000			04205nam a2200253Ia 4500
008			210519s2019 xx 000 0 und d
040			_cManila Tytana Colleges
100			_aScrafford, Carolyn G.
245		0	_aHealth economic evaluation modeling shows potential health care cost savings with increased conformance with healthy dietary patterns among adults in the United States / _cCarolyn G. Scrafford, Xiaoyu Bi, Jasjit K. Multani, Mary M. Murphy, Jordana K. Schmier, Leila M. Barraj
260			_cApril 2019
336			_atext
337			_aunmediated
338			_avolume
440			_n119 : 4, page 599-616 _aJournal of the Academy of Nutrition and Dietetics
520			_aBackground Many American adults have one or more chronic diseases related to a poor diet, resulting in significant direct and indirect economic impacts. The 2015-2020 Dietary Guidelines for Americans (DGA) recognized that dietary patterns may be more relevant for predicting health outcomes compared with individual diet elements and recommended three healthy patterns based on evidence of favorable associations with many chronic disease risk factors and outcomes. Health economic assessments provide a model to estimate the potential influence on costs associated with changes in chronic disease risk resulting from improved diet quality in the US adult population. Objective To estimate the impact on health care costs associated with increased conformance with the three healthy patterns recommended in the 2015-2020 DGA, including the Healthy US-Style, the Healthy Mediterranean-Style, and the Healthy Vegetarian eating patterns. Methods Recent moderate- to high-quality meta-analyses of health outcomes associated with increased conformance with the Healthy US-Style eating pattern as measured by the Healthy Eating Index (HEI) or the Healthy Mediterranean-Style eating pattern measured by a Mediterranean diet score (MED) were identified. Given the lack of quantification of the association between an increased conformance with a vegetarian pattern and health outcomes, the analysis was limited to studies that evaluated Healthy US-style and Healthy Mediterranean-style eating patterns. The 2013-2014 What We Eat in America data provided estimates of conformance with these two eating patterns using the HEI-2015 and the 9-point MED among the US adult population. Risk estimates quantifying the association between eating patterns and health outcomes were combined with the eating pattern score increase under two conformance scenarios: increasing the average HEI-2015 and MED by 20% and increasing the average HEI-2015 and MED to achieve 80% of complete conformance. The resulting change in risk was combined with published data on annual health care and indirect costs, inflated to 2017 US dollars to estimate cost. To address double counting, costs were adjusted to minimize potential overlap of comorbidities. Results Overall modeled cost savings were _16.7 billion (range= _6.7 billion to _25.4 billion) to _31.5 billion (range= _23.9 billion to _38.9 billion) based on a 20% increase in the MED and HEI-2015, respectively, resulting from reductions in cardiovascular disease, cancer, and type 2 diabetes for both patterns and including Alzheimer's disease and hip fractures for the MED. In the case that diet quality of US adults were to improve to achieve 80% of the maximum MED and HEI-2015, cost savings were estimated at _88.2 billion (range= _35.7 billion to _133 billion) and _55.1 billion (range= _41.8 billion to _68.2 billion), respectively. Conclusions This is the first study quantifying savings from all health outcomes identified to be associated with the HEI and the MED to assess conformance with two eating patterns recommended as part of the 2015-2020 DGA. Findings from this study suggest that increasing conformance with healthy eating patterns among US adults could reduce costs, with billions of dollars in potential savings.
521			_aNutrition.
650			_aChronic health outcomes.
650			_aCosts and cost analysis.
650			_aDietary pattern.
650			_aHealthy eating index.
650			_aMediterranean diet.
942			_2lcc _cA
998			_c86220 _d144583
999			_c82617 _d82617