# What is the Cost/Value of a Calorie?

We spend more for healthcare per person than any other country. By a significant amount.

Chart: Yuasan, Wikimedia Commons

Some of this extra cost is in better healthcare facilities, more personnel, higher pay that attracts better caregivers, and other things. These increase costs, but not by much. The biggest chunk, 50-70% of our total healthcare costs, is that we are unhealthy. We require more healthcare to keep us going than people elsewhere do. Too many calories go in and too few get burned up.

What is the cost of one of these calories? In terms of healthcare about 4 to 6 cents depending on how tall you are. That’s per year. For the rest of your life.

Eating an extra 200 calorie dessert above what we should will cost about \$8 to \$11 in additional healthcare for each year of the rest of our life. An extra 200 calories each day for a year will cost about \$3,100 per year more in additional healthcare.

These samples are between 90 and 140 calories each. Eating one will cost between \$2.73 and \$4.24 per year in additional healthcare—each year for the rest of our life.

How Do We Get Here? Some Very Quick Math.

We spend about \$11,000 per year per person for healthcare in the U.S. Costs vary considerably per person though, mostly based on lifestyle choices.

A group of a thousand people of healthy weight averages about \$4,500 per person per year. Many of these will cost less than \$1,000 per year but some will have extra health issues like cancer or broken bones and cost more but when it’s all tallied the average is about \$4,500.

A group of overweight people will cost about \$9,800 per year per person.

A group of obese people will cost about \$17,600 per person per year. Similar to above, some will cost less and others will cost more but as a group they’ll average about \$17k. By the way, the calculations include that they live fewer years than healthier people.

These extra costs due to weight and inactivity include increased incidences of diabetes, joint repair and replacement, cancer, heart disease, strokes, and a number of other medical problems. There are also often higher costs, per treatment, to treat people who are overweight. Then there are numerous secondary and tertiary problems such as those resulting from sleep apnea caused by being overweight.

From this and BMI tables we can get a cost per pound of extra weight we carry which ranges from about \$140 to \$210 per extra pound per person per year. Extra calories cost less the taller someone is. A person who is 5’10” has a per calorie cost of about \$150 while someone who is 5’4” is \$190.

And knowing that consuming 3500 calories adds 1 pound of weight we can get our \$0.04 to \$0.06 cost per calorie consumed.

Note: While the math is rather straight forward, it’s important to note that the numbers we started with, healthcare costs for groups of healthy, overweight and obese, are still somewhat uncertain. Some give a wider range than above and some narrower. I’ve used numbers that I believe are slightly on the conservative narrower side. There is considerable room for refinement but I think we’re at least in the ballpark and I’d be quite surprised if this is off by much. It’s also important to note that while being overweight or obese are health issues in themselves they are perhaps more important in being indicative of other underlying health problems, primarily too little activity.

It should also be noted that weight is not exclusive in the poor lifestyle choices sweepstakes. There are people of a healthy weight but who smoke, do not get enough activity, drink too much or do drugs who are unhealthy and as a group will also cost more than average.

The Value Of A Calorie

An extra calorie consumed has a cost but on the flip side an extra calorie burned has value!

If we ride our upright bicycle 2 miles to lunch, 1 mile to the grocery and then 2 miles back home we’ll have burned about 225 calories which based on our calculations above has a value of about \$9.75 in reduced healthcare costs.

However, activity itself has considerable health value. It’s much better to consume 200 extra calories and then burn 200 extra calories with activity than to sit on the sofa neither consuming nor burning. So, a calorie burned has more value than the cost of a calorie consumed. How much is a big guess and guesstimates range from 10% to 400%. For now perhaps we’ll just stick with ‘more’.

Medical folk I’ve talked to are quick to say that they’d never say this to a patient though, for fear that we would too often consume the extra calories without actually burning the extra calories. Nah. 🙂 But burn 225 calories riding to a local pub for a 225 calorie beer? You Betcha.

A Young Calorie vs Old Calorie

Carrying 10 pounds of extra weight is about \$1,700 per year in increased healthcare costs. If we carry those 10 pounds for 15 years before we die then we’ll cost about \$25,000 in extra healthcare. However, if we begin carrying those pounds when we’re 10 years old and live to 65 then that’s an extra \$93,000 healthcare expense burden we’ll have created.

It works in reverse as well. A calorie burned at a young age will end up being worth more than one burned at an older age. This does not in any way negate the value of burning a calorie when we’re 60 years old though.

What then is the value of encouraging children to walk or ride bicycles to school every day? And then encouraging them to continue this healthy lifestyle in to adulthood?

A Calorie Is Not Always A Calorie

500 calories from leaves, legumes and grains is better than 500 calories from a Big Mac or a donut with sprinkles.

Dutch Hagelslag. Perfect diet is not critical. The Dutch are the only developed country in recent decades to have measurably reduced their overweight and obesity rates that are less than 1/3 our rates today and are expected to be less than 1/4 by 2020. They’re far from perfect eaters though. Hagelslag (chocolate sprinkles) is a favorite breakfast item. Bitterballen, Stroopwaffles, Poffertjes, and french fries dipped in mayonnaise are also quite popular. They eat them in small portions and get enough daily activity to afford these treats though. Photo: https://www.becel.nl/lekkere-recepten/boterham-met-hagelslag-en-fruit/

A recent calorie also appears different from a past calorie. One calorie of activity will burn one recently consumed calorie. However, we’re learning that once a calorie has settled in and become comfortable then it may take as much as two calories of activity to dislodge it later on.

Walking or riding to breakfast, lunch or dinner will satiate us so we’ll eat less and returning afterwards will be the most efficient in burning what we’ve consumed.

What can we do with this information? Do bikeway networks that allow us to ride bicycles for active transportation have value? Do road designs that actively discourage walking and bicycling have costs? Can we really reduce healthcare costs by increasing our activity and living a healthier lifestyle?

## About Walker Angell

Walker Angell is a writer who focuses mostly on social and cultural comparisons of the U.S. and Europe. He occasionally blogs at localmile.org, a blog focused on everyday bicycling and local infrastructure for people who don’t have a chamois in their shorts. And on twitter @LocalMileMN