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

Autoři: Thiago Veiga Jardim aff001;  Dariush Mozaffarian aff003;  Shafika Abrahams-Gessel aff002;  Stephen Sy aff002;  Yujin Lee aff003;  Junxiu Liu aff003;  Yue Huang aff003;  Colin Rehm aff004;  Parke Wilde aff003;  Renata Micha aff003;  Thomas A. Gaziano aff001
Působiště autorů: Department of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America aff001;  Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America aff002;  Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, United States of America aff003;  Office of Community and Population Health, Montefiore Medical Center, Bronx, New York, United States of America aff004
Vyšlo v časopise: Cardiometabolic disease costs associated with suboptimal diet in the United States: A cost analysis based on a microsimulation model. PLoS Med 16(12): e32767. doi:10.1371/journal.pmed.1002981
Kategorie: Research Article



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.

Methods and findings

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.

Klíčová slova:

Cardiovascular diseases – Diet and type 2 diabetes – Fats – Health economics – Health insurance – Meat – Medicare – Schools


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