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...