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

<b>Background/Objectives</b>: 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. <b>Methods</b>: A quasi-experimental study was conducted using the Eat Smart Idaho (ESI) program as a model for federal nutrition education programs (<i>n</i> = 78) and a matched control group (<i>n</i> = 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. <b>Results</b>: 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 (<i>p</i> ≤ 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. <b>Conclusions</b>: Federal funds supporting nutrition education programs contribute to reduced medical costs.