What to expect from the price of healthy and unhealthy foods over time? The case from Brazil

AbstractObjective:To measure change in price of food groups over time (1995–2030) in Brazil, considering the Brazilian Dietary Guidelines’ recommendations.Design:Data from the Household Budget Survey (2008–2009 HBS) and the National System of Consumer Price Indexes (NSCPI) were used to create a data set containing monthly prices for the foods and beverages most consumed in the country (n 102), from January 1995 to December 2017. Data on price of foods and beverages from 2008–2009 HBS (referring to January 2009) were used to calculate real price over time using the monthly variation in prices from NSCPI. All prices were deflated to December 2017. Foods and beverages were classified following the Brazilian Dietary Guidelines’ recommendations. The monthly price for each food group and subgroup was used to analyse changes in prices from 1995 to 2017 and to forecast prices up to 2030 using fractional polynomial models.Setting:Brazil.Participants:National estimates of foods and beverages purchased for Brazil.Results:In 1995, ultra-processed foods were the most expensive group (R$ 6·51/kg), followed by processed foods (R$ 6·44/kg), then unprocessed or minimally processed foods and culinary ingredients (R$ 3·45/kg). Since the early 2000s, the price of ultra-processed foods underwent successive reductions, becoming cheaper than processed foods and reducing the distance between it and the price of the other group. Forecasts indicate that unhealthy foods will become cheaper than healthy foods in 2026.Conclusions:Food prices in Brazil have changed unfavourably considering the Brazilian Dietary Guidelines’ recommendations. This may imply a decrease in the quality of the population’s diet.

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A Food Group Based Approach to Satisfy Nutrient Recommendations in Toddlers (12-24 Months) Using Dietary Modelling (P11-091-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz048.p11-091-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Lynda O'Neill ◽

Anne Dattilo ◽

Matthieu Maillot ◽

Florent Vieux ◽

Jose Saavedra

Keyword(s):

Vitamin D ◽

Daily Intake ◽

Food Group ◽

Dietary Guidelines ◽

Food Groups ◽

University Of Minnesota ◽

Dietary Recommendations ◽

Data Set ◽

Food Component ◽

Nutrient Adequacy

Abstract Objectives The aim of this study was to optimize the quantity of daily intake of food groups to meet energy, nutrient needs, and to assess differences in diets using fortified versus unfortified foods to provide nutrient adequacy in the second year of life. Methods Mathematical modeling was applied to the Feeding Infants and Toddlers Study 2016 (observed diet) data set to develop optimized theoretical toddler (12 – 24 months old) diets. The model was constrained to meet median energy requirements and appropriate nutrient reference values and minimize the deviation from the average observed diet. Only the complementary food component of the diet was modelled. Using the Nutrition Data System for Research (NDSR, version 2015: University of Minnesota, Minneapolis, MN), the current US fortification of grains and dairy were accounted for and the analysis was repeated without fortification. Results The mathematically modeled diets revealed a lower quantity of food (613 to 732 g/day less) and energy (449.3 kcal/per day) were needed to meet nutrient recommendations, compared to the observed diet. The modelled diets contained less meat and fish and less starches and grains, compared to the observed diet. However, the modelled diets contained greater quantities of vegetables and fruit than the observed diet. Additional fruit and vegetables were required when the modelled diet was unfortified rather than when it was fortified. However, the fortified diet allowed for greater variety, and inclusion of other dairy (yogurt and cheese), and starches and grains compared with the unfortified diet. In terms of nutrient adequacy, the modelled fortifed diet met all recommendations, whereas the unfortified diet met all but vitamin D. Conclusions Our results indicate that with the exception of Vitamin D, nutrient needs of young toddler age children can be satisfied with lower and more appropriate energy intake than currently observed. These findings can assist with dietary recommendations based on a food group approach, for meal planning, or for the development of food based dietary guidelines. Funding Sources Nestlé Nutrition, Vevey, Switzerland.

