Herman Patricia M, Nguyen PhuongGiang, Sturm Roland
RAND Corporation, PO Box 2138, 1776 Main Street, Santa Monica, CA90407-2138, USA.
Public Health Nutr. 2021 Jan 13;25(5):1-9. doi: 10.1017/S136898002100015X.
Diets closer aligned with nutritional guidelines could lower the risk of several chronic conditions and improve economic outcomes, such as employment and healthcare costs. However, little is known about the range, order of magnitude and timing of these potential effects.
We used a microsimulation approach to predict US population changes over 30 years in health and economic outcomes that could result from a substantial (but not impossible) improvement in diet quality - an improvement from the third to the fifth quintile of US scores on the Alternate Healthy Eating Index, 2010 version.
Risk ratios from the literature for diabetes, heart disease and stroke were used to modify the Future Adult Model (FAM) to simulate outcomes from a higher-quality diet. Model parameter uncertainty was assessed using bootstrap and sensitivity analysis examined the variation in published risk ratios.
FAM simulates outcomes for the US adult population aged 25 and older.
Improved diet quality initially leads to very small changes in chronic disease prevalence, but these accumulate over time. If diets improved beginning in 2019, after 30 years diabetes prevalence could be reduced by 5·9 million cases (11·5 %), heart disease prevalence by 4·0 million cases (7·2 %) and stroke prevalence by 1·9 million cases (10·3 %). These reductions in disease prevalence would be accompanied that same year by fewer deaths (88 000) and healthcare cost savings of $144·0 billion (2019 USD).
This microsimulation study suggests that improvements in diet are likely to improve health and economic population outcomes over time.
更符合营养指南的饮食可降低多种慢性病风险，并改善经济状况，如就业和医疗成本。然而，对于这些潜在影响的范围、数量级和时间安排知之甚少。
我们采用微观模拟方法，预测因饮食质量大幅（但并非不可能）改善——从美国2010年版替代健康饮食指数得分的第三个五分位数提升至第五个五分位数——可能导致的30年里美国人口健康和经济状况的变化。
利用文献中糖尿病、心脏病和中风的风险比来修正未来成人模型（FAM），以模拟更高质量饮食的结果。使用自举法评估模型参数的不确定性，并通过敏感性分析检验已发表风险比的变化。
FAM模拟25岁及以上美国成年人口的结果。
饮食质量改善最初会导致慢性病患病率的变化非常小，但这些变化会随着时间累积。如果从2019年开始饮食改善，30年后糖尿病患病率可降低590万例（11.5%），心脏病患病率可降低400万例（7.2%），中风患病率可降低190万例（10.3%）。这些疾病患病率的降低在同一年将伴随着死亡人数减少（8.8万）和医疗成本节省1440亿美元（2019年美元）。
这项微观模拟研究表明，随着时间推移，饮食改善可能会改善人群的健康和经济状况。
