April 2, 2019

Prescribing healthy foods could bring cost-effective benefits

At a Glance

  • A sophisticated model estimated that healthy food subsidies could save billions in health care costs and prevent hundreds of thousands of heart disease deaths and diabetes cases.
  • The findings suggest a cost-effective way to improve health.
Senior couple preparing healthy food Researchers explored the idea of prescribing healthy foods to help combat heart disease and diabetes. Halfpoint / iStock / Thinkstock

Your diet plays an important role in your health. An unhealthy diet is one of the leading risk factors for cardiometabolic diseases, such as heart disease, stroke, and diabetes.

Eating a healthy diet can lower your risk for some of these conditions. A healthy eating plan includes vegetables, fruits, whole grains, fat-free or low-fat dairy products, lean meats, poultry, fish, beans, eggs, and nuts. It also limits how much sugar, salt, and fat you eat.

Prescribing healthy foods is one potential approach to help lower heart disease and other cardiometabolic conditions. However, it hasn’t been well established whether this would be cost effective or help lower the disease burden.

A team led by Drs. Yujin Lee, Dariush Mozaffarian, and Renata Micha at Tufts University and Dr. Thomas A. Gaziano at Brigham and Women’s Hospital simulated the health and cost benefits of food prescriptions using data from the National Health and Nutrition Examination Survey (NHANES). They modeled the potential outcomes for including healthy food incentive policies in Medicare and Medicaid, which together cover about a third of U.S. citizens. The research was supported in part by NIH’s National Heart, Lung, and Blood Institute (NHLBI). Results were published on March 19, 2019, in PLoS Medicine.

The team modeled two food incentives: a 30% subsidy for fruits and vegetables and a 30% subsidy on healthy foods in general, including fruits, vegetables, whole grains, nuts, seeds, seafood, and plant oils. Using NHANES data from adults on Medicare and Medicaid, the researchers built a computer simulation to estimate the health and economic benefits of these incentive programs over 5, 10, and 20 years and the participants’ lifetime.

If the fruit and vegetable incentive was carried out over a lifetime, the model estimated that the average consumption of fruits and vegetables would increase by about 0.4 servings per day. This would prevent about 1.93 million cardiovascular disease events and save $39.7 billion in health care costs.

The model predicted that the general healthy foods incentive carried out over a lifetime would increase fruit and vegetable intake by the same amount. It would also increase the average consumption of whole grains by 0.2 servings per day, nuts and seeds by 0.1 servings, seafood by 0.2 servings, and plant oils by 1.5 teaspoons. This would prevent about 3.28 million cardiovascular disease events and 120,000 cases of diabetes and save $100.2 billion in health care costs.

“Our findings support implementation and evaluation of healthy food prescriptions within health care systems to improve the diet and health of Americans,” Micha says.

“These new findings support the concept of Food is Medicine: That innovative programs to encourage and reimburse healthy eating can and should be integrated into the health care system,” Mozaffarian says.

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References: Cost-effectiveness of financial incentives for improving diet and health through Medicare and Medicaid: A microsimulation study. Lee Y, Mozaffarian D, Sy S, Huang Y, Liu J, Wilde PE, Abrahams-Gessel S, Jardim TSV, Gaziano TA, Micha R. PLoS Med. 2019 Mar 19;16(3):e1002761. doi: 10.1371/journal.pmed.1002761. eCollection 2019 Mar. PMID: 30889188.

Funding: NIH’s National Institutes of Health, National Heart, Lung, and Blood Institute (NHLBI) and American Heart Association.