Study: Do healthier foods and diet patterns cost more than less healthy options?

BMJ Open:

Objective: To conduct a systematic review and meta-analysis of prices of healthier versus less healthy foods/diet patterns while accounting for key sources of heterogeneity.

Data sources: MEDLINE (2000–2011), supplemented with expert consultations and hand reviews of reference lists and related citations.

Design: Studies reviewed independently and in duplicate were included if reporting mean retail price of foods or diet patterns stratified by healthfulness. We extracted, in duplicate, mean prices and their uncertainties of healthier and less healthy foods/diet patterns and rated the intensity of health differences for each comparison (range 1–10). Prices were adjusted for inflation and the World Bank purchasing power parity, and standardised to the international dollar (defined as US$1) in 2011. Using random effects models, we quantified price differences of healthier versus less healthy options for specific food types, diet patterns and units of price (serving, day and calorie). Statistical heterogeneity was quantified using I2statistics.

Results: 27 studies from 10 countries met the inclusion criteria. Among food groups, meats/protein had largest price differences: healthier options cost $0.29/serving (95% CI $0.19 to $0.40) and $0.47/200 kcal ($0.42 to $0.53) more than less healthy options. Price differences per serving for healthier versus less healthy foods were smaller among grains ($0.03), dairy (−$0.004), snacks/sweets ($0.12) and fats/oils ($0.02; p<0.05 each) and not significant for soda/juice ($0.11, p=0.64). Comparing extremes (top vs bottom quantile) of food-based diet patterns, healthier diets cost $1.48/day ($1.01 to $1.95) and $1.54/2000 kcal ($1.15 to $1.94) more. Comparing nutrient-based patterns, price per day was not significantly different (top vs bottom quantile: $0.04; p=0.916), whereas price per 2000 kcal was $1.56 ($0.61 to $2.51) more. Adjustment for intensity of differences in healthfulness yielded similar results.

Conclusions: This meta-analysis provides the best evidence until today of price differences of healthier vs less healthy foods/diet patterns, highlighting the challenges and opportunities for reducing financial barriers to healthy eating.

I’ve been guilty (as have MANY others) of believing that it costs much, much more to eat healthy. That’s not really the case:

A healthier diet rich in fruits, vegetables, fish, and nuts cost about $1.50 per day more than a poor diet filled with processed foods, fatty meat, and refined grains, the study showed. The cost difference was greatest for meat: 29 cents per serving and 47 cents per 200 calories more for healthy options.

The investigators noted that the daily $1.50 price difference totals $550 per year. “For many low-income families, this additional cost represents a genuine barrier to healthy eating,” they wrote. However, they estimated that annual US health care costs linked with unhealthy eating total $393 billion, or $1200 per person.

$550 a year is not an insignificant amount of money, especially for people at the low end of the socioeconomic spectrum. But if you really believe that obesity is driving health care costs through the roof, then it’s actually a good investment.

Read the full study here.

@aaronecarroll

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