Choosing oatmeal porridge and simmered mackerel improves life expectancy in PLOS Medicine: A modeling study

A recent paper in PLOS Medicine showed modeled gains in life expectancy following dietary shifts from a typical Western (TA) to a Feasible (FA) and an Optimal Diet (OD). A Food4HealthyLife calculator was provided on line. However, energy density data for 14 “representative” foods does not correspond to energy density data for 1151 foods in the same food groups from the USDA Department of Agriculture databases. The present recalculation shows that the FA and OD diet plans were lower in saturated fat and added sugar but were higher in energy and sodium, and entailed substantially higher daily diet cost, as based on 2021 national food prices used in the USDA Thrifty Food Plan. First, a diet plan of oatmeal porridge with water, simmered mackerel, half a boiled egg, milk 1%, fresh orange, mixed vegetables, chickpeas, and a handful of nuts and berries is not necessarily the same as a diet of whole grains, seafood, eggs and dairy, vegetables, fruits, nuts and legumes. Second, any well-meaning dietary advice needs to be accompanied by economic feasibility studies and estimates of diet cost. Clinicians, policymakers, and consumers need to understand not only the health impact but also the economic cost of dietary choices. Access to affordable nutrient rich foods is one of the social and political determinants of health.