I ran a set of Rickson's early steel wheels with 225/70-19. 5 tires for nigh on 200K miles. I saw some improvement in fuel economy, probably due to the significantly lower rolling resistance. When I recently changed back to 16" a year ago, I noticed a 1-2 MPG drop. My odo is set using a TruSpeed unit; it's set within 1%, based on 100 elapsed mile markers.
You won't lose fuel economy. Even if you do, you won't care: the truck is simply that much more stable, predictable and controllable.