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Batis C, Gatica-Domínguez G, Marrón-Ponce JA, Colchero MA, Rivera JA, Barquera S, Stern D. Price Trends of Healthy and Less Healthy Foods and Beverages in Mexico from 2011-2018. J Acad Nutr Diet 2022; 122:309-319.e16. [PMID: 34403815 PMCID: PMC8792151 DOI: 10.1016/j.jand.2021.08.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 07/06/2021] [Accepted: 08/11/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Cost is one of the main drivers of food selection; thus it is important to monitor food prices. Evidence from low- and middle-income countries such as Mexico is limited. OBJECTIVE The aim of this study was to evaluate the prices and price trends of healthy and less healthy food/beverage groups in Mexico from 2011 to 2018. DESIGN This study used a time series of the prices of foods and beverages classified by 1) healthiness, 2) processing level, and 3) pairs of healthy/less healthy substitutes. SETTING Food and beverage prices used to estimate the Consumer Price Index were obtained. Prices were collected weekly from 46 cities (>20,000 habitants) distributed across the country. MAIN OUTCOME MEASURES Price trend (% change/year) from 2011 to 2018 for all food/beverage groups and price/100 g in 2018 for pairs of healthy/less healthy substitutes were obtained. STATISTICAL ANALYSES Linear regression models were used for each food/beverage group, with the logarithm of deflated price as the dependent variable and time (years) as the independent variable. RESULTS On average, prices for less healthy foods and beverages increased more than prices of healthy foods and beverages (foods: 1.72% vs 0.70% change/year; beverages: 1.61% vs -0.19% change/year). The price change was similar for unprocessed/minimally processed foods and ultraprocessed foods (1.95% vs 1.85% change/year); however, within each processing category, the price of less healthy foods increased more. By pairs of substitutes (within food/beverage groups), the healthier option for bread, sodas, and poultry was more expensive (price/100 g) in 2018, whereas for red meat, cheese, mayonnaise, and milk, the healthier option was cheaper. CONCLUSIONS Overall, the food prices of less healthy foods and beverages increased more than the food prices of healthy foods and beverages. However, by processing level there was no difference, and for pairs of healthy/less healthy substitutes results were mixed. Continued monitoring of food prices is warranted, and future research is needed to understand how these price changes affect dietary quality.
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Affiliation(s)
- Carolina Batis
- CONACYT - Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Joaquín A Marrón-Ponce
- Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - M. Arantxa Colchero
- Health Systems Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Juan A. Rivera
- National Institute of Public Health, Cuernavaca, Morelos, México
| | - Simon Barquera
- Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Dalia Stern
- CONACyT-Population Health Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico.,corresponding author:
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Batis C, Marrón-Ponce JA, Stern D, Vandevijvere S, Barquera S, Rivera JA. Adoption of healthy and sustainable diets in Mexico does not imply higher expenditure on food. NATURE FOOD 2021; 2:792-801. [PMID: 37117976 DOI: 10.1038/s43016-021-00359-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 07/28/2021] [Indexed: 04/30/2023]
Abstract
The relative cost of healthy and sustainable diets is key for their adoption in different countries. Using a newly developed modelling tool that generates different diet baskets, we compared the costs of diets following the EAT-Lancet healthy reference diet, the Mexican dietary guidelines and locals' current food intake. On average, the cost of the EAT-Lancet healthy reference diet baskets was 21% lower than that of the Mexican dietary guidelines baskets, and 40% lower than that of the current intake baskets (29% lower if the comparison was isocaloric). Findings were similar over time (2011-2018) and by geographic region. The higher cost associated with the larger amount of fruits, vegetables, legumes and nuts in healthy and sustainable diets was surpassed by the savings associated with their lower amount of animal protein sources, sugar-sweetened beverages and discretionary foods. We conclude that transitioning to better diets in Mexico is possible without a higher expenditure on food.
