Assessing the Cost of Healthy and Unhealthy Diets: A Systematic Review of Methods

Abstract

Purpose of Review Poor diets are a leading risk factor for chronic disease globally. Research suggests healthy foods are often harder to access, more expensive, and of a lower quality in rural/remote or low-income/high minority areas. Food pricing studies are frequently undertaken to explore food affordability. We aimed to capture and summarise food environment costing methodologies used in both urban and rural settings. Recent Findings Our systematic review of high-income countries between 2006 and 2021 found 100 relevant food pricing studies. Most were conducted in the USA (n = 47) and Australia (n = 24), predominantly in urban areas (n = 74) and cross-sectional in design (n = 76). All described a data collection methodology, with just over half (n = 57) using a named instrument. The main purpose for studies was to monitor food pricing, predominantly using the ‘food basket’, followed by the Nutrition Environment Measures Survey for Stores (NEMS-S). Comparatively, the Healthy Diets Australian Standardised Affordability and Price (ASAP) instrument supplied data on relative affordability to household incomes. Summary Future research would benefit from a universal instrument reflecting geographic and socio-cultural context and collecting longitudinal data to inform and evaluate initiatives targeting food affordability, availability, and accessibility.

Barriers to Adherence to Healthy Diet and Recommended Physical Activity Perceived by the Polish Population

“…Some researchers indicate that maintaining a healthy diet is associated with higher total expenditure, others that adhering to a healthy diet might be more economical than adopting an unhealthy one [ 23 ]. The recently observed 19% increase in food prices in Poland compared to the previous year may be conducive to a lower diet quality and lead to inadequate consumption of nutrient-rich foods [ 24 ]. Improving the affordability of healthy foods has the potential to enhance the quality of the population’s diet [ 25 ].…”