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Economic evaluation of a web-based menu planning intervention to improve childcare service adherence with dietary guidelines.

10.21203/rs.3.rs-37439/v1 ◽

2020 ◽

Author(s):

Penny Reeves ◽

Kim Edmunds ◽

Zoe Szewczyk ◽

Alice Grady ◽

Sze Lin Yoong ◽

...

Keyword(s):

Food Group ◽

Dietary Guidelines ◽

Food Groups ◽

Healthy Foods ◽

Web Based ◽

Usual Practice ◽

Menu Planning ◽

Relative Value ◽

The Cost ◽

Planning Intervention

Abstract Background Despite the known benefits of healthy eating in childhood, few Australian childcare services provide food that is consistent with dietary guidelines. The effectiveness of a web-based menu planning intervention to increase childcare service provision of healthy foods, and decrease provision of discretionary foods in long daycare centres in Australia was assessed in a randomised controlled trial. Here we consider the costs, consequences, cost-effectiveness and budget impact of the intervention using data collected within the trial. Methods The prospective trial-based economic evaluation involved 54 childcare services across New South Wales (NSW), Australia. Services were randomised to a 12-month intervention or usual care. The intervention involved access to a web-based menu planning and decision support tool, and online resources. Effectiveness measures included: mean number of food groups, overall menu and individual food group compliance with dietary guidelines, and mean servings of food groups at 12 months. Costs (reported in $AUD, 2017/18) were evaluated from both health sector and societal perspectives. The direct cost to support uptake of the intervention was calculated, as were costs to each childcare centres. The incremental cost of the intervention was calculated as the net difference in the cost to undertake menu planning and review plus the direct cost of the intervention. Incremental cost–effectiveness ratios (ICERs) including uncertainty intervals, were estimated for differences in costs and effects between intervention and control groups. A relative value index was calculated to determine overall value for money. Results Over the 12 months of the trial, we calculated a difference in cost between usual practice and intervention groups of -$482 (95% UI -$859, -$56). While the measured increase in menu and food group compliance within the trial did not reach statistical significance, there were significant improvements in mean servings of fruit and discretionary food, represented in the cost-consequence analysis. The calculated relative value index of 1.1 suggests that the intervention returns acceptable value for money for the outcomes generated. Conclusion Compared to usual practice, web-based programs may offer an efficient and sustainable alternative for childcare centres to improve the provision of healthy foods to children in their care. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12616000974404

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Economic evaluation of a web-based menu planning intervention to improve childcare service adherence with dietary guidelines

Implementation Science ◽

10.1186/s13012-020-01068-x ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Penny Reeves ◽

Kim Edmunds ◽

Zoe Szewczyk ◽

Alice Grady ◽

Sze Lin Yoong ◽

...

Keyword(s):

