Introduction
Epidemiologic studies relating health outcomes to dietary patterns captured by diet
quality indices have shown better quality scores associated with lower mortality and
chronic disease incidence. However, changing chronic disease risk factors only alters
population health over time, and initial diet quality systematically varies across
the population by sociodemographic status. This study uses microsimulation to examine
30-year impacts of improved diet quality by sociodemographic group.
Methods
Diet quality across 12 sex-, race/ethnicity-, and education-defined subgroups was
estimated from the 2011–2012 National Health and Nutrition Examination Survey. In
2021, the Future Adults (dynamic microsimulation) Model was used to simulate population
health and economic outcomes over 30 years for these subgroups and all adults. The
modeled pathway was through lowering risk for heart disease by following U.S. Dietary
Guidelines.
Results
Diet quality varied across the sociodemographic subgroups, and half of U.S. adults
had diet quality that would be classified as poor. Improving U.S. diet quality to
that reported for the top 20% in 2 large health professionals’ samples could reduce
incidence of heart disease by 9.9% (7.6%–13.8% across the 12 sociodemographic groups)
after 30 years. Year 30 would also have 37,000 fewer deaths, 694,000 more quality-adjusted
life years, and healthcare cost savings of $59.6 billion (2019 U.S. dollars).
Conclusions
Dynamic microsimulation enables predictions of socially important outcomes of prevention
efforts, most of which are many years in the future and beyond the scope of trials.
This paper estimates the 30-year population health and economic impact of poor diet
quality by sociodemographic group.
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Article Info
Publication History
Published online: March 20, 2022
Identification
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© 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
