Contribution of food prices and diet cost to socioeconomic disparities in diet quality and health: a systematic review and analysis

Abstract

Context: It is well established in the literature that healthier diets cost more than unhealthy diets.

Objective: The aim of this review was to examine the contribution of food prices and diet cost to socioeconomic inequalities in diet quality.

Data sources: A systematic literature search of the PubMed, Google Scholar, and Web of Science databases was performed.

Study selection: Publications linking food prices, dietary quality, and socioeconomic status were selected.

Data extraction: Where possible, review conclusions were illustrated using a French national database of commonly consumed foods and their mean retail prices.

Data synthesis: Foods of lower nutritional value and lower-quality diets generally cost less per calorie and tended to be selected by groups of lower socioeconomic status. A number of nutrient-dense foods were available at low cost but were not always palatable or culturally acceptable to the low-income consumer. Acceptable healthier diets were uniformly associated with higher costs. Food budgets in poverty were insufficient to ensure optimum diets.

Conclusions: Socioeconomic disparities in diet quality may be explained by the higher cost of healthy diets. Identifying food patterns that are nutrient rich, affordable, and appealing should be a priority to fight social inequalities in nutrition and health.

Keywords: diet cost; energy density; food prices; nutrient density; nutrition economics; socioeconomic status.

Figure 1

Flowchart of search and screening process for studies on nutrition economics and diet cost

Figure 2

Energy density (kcal/100 g) and energy cost (€/100 kcal) of foods (n = 1117) in the French food database, based on 2007 national food prices

Figure 3

Median (in gray) and mean (in black) cost of energy provided by foods in each main food group in the French food database

Figure 4

Foods with a good quality-to-price ratio in the French food database (n = 1117). Abbreviations: SAIN/LIM, Score of Nutritional Adequacy of Individual foods / score of nutrients to be LIMited