Food Group ◽

Dietary Guidelines ◽

Food Groups ◽

Healthy Foods ◽

Web Based ◽

Usual Practice ◽

Menu Planning ◽

Relative Value ◽

The Cost ◽

Planning Intervention

Abstract Background Despite the known benefits of healthy eating in childhood, few Australian childcare services provide food that is consistent with dietary guidelines. The effectiveness of a web-based menu planning intervention to increase childcare service provision of healthy foods and decrease provision of discretionary foods in long day-care services in Australia was assessed in a randomised controlled trial. Here we consider the costs, consequences, cost-effectiveness and budget impact of the intervention using data collected within the trial. Methods The prospective trial-based economic evaluation involved 54 childcare services across New South Wales (NSW), Australia. Services were randomised to a 12-month intervention or usual care. The intervention involved access to a web-based menu planning and decision support tool and online resources. Effectiveness measures included mean number of food groups, overall menu and individual food group compliance with dietary guidelines, and mean servings of food groups at 12 months. Costs (reported in $AUD, 2017/18) were evaluated from both health sector and societal perspectives. The direct cost to support uptake of the intervention was calculated, as were costs to each childcare service. The incremental cost of the intervention was calculated as the net difference in the cost to undertake menu planning and review plus the direct cost of the intervention. Incremental cost-effectiveness ratios (ICERs) including uncertainty intervals were estimated for differences in costs and effects between intervention and control groups. A relative value index was calculated to determine overall value for money. Results Over the 12 months of the trial, we calculated a difference in cost between usual practice and intervention groups of − $482 (95% UI − $859, − $56). While the measured increase in menu and food group compliance within the trial did not reach statistical significance, there were significant improvements in mean servings of fruit and discretionary food, represented in the cost-consequence analysis. The calculated relative value index of 1.1 suggests that the intervention returns acceptable value for money for the outcomes generated. Conclusion Compared to usual practice, web-based programmes may offer an efficient and sustainable alternative for childcare services to improve the provision of healthy foods to children in their care. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12616000974404

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Economic evaluation of a web-based menu planning intervention to improve childcare service adherence with dietary guidelines.

10.21203/rs.3.rs-37439/v2 ◽

2020 ◽

Author(s):

Penny Reeves ◽

Kim Edmunds ◽

Zoe Szewczyk ◽

Alice Grady ◽

Sze Lin Yoong ◽

...

Keyword(s):

Food Group ◽

Dietary Guidelines ◽

Food Groups ◽

Healthy Foods ◽

Web Based ◽

Usual Practice ◽

Menu Planning ◽

Relative Value ◽

The Cost ◽

Planning Intervention

Abstract BackgroundDespite the known benefits of healthy eating in childhood, few Australian childcare services provide food that is consistent with dietary guidelines. The effectiveness of a web-based menu planning intervention to increase childcare service provision of healthy foods and decrease provision of discretionary foods in long day-care services in Australia was assessed in a randomised controlled trial. Here we consider the costs, consequences, cost-effectiveness and budget impact of the intervention using data collected within the trial. MethodsThe prospective trial-based economic evaluation involved 54 childcare services across New South Wales (NSW), Australia. Services were randomised to a 12-month intervention or usual care. The intervention involved access to a web-based menu planning and decision support tool, and online resources. Effectiveness measures included: mean number of food groups, overall menu and individual food group compliance with dietary guidelines, and mean servings of food groups at 12 months. Costs (reported in $AUD, 2017/18) were evaluated from both health sector and societal perspectives. The direct cost to support uptake of the intervention was calculated, as were costs to each childcare service. The incremental cost of the intervention was calculated as the net difference in the cost to undertake menu planning and review plus the direct cost of the intervention. Incremental cost–effectiveness ratios (ICERs) including uncertainty intervals, were estimated for differences in costs and effects between intervention and control groups. A relative value index was calculated to determine overall value for money.ResultsOver the 12 months of the trial, we calculated a difference in cost between usual practice and intervention groups of -$482 (95% UI -$859, -$56). While the measured increase in menu and food group compliance within the trial did not reach statistical significance, there were significant improvements in mean servings of fruit and discretionary food, represented in the cost-consequence analysis. The calculated relative value index of 1.1 suggests that the intervention returns acceptable value for money for the outcomes generated.ConclusionCompared to usual practice, web-based programs may offer an efficient and sustainable alternative for childcare services to improve the provision of healthy foods to children in their care. Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12616000974404

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Food and Food Groups in Inflammatory Bowel Disease (IBD): The Design of the Groningen Anti-Inflammatory Diet (GrAID)

Nutrients ◽

10.3390/nu13041067 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1067

Author(s):

