Abstract 059: Do Healthier Foods or Diet Patterns Cost More Than Less Healthy Options? A Systematic Review and Meta-Analysis
Background: Conventional wisdom holds that healthier foods cost more than less healthy options. Yet, this research question has not been systematically evaluated, including consideration of types of foods and diet patterns and definitions of healthfulness.
Methods: Using MOOSE guidelines, we conducted a systematic review and meta-analysis of prices of healthier vs less healthy foods and diet patterns, evaluating and accounting for key sources of heterogeneity. We searched PubMed, related articles, and citations for original studies comparing retail food prices by metrics of healthfulness. We estimated pooled price differences per serving for different food groups and per day for diet patterns. We also evaluated prices per calorie and weighted by intensity of differences in healthfulness of foods/diets being compared (range 1 to 10, determined in duplicate).
Results: Of 1,101 articles, 26 met inclusion criteria. Among food groups, meats/protein had largest price differences by healthfulness (Figure): healthier options cost $0.33/serving (95% CI 0.19, 0.47) more than less healthy options, with heterogeneity by type of protein source. Comparing extremes (e.g., quintile 5 vs 1) of diet patterns (20 studies evaluating 13 metrics, e.g. energy density, Mediterranean diet), healthier diet patterns cost $1.43/day (0.82, 2.04) and $1.92/2000 calories (1.57, 2.26) more, with some heterogeneity by type of diet pattern (to be shown). Results were similar weighted by intensity of differences in healthfulness or stratified by study location.
Conclusions: This systematic assessment quantifies price differences of healthier vs less healthy foods, including for specific food types, diet patterns, intensities of differences, and units of cost (serving, day, calorie). Healthier diet patterns and some healthier foods cost more; for diet patterns, the pooled price difference was ~$1.50/day. These findings highlight both the nuanced challenges and the opportunities for reducing financial barriers to healthy eating.
- © 2013 by American Heart Association, Inc.