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Affiliation(s)
- Carolina Batis
- CONACYT - National Institute of Public Health, Cuernavaca, Mexico.
| | | | - Dalia Stern
- CONACYT - National Institute of Public Health, Cuernavaca, Mexico
| | | | | | - Juan A Rivera
- National Institute of Public Health, Cuernavaca, Mexico
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Daniel C. Is healthy eating too expensive?: How low-income parents evaluate the cost of food. Soc Sci Med 2020; 248:112823. [PMID: 32062569 PMCID: PMC7065490 DOI: 10.1016/j.socscimed.2020.112823] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 01/21/2020] [Accepted: 01/28/2020] [Indexed: 11/19/2022]
Abstract
Debates about whether a healthy diet is affordable often overlook how low-income consumers themselves evaluate food cost. This question is relevant to explaining food choices and measuring food prices. Drawing on interviews with 49 low-income primary caregivers and grocery-shopping observations with 34 of these interviewees, I find that respondents judge food cost in two ways: 1) absolute judgments, or assessments of whether a food covers a family's needs with scarce resources and 2) relative judgments, or interpretations of price relative to another food that frames an item as affordable or pricey by contrast. Absolute judgments reflect actual expenditures, including not just the sticker price, but also four underappreciated monetary costs. These underappreciated costs stem from food waste; packages containing more than is needed; food that is consumed too quickly; and unsatiating foods. When monetary costs go unmeasured and when consumers interpret prices in relative terms, researchers' views of food cost diverge from the experiences of low-income people. Divergent views have two results: food-cost estimates overstate the affordability of a healthy diet and observers may misconstrue purchases as financially imprudent. These findings can inform policy, programming, and public discourse.
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Affiliation(s)
- Caitlin Daniel
- University of California, Berkeley, Department of Sociology, Barrows Hall, Berkeley, CA 94720, United States.
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Nansel TR, Lipsky LM, Eisenberg MH, Liu A, Mehta SN, Laffel LM. Can Families Eat Better Without Spending More? Improving Diet Quality Does Not Increase Diet Cost in a Randomized Clinical Trial among Youth with Type 1 Diabetes and Their Parents. J Acad Nutr Diet 2016; 116:1751-1759.e1. [PMID: 27597745 PMCID: PMC5085870 DOI: 10.1016/j.jand.2016.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 07/08/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Although cost is a frequently cited barrier to healthful eating, limited prospective data exist. OBJECTIVE To examine the association of diet cost with diet quality change. DESIGN An 18-month randomized clinical trial evaluated a dietary intervention. PARTICIPANTS AND SETTING Youth with type 1 diabetes duration ≥1 year, age 8.0 to 16.9 years, receiving care at an outpatient tertiary diabetes center in Boston, MA, participated along with a parent from 2010 to 2013 (N=136). Eighty-two percent of participants were from middle- to upper-income households. INTERVENTION The family-based behavioral intervention targeted intake of whole plant foods. MAIN OUTCOME MEASURES Diet quality as indicated by the Healthy Eating Index 2005 (HEI-2005) (which measures conformance to the 2005 Dietary Guidelines for Americans) and whole plant food density (cup or ounce equivalents per 1,000 kcal target food groups) were calculated from 3-day food records of youth and parent dietary intake at six and four time points, respectively. Food prices were obtained from two online supermarkets common to the study location. Daily diet cost was calculated by summing prices of reported foods. STATISTICAL ANALYSES PERFORMED Random effects models estimated treatment group differences in time-varying diet cost. Separate models for youth and parent adjusted for covariates examined associations of time-varying change in diet quality with change in diet cost. RESULTS There was no treatment effect on time-varying diet cost for either youth (β -.49, 95% CI -1.07 to 0.08; P=0.10) or parents (β .24, 95% CI -1.61 to 2.08; P=0.80). In addition, time-varying change in diet quality indicators was not associated with time-varying change in diet cost for youth. Among parents, a 1-cup or 1-oz equivalent increase in whole plant food density was associated with a $0.63/day lower diet cost (β -.63, 95% CI -1.20 to -0.05; P=0.03). CONCLUSIONS Improved diet quality was not accompanied by greater cost for youth with type 1 diabetes and their parents participating in a randomized clinical trial. Findings challenge the prevailing assumption that improving diet quality necessitates greater cost.