Marjo J. E. Campmans-Kuijpers ◽

Gerard Dijkstra

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Food Group ◽

Dietary Guidelines ◽

Current Evidence ◽

Group Level ◽

Food Groups ◽

Inflammatory Bowel ◽

Anti Inflammatory

Diet plays a pivotal role in the onset and course of inflammatory bowel disease (IBD). Patients are keen to know what to eat to reduce symptoms and flares, but dietary guidelines are lacking. To advice patients, an overview of the current evidence on food (group) level is needed. This narrative review studies the effects of food (groups) on the onset and course of IBD and if not available the effects in healthy subjects or animal and in vitro IBD models. Based on this evidence the Groningen anti-inflammatory diet (GrAID) was designed and compared on food (group) level to other existing IBD diets. Although on several foods conflicting results were found, this review provides patients a good overview. Based on this evidence, the GrAID consists of lean meat, eggs, fish, plain dairy (such as milk, yoghurt, kefir and hard cheeses), fruit, vegetables, legumes, wheat, coffee, tea and honey. Red meat, other dairy products and sugar should be limited. Canned and processed foods, alcohol and sweetened beverages should be avoided. This comprehensive review focuses on anti-inflammatory properties of foods providing IBD patients with the best evidence on which foods they should eat or avoid to reduce flares. This was used to design the GrAID.

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A short food-group-based dietary questionnaire is reliable and valid for assessing toddlers' dietary risk in relatively advantaged samples

British Journal Of Nutrition ◽

10.1017/s0007114514001184 ◽

2014 ◽

Vol 112 (4) ◽

pp. 627-637 ◽

Cited By ~ 15

Author(s):

Lucinda K. Bell ◽

Rebecca K. Golley ◽

Anthea M. Magarey

Keyword(s):

Risk Score ◽

Dietary Patterns ◽

Reliability And Validity ◽

Food Group ◽

Dietary Guidelines ◽

Risk Category ◽

Food Groups ◽

Sweetened Beverages ◽

Dietary Risk ◽

Highly Correlated

Identifying toddlers at dietary risk is crucial for determining who requires intervention to improve dietary patterns and reduce health consequences. The objectives of the present study were to develop a simple tool that assesses toddlers' dietary risk and investigate its reliability and validity. The nineteen-item Toddler Dietary Questionnaire (TDQ) is informed by dietary patterns observed in Australian children aged 14 (n552) and 24 (n493) months and the Australian dietary guidelines. It assesses the intake of ‘core’ food groups (e.g. fruit, vegetables and dairy products) and ‘non-core’ food groups (e.g. high-fat, high-sugar and/or high-salt foods and sweetened beverages) over the previous 7 d, which is then scored against a dietary risk criterion (0–100; higher score = higher risk). Parents of toddlers aged 12–36 months (Socio-Economic Index for Areas decile range 5–9) were asked to complete the TDQ for their child (n111) on two occasions, 3·2 (sd1·8) weeks apart, to assess test–retest reliability. They were also asked to complete a validated FFQ from which the risk score was calculated and compared with the TDQ-derived risk score (relative validity). Mean scores were highly correlated and not significantly different for reliability (intra-class correlation = 0·90, TDQ1 30·2 (sd8·6)v. TDQ2 30·9 (sd8·9);P= 0·14) and validity (r0·83, average TDQ ((TDQ1+TDQ2)/2) 30·5 (sd8·4)v. FFQ 31·4 (sd8·1);P= 0·05). All the participants were classified into the same (reliability 75 %; validity 79 %) or adjacent (reliability 25 %; validity 21 %) risk category (low (0–24), moderate (25–49), high (50–74) and very high (75–100)). Overall, the TDQ is a valid and reliable screening tool for identifying at-risk toddlers in relatively advantaged samples.

