Affordable Nutrient Density in Brazil: Nutrient Profiling in Relation to Food Cost and NOVA Category Assignments

Abstract

Affordable nutrient density is provided by low-cost and nutrient-rich foods. We explored nutrient density, cost, and NOVA category assignments within and across food groups in Brazil. The nutrient density of the foods (n = 591) was assessed using the Nutrient Rich Food Index (NRF9.3) based on protein, fiber, vitamin A (RAE), vitamin C, vitamin E (mg), Ca, Fe, K and Mg; and NRF6.3 score for priority nutrients: Ca, Fe, Zn, vitamin A, vitamin B12, and folate. Nutrients to limit (LIM) were saturated fat, added sugar, and sodium. Affordability was defined as the ratio of energy and/or nutrient density of foods and retail price per 100 kcal. Foods were classified as minimally processed (n = 106), processed (n = 188), ultra-processed (n = 286), and culinary ingredients (n = 11). Nutrient density was positively linked to per 100 kcal food cost. Ultra-processed foods (UPF) contained more energy, fat, sugar, and salt and had lower NRF scores compared to minimally processed (MPF) foods. UPF was also less expensive than MPF foods. Nutrient-rich foods below the median per 100 kcal costs included MPF foods, but also processed foods (PF) and UPF. Affordable nutrient-rich foods can be found in the different categories of the NOVA classification.

Reported recommendations to address cardiovascular risk factors differ by socio-economic status in Brazil. Results from the Brazilian National Health Survey 2019

“…The reason for a lower provision of healthy eating and physical activity recommendations to participants of lower SES or lower income could be because people in those groups cannot afford to buy nutrient-rich foods, as these foods are more expensive than ultraprocessed, nutrient-poor foods ( Mendoza-Velazquez et al, 2022 ). They could also be explained by the fact that most exercise is performed in paying facilities, due to the decline in availability of public spaces and awareness about public programs ( Wendt et al, 2013 ).…”

Toward a science-based classification of processed foods to support meaningful research and effective health policies

“…Lower cost diets are likely to be selected by groups of lower socioeconomic status ( 59 ). Some Nova 4 foods may be more cost-effective sources of nutrients than less-processed options ( 60 ). While some studies have adjusted for income ( 61–63 ), income had a limited influence on UPF intake.…”