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Affiliation(s)
- Tonja R. Nansel
- Senior Investigator, Health Behavior Branch; Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Dr., MSC 7004, Bethesda, MD 20892, phone 301-435-6937, fax 301-402-2084
| | - Leah M. Lipsky
- Staff Scientist, Health Behavior Branch; Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Dr., MSC 7004, Bethesda, MD 20892, phone 301-435-6951, fax 301-402-2084
| | - Miriam H. Eisenberg
- Postdoctoral Fellow, Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Dr., MSC 7004, Bethesda, MD 20892, phone 301-435-6940, fax 301-402-2084
| | - Aiyi Liu
- Senior Investigator, Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Dr., MSC 7004, Bethesda, MD 20892, phone 301-435-6952, fax 301-402-2084
| | - Sanjeev N. Mehta
- Assistant Investigator, Section on Genetics and Epidemiology, Joslin Diabetes Center, One Joslin Place, Boston, MA, 02215, phone: 617-732-2603, fax: 617-309-2451. Pediatric, Adolescent, and Young Adult Section, Genetics and Epidemiology Section; Joslin Diabetes Center; One Joslin Place, Harvard Medical School, Boston, MA
| | - Lori M.B. Laffel
- Chief, Pediatric, Adolescent and Young Adult Section, Investigator, Section on Genetics and Epidemiology, Joslin Diabetes Center, One Joslin Place, Boston, MA, 02215, phone: 617-732-2603, fax: 617-309-2451
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Schröder H, Gomez SF, Ribas-Barba L, Pérez-Rodrigo C, Bawaked RA, Fíto M, Serra-Majem L. Monetary Diet Cost, Diet Quality, and Parental Socioeconomic Status in Spanish Youth. PLoS One 2016; 11:e0161422. [PMID: 27622518 PMCID: PMC5021338 DOI: 10.1371/journal.pone.0161422] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 08/07/2016] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Using a food-based analysis, healthy dietary patterns in adults are more expensive than less healthy ones; studies are needed in youth. Therefore, the objective of the present study was to determine relationships between monetary daily diet cost, diet quality, and parental socioeconomic status. DESIGN AND METHODS Data were obtained from a representative national sample of 3534 children and young people in Spain, aged 2 to 24 years. Dietary assessment was performed with a 24-hour recall. Mediterranean diet adherence was measured by the KIDMED questionnaire. Average food cost was calculated from official Spanish government data. Monetary daily diet cost was expressed as euros per day (€/d) and euros per day standardized to a 1000kcal diet (€/1000kcal/d). RESULTS Mean monetary daily diet cost was 3.16±1.57€/d (1.56±0.72€/1000kcal/d). Socioeconomic status was positively associated with monetary daily diet cost and diet quality measured by the KIDMED index (€/d and €/1000kcal/d, p<0.019). High Mediterranean diet adherence (KIDMED score 8-12) was 0.71 €/d (0.28€/1000kcal/d) more expensive than low compliance (KIDMED score 0-3). Analysis for nonlinear association between the KIDMED index and monetary daily diet cost per1000kcal showed no further cost increases beyond a KIDMED score of 8 (linear p<0.001; nonlinear p = 0.010). CONCLUSION Higher monetary daily diet cost is associated with healthy eating in Spanish youth. Higher socioeconomic status is a determinant for higher monetary daily diet cost and quality.