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Under- and overreporting of energy is related to obesity, lifestyle factors and food group intakes in Jamaican adults

Public Health Nutrition ◽

10.1079/phn2003508 ◽

2004 ◽

Vol 7 (1) ◽

pp. 9-19 ◽

Cited By ~ 87

Author(s):

Michelle A Mendez ◽

Suzanne Wynter ◽

Rainford Wilks ◽

Terrence Forrester

Keyword(s):

Food Group ◽

Normal Weight ◽

Capital City ◽

Food Groups ◽

Healthy Foods ◽

Middle Income ◽

Multinomial Models ◽

High Prevalence ◽

Obese Subjects ◽

Industrialised Countries

AbstractObjective:Research in industrialised countries has documented a high prevalence of underreported energy intakes associated with characteristics such as obesity. This paper examines the prevalence, patterns and impact of energy under- and overreporting on diet–obesity relationships in a middle-income developing country.Design:A 70-item food-frequency questionnaire was used. Underreporters had reported energy intakes < 1.35 × basal metabolic rate (BMR), overreporters > 2.4 × BMR. Multinomial models were used to identify characteristics associated with implausible reporting. Intakes were compared across reporting groups to assess evidence of bias. Associations between diet and obesity were compared with and without adjustment for implausible reporting.Setting:Spanish Town, neighbouring the capital city of Kingston, Jamaica.Subjects:Eight hundred and ninety-one Jamaican adults, aged 25–75 years, were randomly recruited.Results:More women than men (38.6% vs. 22.5%) underreported, but more men overreported energy (23.7% vs. 16.0%). Underreporting was positively associated with obesity, special diets, smoking and age; age was inversely associated with overreporting. Underreporters estimated lower energy from potentially socially undesirable food groups (e.g. snacks) and higher intakes of ‘healthy’ foods (e.g. fruit) than did plausible reporters. For some of these food groups, significant differences in intakes among normal-weight versus obese subjects observed among plausible reporters were absent when implausible reporters were included. In models of food group–obesity associations, adjusting for implausible energy yielded more credible results that more closely resembled findings in plausible reporters.Conclusions:Energy under- and overreporting are highly prevalent in Jamaica. Adjusting for implausible reporting may help to reduce bias in diet–health outcome associations.

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The Relative Caloric Prices of Healthy and Unhealthy Foods Differ Systematically across Income Levels and Continents

Journal of Nutrition ◽

10.1093/jn/nxz158 ◽

2019 ◽

Vol 149 (11) ◽

pp. 2020-2033 ◽

Cited By ~ 37

Author(s):

Derek D Headey ◽

Harold H Alderman

Keyword(s):

Soft Drink ◽

Food Group ◽

Food Composition ◽

Food Prices ◽

Future Research ◽

Food Groups ◽

Relative Prices ◽

Income Levels ◽

Food Composition Tables ◽

Overweight Prevalence

ABSTRACT Background Relative prices of healthy/unhealthy foods have been implicated in the obesity epidemic, but never extensively quantified across countries or empirically linked to undernutrition. Objectives This study compared relative caloric prices (RCPs) for different food categories across 176 countries and ascertained their associations with dietary indicators and nutrition outcomes. Methods We converted prices for 657 standardized food products from the 2011 International Comparison Program into caloric prices using USDA Food Composition tables. We classified products into 21 specific food groups. We constructed RCPs as the ratio of the 3 cheapest products in each food group, relative to the weighted cost of a basket of starchy staples. We analyzed RCP differences across World Bank income levels and regions and used cross-country regressions to explore associations with Demographic Health Survey dietary indicators for women 15–49 y old and children 12–23 mo old and with WHO indicators of the under-5 stunting prevalence and adult overweight prevalence. Results Most noncereal foods were relatively cheap in high-income countries, including sugar- and fat-rich foods. In lower-income countries, healthy foods were generally expensive, especially most animal-sourced foods and fortified infant cereals (FICs). Higher RCPs for a food predict lower consumption among children for 7 of 9 food groups. Higher milk and FIC prices were positively associated with international child stunting patterns: a 1-SD increase in milk prices was associated with a 2.8 percentage point increase in the stunting prevalence. Similarly, a 1-SD increase in soft drink prices was associated with a reduction in the overweight prevalence of ∼3.6 percentage points. Conclusions Relative food prices vary systematically across countries and partially explain international differences in the prevalences of undernutrition and overweight adults. Future research should focus on how to alter relative prices to achieve better dietary and nutrition outcomes.

