# Defining Optimal Nutrition Behaviors to Determine Benefit–Cost Ratio of Federal Nutrition Education Programs

## TL;DR

This study evaluates how nutrition education programs reduce healthcare costs by improving dietary behaviors and preventing chronic diseases.

## Contribution

The study introduces evidence-based Optimal Nutrition Behavior criteria to assess the economic benefits of federal nutrition education programs.

## Key findings

- The ESI program significantly increased the frequency of optimal nutrition behaviors compared to a control group.
- The benefit–cost ratio of the ESI program was $11.62, indicating substantial economic returns from the program.
- The program showed significant improvements in chronic disease risk reduction for all diseases except colorectal cancer.

## Abstract

Background/Objectives: Historically, federal investment in nutrition education programming in the U.S. has exceeded USD 500 million annually. The purpose of this study was to develop evidence-based Optimal Nutrition Behavior (ONB) criteria related to data collected by federal nutrition education programs and apply these criteria to established cost–benefit analysis methodology to determine the healthcare savings attributable to participation in these programs. Methods: A quasi-experimental study was conducted using the Eat Smart Idaho (ESI) program as a model for federal nutrition education programs (n = 78) and a matched control group (n = 78). Surveys administered at baseline and post-program collected dietary intake and physical activity behaviors. Optimal Nutrition Behaviors were defined as those behaviors that were associated with reduced chronic disease risk as determined by published meta-analyses, systematic reviews, or large cohort studies. Direct and indirect benefits generated by ESI were calculated using established methods. Results: The frequency of individuals meeting ONB criteria at post-assessment was significantly greater in the ESI group compared to control for all diseases except for colorectal cancer (p ≤ 0.05). ESI’s benefit–cost ratio of $11.62 suggests each dollar spent to administer the program results in USD 11.62 of economic benefits through chronic disease medical costs and lost earnings avoided. Conclusions: Federal funds supporting nutrition education programs contribute to reduced medical costs.