of saturated fat intake in those with elevated cholesterol would eliminate 3.9 million cases, saving $2.0 billion annually. Conclusions. Modest to aggressive changes in diet can improve health and reduce annual national medical expenditures by $60 billion to $120 billion. One use of the model is to estimate the impact of dietary change related to setting public health priorities for dietary guidance. The findings here argue that emphasis on reduction in caloric intake should be the highest priority.