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Abstract Objective: To examine the association between red and processed meat consumption and total food expenditures in US households and explore whether households could reduce food costs by substituting these meats with other protein sources such as poultry, seafood, eggs and plant proteins. Design: Cross-sectional study using data from the National Household Food Acquisition and Purchase Survey (FoodAPS). Using adult male equivalents (AME) for standardisation, we categorised red and processed meat purchases into quintiles. We used generalised linear models to explore the association between red or processed meat consumption and food expenditures and the cost effect of substituting meat with other proteins. Setting: United States. Participants: Data from 4739 households with valid acquisition information from FoodAPS, a stratified multistage probability sample of US households. Results: Higher red and processed meat consumption were both significantly associated with higher total weekly food expenditures, particularly among households with low income. Substituting red or processed meat with poultry, eggs or plant proteins did not significantly affect overall food expenditures, whereas replacing meat with seafood, especially varieties high in n-3 fatty acids, led to increased costs. Conclusions: Reducing red and processed meat consumption could offer savings for households, particularly those with low income. Although substitutions with seafood high in n-3 could increase expenses, alternative protein sources like poultry and plant proteins may serve as cost-neutral replacements. Public health strategies should emphasise dietary shifts’ economic, health and environmental benefits and aim to make nutritious yet affordable protein sources more accessible.

High cost of nutritious foods and eating out of home (OH) might be barriers to healthy and sustainable diets. We examined adherence to Dietary Approaches to Stop Hypertension (DASH), EAT–Lancet reference diet (EAT) and Mediterranean diet score (MDS) and the associations with dietary cost and eating OH. We evaluated cross-sectional data from single multiple-pass 24-h diet recalls from 289 young adults (18–24 years) in Tirana, Albania. Dietary cost (in Albanian Lek (ALL)) was estimated by matching food consumption data with retail prices from local fast-food chains, supermarkets, restaurants and food vendors. Poisson regression was fitted to models that included DASH, EAT and MDS as dependent variables to assess associations between healthy sustainable diet indicators and dietary cost and eating OH. Adjusted models were controlled for BMI, sex and total energy intake (kJ) using the residual method. Our findings indicate relatively poor adherence to healthy and sustainable dietary patterns among young men and women in Albania. Furthermore, better adherence to DASH, EAT or MDS was not associated with dietary cost (per 100 ALL; range incidence rate ratios (IRR): 0·97–1·00; all (un-)adjusted P > 0·05). Nonetheless, eating OH was related to lower adherence to DASH (IRR: 0·79; P = 0·003) and MDS (IRR: 0·69; P < 0·001). In conclusion, adherence to health and sustainable dietary patterns was poor and not differentiated by cost, but rather source of foods (i.e. OH or at home). Further research on the potential public and environmental health effects of these findings is warranted in Albania. [ABSTRACT FROM AUTHOR]

We compared subgroups of fruit and vegetables which provide the best nutritional value per unit cost. For this purpose, nutrient adequacy score and nutrient density score, based on the content of vitamins A, C, E, folate, thiamine, riboflavin, calcium, iron, potassium and magnesium, were calculated and subsequently complemented by food prices. The study was focused on elderly people over 65 years. The nutrient density score for vegetables was found significantly higher than that for fruit (P < 0.001), which implies that vegetables provide a higher amount of nutrients per energy unit. The highest nutrient-to-price ratio was observed for carrot, savoy cabbage, head cabbage, pepper, kohlrabi, green peas, and potatoes. Our results can help consumers identify affordable nutrient-rich types of fruit and vegetables and maximise the nutrient-to-calorie ratio.

High cost of healthy foods could be a barrier to healthy eating. We aimed to examine the association between dietary cost and adherence to the Mediterranean diet in a non-Mediterranean country. We evaluated cross-sectional data from 12 417 adults in the UK Fenland Study. Responses to 130-item FFQ were used to calculate a Mediterranean diet score (MDS). Dietary cost was estimated by matching food consumption data with retail prices of five major supermarkets. Using multivariable-adjusted linear regression, we examined the association of MDS and individual foods with dietary cost in absolute and relative scales. Subsequently, we assessed how much the association was explained by education, income, marital status and occupation, by conducting mediation analysis and testing interaction by these variables. High compared with low MDS (top to bottom third) was associated with marginally higher cost by 5·4 % (95 % CI 4·4, 6·4) or £0·20/d (95 % CI 0·16, 0·25). Participants with high adherence had higher cost associated with the healthier components (e.g. vegetables, fruits and fish), and lower cost associated with the unhealthy components (e.g. red meat, processed meat and sweets) (Pfor trend<0·001 each). In total, 20·7 % (95 % CI 14·3, 27·0) of the MDS-cost association was explained by the selected socio-economic factors, and the MDS-cost association was of greater magnitude in lower socio-economic groups (Pinteraction<0·005). Overall, greater adherence to the Mediterranean diet was associated with marginally higher dietary cost, partly modified and explained by socio-economic status, but the potential economic barriers of high adherence might be offset by cost saving from reducing unhealthy food consumption. [ABSTRACT FROM AUTHOR]

Food price is a determining factor of food choices; however its relationship with diet quality is unclear in Malaysia. This study aimed to examine socio-economic characteristics and daily dietary cost (DDC) in relation to diet quality in the state of Selangor, Malaysia. Dietary intake was assessed using a Food Frequency Questionnaire (FFQ) and diet quality was estimated using a Malaysian Healthy Eating Index (M-HEI). DDC in Malaysian Ringgit (RM) was calculated from dietary intake and national food prices. Linear regression models were fitted to determine associations between DDC and M-HEI scores and predictors of diet quality. The mean M-HEI score of respondents was 61.31 ± 10.88 and energy adjusted DDC was RM10.71/2000 kcal (USD 2.49). The highest quintile of adjusted DDC had higher M-HEI scores for all respondents (Q1: 57.14 ± 10.07 versus Q5: 63.26 ± 11.54, p = 0.001). There were also positive associations between DDC and M-HEI scores for fruits (p < 0.001) and vegetables (p = 0.017) for all respondents. Predictors of diet quality included carbohydrate (b = 0290; p < 0.001) and fat intakes (β = -0.242; p < 0.001) and energy adjusted DDC (b = 0.196; p < 0.001). Higher dietary cost is associated with healthy eating among Malaysian adults. [ABSTRACT FROM AUTHOR]

We compared subgroups of fruit and vegetables which provide the best nutritional value per unit cost. For this purpose, nutrient adequacy score and nutrient density score, based on the content of vitamins A, C, E, folate, thiamine, riboflavin, calcium, iron, potassium and magnesium, were calculated and subsequently complemented by food prices. The study was focused on elderly people over 65 years. The nutrient density score for vegetables was found significantly higher than that for fruit (P < 0.001), which implies that vegetables provide a higher amount of nutrients per energy unit. The highest nutrient-to-price ratio was observed for carrot, savoy cabbage, head cabbage, pepper, kohlrabi, green peas, and potatoes. Our results can help consumers identify affordable nutrient-rich types of fruit and vegetables and maximise the nutrient-to-calorie ratio. [ABSTRACT FROM AUTHOR]