The Cost of the Healthy Diet
Shoppers and Trends
May 25, 2009
Since this study was focused on the link between the cost and quality of people's diets, study co-authors Drs. Pablo Monsivais and Adam Drewnowski took quantity out of the picture by standardizing the diets of all 164 participants to the 2,000 kcal level. They found that for each 2,000 kcal of dietary energy, men spent $7.43 daily compared to $8.12 spent by women.
Diets that were more costly were also lower in energy density and contained higher levels of nutrients. In fact, for each additional dollar spent by women, there was a decrease in energy density of .12 kcal/g. Energy density is one indicator of diet quality as healthier items like fruits and vegetables, lean means and low-fat dairy products provide less energy per unit weight than do fast foods and sweets. So lowerenergy dense diets are associated with higher intakes of nutrients; higher energy density diets are associated with lower intakes of nutrients.
“We've known for decades that less affluent and less educated people tend to have poor diets and more health problems,” says Monsivais. “Now we are beginning to see that eating a nutritious diet carries a price premium. Current dietary guidance does not take cost into account. If we don't address the monetary hurdles, simply telling people to eat more fruit and vegetables won't go anywhere.”
While women who spent more per 2,000 kcal tended to get more nutritious diets in return, there was little connection between spending and quality for men. This might reveal, says Monsivais, some gender differences in nutrition knowledge or skills necessary to translate larger food budgets into better nutrition. As diets of lower energy density go hand in hand with diets of higher quality, lower body weights and better health outcomes, the health promotion implications of this finding is significant.
Although income level contributed to spending on higher-priced, healthier items, the biggest predictor of both energy density and energy cost was education level. The two higher education groups spent nearly $1 per 2,000 kcal more than the reference group (individuals with less than a four year college education) – suggesting that consumers in these categories could have better access to nutrition information.
Monsivais says that these findings provide a great opportunity for retailers to distinguish themselves, get the word out on health education and participate in the overhauling of our food system – which places too much emphasis on calories over nutrients. He hopes that the next set of federal dietary guidelines, released next year, will provide more specific guidance that can help consumers find the most affordable, nutrient rich foods.
Monsivais also hopes the guidelines will be more sensitive to economic realities, because many fruits and vegetables, seafoods and lean cuts of meat are currently out of reach of lower-income families. In a separate study, Monsivais and Drewnowski found that the price of these lower energy density food items rose by almost 20% over a 2-year period. Furthermore, due to the economy, many shoppers may be facing income limitations in the market for the first time.
“It's no longer enough to claim to have the lowest prices. Food retailers can and should get ahead of this issue by working with the nutrition community, health professionals and food producers to promote more of the most nutritious foods,” he adds.