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Affiliation(s)
- Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- * E-mail:
| | - Santiago F. Gomez
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- AQuAS / ASPCAT, Departament de Salut, Generalitat de Catalunya, Barcelona, Spain
- PhD Programme in Biomedicine, Universidad Pompeu Fabra, Barcelona, Spain
| | - Lourdes Ribas-Barba
- Fundación para la Investigación Nutricional (Nutrition Research Foundation), Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Rowaedh Ahmed Bawaked
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Montserrat Fíto
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Lluis Serra-Majem
- Fundación para la Investigación Nutricional (Nutrition Research Foundation), Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Reseach Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
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Jones HA, Charlton KE. A cross-sectional analysis of the cost and affordability of achieving recommended intakes of non-starchy fruits and vegetables in the capital of Vanuatu. BMC Public Health 2015; 15:301. [PMID: 25885864 PMCID: PMC4392615 DOI: 10.1186/s12889-015-1644-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 03/16/2015] [Indexed: 11/20/2022] Open
Abstract
Background The low-income Pacific Island nation of Vanuatu is experiencing a double burden of diet-related disease whereby micronutrient deficiencies and underweight occur at the same time as obesity related non-communicable diseases. Increasing intakes of nutrient dense, energy dilute foods such as fruits and vegetables will be important to address this issue. However, reduced access to agricultural land in urban areas provides limited opportunities for traditional subsistence fruit and vegetable production. Set in Port Vila, Vanuatu’s capital and main urban centre, this study aimed to determine the cost and affordability of meeting international recommendations to consume at least 400 g of non-starchy fruits and vegetables (NSFV) per person per day, and assess the adequacy of households’ NSFV expenditure. Methods NSFV prices from the 2010 Vanuatu Consumer Price Index (n = 56) were used to determine the minimum monthly cost of purchasing 400 g of local NSFV per person, after accounting for wastage. The 2010 Vanuatu Household Income and Expenditure Survey (n = 578 households) was analysed to determine the proportion of households’ total and food budget required to purchase 400 g of local NSFV for all household members. Household NSFV costs were also compared against actual household expenditure on these items. Consumption of own-produce and gifts received were included within estimates of food expenditure. Results The minimum cost of purchasing the recommended amount of local NSFV was 1,486.24 vatu ($16.60 US) per person per month. This level of expenditure would require an average of 9.6% (SD 6.4%) of households’ total budget and 26.3% (SD 25.8%) of their food budget. The poorest households would need to allocate 40.9% (SD 34.3%) of their total food budget to NSFV to purchase recommended amounts of these foods. Twenty-one percent of households recorded sufficient NSFV expenditure while 23.4% recorded less than 10% of the expenditure required to meet the NSFV recommendations. Conclusions Achieving recommended intakes of local NSFV in Port Vila is largely unaffordable, and expenditure on these foods was inadequate for most households in Port Vila in 2010. Addressing fruit and vegetable affordability will be an important consideration in prevention of non-communicable diseases in the Pacific region.
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Affiliation(s)
- Holly A Jones
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW, Australia.
| | - Karen E Charlton
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW, Australia.
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Nansel T, Haynie D, Lipsky L, Mehta S, Laffel L. Little variation in diet cost across wide ranges of overall dietary quality among youth with type 1 diabetes. J Acad Nutr Diet 2015; 115:433-439.e1. [PMID: 25266245 PMCID: PMC4344866 DOI: 10.1016/j.jand.2014.07.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 07/24/2014] [Indexed: 11/22/2022]
Abstract
We examined the association of diet quality with diet cost in a sample of youth with type 1 diabetes, for whom diet is an important component of medical management. Differences in food group spending by diet quality were also examined to identify potential budgetary reallocation to improve overall diet quality. Families of 252 youth with type 1 diabetes aged 8 to 18 years completed 3-day youth diet records. Cost of each food reported was calculated based on the average price obtained from two online grocery stores. Diet cost was estimated as average daily cost of foods consumed. The Healthy Eating Index 2005 (HEI2005), Nutrient Rich Foods Index version 9.3, and Whole Plant Food Density scores were evaluated. Differences in mean daily diet cost across tertiles of HEI2005, Nutrient Rich Foods Index version 9.3, and Whole Plant Food Density were modest, with none reaching statistical significance. Those in the upper tertile of HEI2005 spent more on whole fruit, whole grains, lean meat, and low-fat dairy, and less on high-fat meat and high-fat dairy compared with those in the lower tertiles. Higher-quality diets can be obtained at comparable costs to lesser-quality diets, suggesting that cost need not be an insurmountable barrier to more healthful eating. Reallocation of spending may increase overall quality without substantially increasing overall spending. Findings suggest potential strategies for assisting families of youth with type 1 diabetes in identifying cost-effective ways to achieve a more healthful diet.
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Affiliation(s)
- Tonja Nansel
- Prevention Research Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Shriver Kennedy National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Blvd., Rm 7B13, Bethesda, MD 20892-7510, 301-435-6937, 301-402-2084(FAX)
| | - Denise Haynie
- Prevention Research Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Shriver Kennedy National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892-7510
| | - Leah Lipsky
- Prevention Research Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Shriver Kennedy National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892-7510
| | - Sanjeev Mehta
- Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215
| | - Lori Laffel
- Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215
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