How much can healthier diets reduce future economic and human costs? Results from Ethiopia and the Philippines

As countries progress through the 'nutrition transition' and experience rising rates of obesity and noncommunicable disease, concern has broadened from a primary focus on economic consequences of child stunting, to incorporate multiple forms of malnutrition, including overweight and obesity, or a more ambitious set of individual dietary risk factors from the Global Burden of Disease work. This paper conceptualizes a methodology that uses unhealthy diets to better understand the economic impact as the nutrition transition progresses. The Lives Saved Tool (LiST) is used to estimate how much healthier diets alone (without other health interventions) can reduce future child stunting. The Global Burden of Disease Results Tool is used to estimate how much healthier diets can reduce future noncommunicable disease among adults, via effects on three metabolic markers (high body mass index -BMI, high systolic blood pressure, and high fasting blood glucose). We then link the metabolic markers to diet quality (measured by the Global Diet Quality Score). Calculations are made for the Philippines for 2014 and 2021 and Ethiopia for 2011 and 2019. Recent studies have estimated the present value of future child stunting costs as 2.0% of GDP for the Philippines and 5.25% for Ethiopia, in both cases in 2023, of which we estimate up to 45% and 50%, respectively, are avertible over the long run by healthier diets, while public nutrition and public health programs account for the rest. The present value of costs associated with the three metabolic markers among adults is estimated as 7.99% of GDP (Philippines 2021) and 2.15% (Ethiopia 2019), of which we estimate 20% is avertible by healthier diets. The total losses avertible by healthier diets are therefore estimated as 2.5% of GDP (Philippines 2021) and 3.1% (Ethiopia 2019), with metabolic factors predominating in the Philippines and stunting in Ethiopia.