High monetary costs of dietary patterns associated with lower body mass index: a population-based study

Objective: To examine diet costs in relation to dietary quality and socio-economic position, and to investigate underlying reasons for differences in diet costs. Design: Dietary intake was assessed by a 4 d food diary and evaluated using the 2005 Healthy Eating Index (HEI). National consumer food prices collected by Statistics Sweden and from two online stores/supermarkets were used to estimate diet costs. Setting: Sweden. Subjects: A nationally representative sample of 2160 children aged 4, 8 or 11 years. Results: Higher scores on the HEI resulted in higher diet costs and, conversely, higher diet costs were linked to increased total HEI scores. Children who consumed the most healthy and/or expensive diets ate a more energy-dilute and varied diet compared with those who ate the least healthy and/or least expensive diets. They also consumed more fish, ready meals and fruit. Regression analysis also linked increased food costs to these food groups. There was a positive, but weak, relationship between HEI score and diet cost, parental education and parental occupation respectively. Conclusions: Healthy eating is associated with higher diet cost in Swedish children, in part because of price differences between healthy and less-healthy foods. The cheapest and most unhealthy diets were found among those children whose parents were the least educated and had manual, low-skill occupations. Our results pose several challenges for public health policy makers, as well as for nutrition professionals, when forming dietary strategies and providing advice for macro-and microlevels in society.

Section: Discussionsupporting

confidence: 93%

Diet cost, diet quality and socio-economic position: how are they related and what contributes to differences in diet costs?

Rydén

Hagfors

2011

“…The present findings may imply that public health interventions aimed at decreasing the energy cost of healthy diets could have a potential to improve population health. Consistent with previous Spanish (3) and Japanese (4) studies, we found that the monetary cost of dietary energy was negatively associated with BMI in a group of lean and young Japanese women. Additionally, we also found for the first time a negative relationship with waist circumference.…”

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Monetary cost of dietary energy is negatively associated with BMI and waist circumference, but not with other metabolic risk factors, in young Japanese women

Murakami

Sasaki

Takahashi

et al. 2009

Objective: Little is known about the relationship of dietary cost to health status. The present cross-sectional study examined the association between the monetary cost of dietary energy (Japanese yen/4184 kJ) and several metabolic risk factors. Design: Monetary cost of dietary energy was estimated based on dietary intake assessed by a self-administered diet history questionnaire and retail food prices. Body height and weight, from which BMI was derived, waist circumference and blood pressure were measured and fasting blood samples were collected for biochemical measurements. Setting: A total of fifteen universities and colleges in Japan. Subjects: A total of 1136 female Japanese dietetic students aged 18-22 years. Results: After adjustment for potential confounding factors, monetary cost of dietary energy was significantly and negatively associated with BMI (P for trend 5 0?0024). Monetary cost of dietary energy also showed a significant and negative association with waist circumference independently of potential confounding factors, including BMI (P for trend 5 0?0003). No significant associations were observed for other metabolic risk factors examined (P for trend 5 0?10-0?88). Conclusions: The monetary cost of dietary energy was independently and negatively associated with both BMI and waist circumference, but not other metabolic risk factors, in a group of young Japanese women. Keywords Monetary cost Diet Energy intake Body mass index Waist circumference Japanese women EpidemiologyWhile several studies have shown that monetary diet cost is associated with diet quality (1,2) , little is known about the relationship of dietary cost to health status. A Spanish study reported an association between higher costs of healthy dietary patterns and lower BMI (3) . The monetary cost of dietary energy was negatively associated with BMI in Japanese women (4) . However, the possible association between dietary cost and other metabolic risk factors has not been investigated. The relationship of monetary cost of dietary energy to health status is an important topic for public health nutrition, because if an independent and direct association actually exists between the cost of dietary energy and health, this may imply that public health interventions aimed at decreasing the energy cost of healthy diets could have a potential to improve population health. Here, we investigated the association of monetary cost of dietary energy with several metabolic risk factors, including BMI, waist circumference, systolic and diastolic blood pressure, total, HDL and LDL cholesterol, fasting TAG and glucose, and glycated haemoglobin.y Members of the Japan Dietetic Students' Study for Nutrition and Biomarkers Group (in addition to the authors) are:

“…As this procedure gives only an approximation of actual diet costs, the results of the present study should be interpreted with caution. We note, however, that a similar methodology has been used in all previous observational studies [5][6][7][8][9][10] . , size of residential area (city with $1 million; city with ,1 million; town and village), living status (living with family; living alone; living with others), current smoking (yes; no), current alcohol drinking (yes; no), current dietary supplement use (yes; no), currently trying to lose weight (yes; no), rate of eating (very slow; relatively slow; medium; relatively fast; very fast) and energy intake (kcal day 21 , continuous).…”

Section: Discussionmentioning

confidence: 99%

Monetary costs of dietary energy reported by young Japanese women: association with food and nutrient intake and body mass index

Murakami

Sasaki

Okubo

et al. 2007

Objective: Little is known about the relationship of monetary diet costs to dietary intake and obesity, particularly in non-Western populations. This study examined monetary cost of dietary energy in relation to diet quality and body mass index (BMI) among young Japanese women. Design: Dietary intake was assessed by a validated, self-administered, diet history questionnaire. Diet costs were estimated using retail food prices. Monetary cost of dietary energy (Japanese yen 1000 kcal 21 ) was then calculated. BMI was computed from self-reported body weight and height. Subjects: A total of 3931 female Japanese dietetic students aged 18-20 years. Results: Monetary cost of dietary energy was positively associated with intakes of fruits, vegetables, fish and shellfish, and pulses; however, higher monetary cost of dietary energy was also associated with higher consumption of fat and oil, meat and energy-containing beverages, and lower consumption of cereals (rice, bread and noodles) (all P for trend ,0.01). At the nutrient level, monetary cost of dietary energy was positively associated with intakes of dietary fibre and key vitamins and minerals, but also associated positively with intakes of fat, saturated fatty acids, cholesterol and sodium, and negatively with carbohydrate intake (all P for trend ,0.0001). After adjustment for possible confounders, monetary cost of dietary energy was quite weakly but significantly negatively associated with BMI (P for trend 5 0.0197). Conclusions: Increasing monetary cost of dietary energy was associated with both favourable and unfavourable dietary intake patterns and a quite small decrease in BMI in young Japanese women. Keywords Monetary cost Energy intake Energy density Nutrient intakeFood intake Diet quality Body mass index Japanese women EpidemiologyWhile food choice is influenced by a large number of factors 1 , the price of food is clearly an important determinant 2,3 . An inverse relationship exists between the energy density of foods (energy derived from foods per edible weight of foods) and energy cost (monetary cost of foods per energy derived from foods) 4 . Generally, energy-dense and nutrient-dilute foods such as cereals, fats and oils, and sugar and sweets provide dietary energy at the lowest cost. Conversely, the cost per calorie of energy-dilute and nutrient-dense foods including fish and shellfish, vegetables and fruit is much higher. If healthier foods cost more then so too will healthier diets, suggesting that consumers with limited financial resources might select energy-dense and nutrient-dilute diets as a means of saving money. Observational studies (albeit a limited number) on the cost of freely chosen diets have consistently shown that healthful diets are more expensive than less healthful diets 5-10 . To our knowledge, however, all studies of self-selected diets and monetary costs have been conducted in European countries, with none reported in Asian countries, including Japan.In contrast to Western populations, Japanese obtain the largest part of t...