Longitudinal change in the diet's monetary value is associated with its change in quality and micronutrient adequacy among urban adults

Abstract

BackgroundReducing diet costs may lead to the selection of energy-dense foods, such as refined grains or foods high in added sugars and/or fats, which can lower overall dietary quality. We examined the longitudinal association between the monetary value of the diet (MVD) and the overall dietary quality across sex, race and income groups.Methods and findingsLongitudinal data from 1,466 adult urban participants from Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study were used. Healthy Eating Index–2010 (HEI–2010) and Mean Adequacy Ratio (MAR) were computed and a national food price database was used to estimate MVD. Multiple linear regression analyses were conducted linking annual rates of change (Δ) in MVD to ΔHEI-2010 and ΔMAR, stratifying by sex, race and income groups. Among key findings, ΔHEI-2010 was comparable across socio-demographic groups, while ΔMAR was higher among women and individuals above poverty. Adjusting for key covariates, ΔMVD was positively associated with both ΔHEI-2010 and ΔMAR, and with a consistently stronger association among individuals above poverty, specifically for the total proteins and empty calories components of HEI-2010 and several nutrient adequacy ratios (NARs: vitamins C, E, B-6 and Zinc). ΔMVD-ΔMAR association was stronger in women, mainly influenced by ΔMVD’s positive associations with B-vitamins, copper, calcium, magnesium and phosphorus NARs. ΔMVD-Δvitamin D NAR’s positive relationship was stronger among Whites, while ΔMVD-Δvitamin B-12 NAR’s association was stronger among African-Americans.ConclusionsIn sum, a potential increase in MVD may have a stronger impact on dietary quality among urban adult women and above-poverty individuals.

Higher-diet quality is associated with higher diet costs when eating at home and away from home: National Health and Nutrition Examination Survey, 2005–2016

“…The observed direct association between diet quality and cost is consistent with previous cross-sectional studies (9)(10)(11)(12) , longitudinal studies (14,15) , systematic reviews (8) and meta-analyses (13) . In the present study, this association was similar regardless of the instrument used to measure diet quality.…”

“…Prior research showing positive associations between longitudinal change in food spending and diet quality (14,15) underscores the risk of decreased diet quality as a result of financial hardship. The primary vehicle for providing nutrition assistance in the USA is the Supplemental Nutrition Assistance Program (SNAP), which provides monthly benefits for food purchases based on household size and income (46) .…”

“…Others have demonstrated that lower cost food options tend to have lower nutritional value (7) , which presents a barrier to healthy eating that is more salient for individuals with lower income (8) . Consistent evidence from cross-sectional (9)(10)(11)(12)(13) and longitudinal (14,15) studies, as well as reviews and meta-analyses (8,13) , demonstrate that higher diet quality is associated with higher cost, which partly explains the suboptimal eating patterns observed in the USA and elsewhere (3,4) .…”

“…grocery stores) and away from home (e.g. restaurants) (9)(10)(11)(12)14,15) . Furthermore, not all studies have explicitly accounted for the cost of food waste and inedible portions, which represent over 40 % of the cost of purchased food (16) .…”

Household food insecurity, dental caries and oral-health-related quality of life in Brazilian Indigenous adults

“…The unhealthy food choices made by groups in situation of food insecurity might not be simply a matter of lack of information, but rather an actual strategy employed by families to cope with the food-resource inadequacy 45 . Families experiencing financial constraints are likely to reduce diet costs by prioritizing the purchase of energy-dense foods, which often leads to lower overall diet quality 46 .…”