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Food prices in a pandemic: Global data show higher costs for nutritious food groups

10.21203/rs.3.rs-710555/v1 ◽

2021 ◽

Author(s):

Yan Bai ◽

Leah Costlow ◽

Alissa Ebel ◽

Sarah Laves ◽

Yurika Ueda ◽

...

Keyword(s):

Supply Chains ◽

Commodity Prices ◽

Food Group ◽

Food Prices ◽

Food Groups ◽

Nutritious Food ◽

Price Indexes ◽

On Farm ◽

Retail Food ◽

Global Data

Abstract The COVID pandemic has cut lives, livelihoods and supply chains, leading to price spikes for some foods and decline for others. We compare monthly retail food prices in up to 180 countries through February 2021, and find significant rises for more nutritious food groups with higher case counts. Prices by food group complement data on farm commodity prices and overall consumer price indexes, and can help guide policy for resilience and response to shocks.

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Optimizing Complementary Diets to Provide Nutrient Adequacy for Infants 6 to 12 Months Old: A Dietary Modelling Study (P11-090-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz048.p11-090-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Lynda O'Neill ◽

Anne Dattilo ◽

Matthieu Maillot ◽

Florent Vieux ◽

Jose Saavedra

Keyword(s):

Vitamin D ◽

Breast Milk ◽

Daily Intake ◽

Dietary Guidelines ◽

Food Groups ◽

University Of Minnesota ◽

Data Set ◽

Nutrient Adequacy ◽

Developmental Appropriateness ◽

Breast Fed

Abstract Objectives The purpose of this study was to determine the optimal composition of complementary diets for infants 6 to 12 months old (m.o), in terms of daily intake of food groups to ensure nutrient adequacy. A secondary goal was to determine differences in these optimized diets with fortified versus unfortified foods. Methods Dietary modelling using linear programming was applied to the Feeding Infants and Toddlers Study 2016 data set to develop theoretical diets that satisfy nutrient requirements, while meeting median energy needs, for 6 to 8 m.o. and 9 to 12 m.o. breast-fed, formula-fed, and mixed-fed infants. The food data set was adjusted to ensure, among other criteria, developmental appropriateness and safety. Using the Nutrition Data System for Research (NDSR, version 2015: University of Minnesota, Minneapolis, MN), the current US fortification for grains was included, and analyses were then performed without fortification. Results Among modelled diets for 6 to 8 m.o., a greater amount of total food, particularly vegetables, was required to achieve nutrient adequacy in the absence of fortification. The quantity of vegetables ranged from 54 g/day (3.5% of total energy (E)) in the formula based fortified diet up to 206 g/day (15% of E) in the breast milk unfortified diet. The modelling showed that inclusion of starches and grains was negligible in the unfortified diets, being primarily replaced by vegetables and pulses. For 9 to 12 m.o., daily intake of vegetables were particularly high at 222 g/day (12% of E), in the breast-fed, unfortified group. Pulses, nuts and seeds were featured in the unfortified diets at a level of 61 g/day (10% of E) in both the breast milk diet and the mixed diet. In terms of nutrient adequacy, all requirements were met apart from iron in the breast fed unfortified diet for 6 to 8 m.o.. Meeting Vitamin D was unachievable in all but the formula based diets for 6 to 8 m.o. Conclusions Fortification or supplementation is required to provide adequate iron to breast-fed infants, particularly in the early months of complementary feeding, and vitamin D to most infants. The diet optimization, which could be the basis for food based dietary guidelines, showed that complementary diets should be adapted according to the milk source in the infant diet. Funding Sources Nestlé Nutrition, Vevey, Switzerland.

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