scholarly journals Assessment of the Cost of the Mediterranean Diet in a Low-Income Region: Adherence and Relationship with Available Incomes

Author(s):  
Alessia Rubini ◽  
Cristina Vilaplana Prieto ◽  
Marta Flor-Alemany ◽  
Lorena Yeguas-Rosa ◽  
Miriam Hernández-González ◽  
...  

Abstract BackgroundThe Mediterranean Diet (MD) is recognized as heart-healthy, but the economic cost associated with this type of diet has scarcely been studied.AimThe objective of the present study was to explore the cost and adherence of the low-income region population to the MD and its relationship with available incomes.MethodsA population-based study was carried out on 2,833 subjects between 25 and 79 years of age, 54% women, selected at random from the communities of Vegas Altas, La Siberia and La Serena in the province of Badajoz, Extremadura, Spain. The average cost of each product included in the MD and monthly expenditure were calculated. The expenditure was related to the degree of adherence to the MD (the Panagiotakos Index) and to the incomes of the participants.ResultsThe monthly median cost was 203.6 euros (IQR 154.04-265.37). Food-related expenditure was higher among the male population (p<0.001) of between 45 and 54 years of age (p<0.013) and living in urban areas (p<0.001). A positive correlation between food-related expenditure and the MD adherence was found. Expenditure represents 15% of total incomes, ranging from 11% for the group with a low MD adherence to 17% for the group with a high MD adherence.Conclusions The monthly cost of the MD was positively correlated with the degree of adherence to this dietary pattern, and is similar to that of other regions of Spain with higher per capita income, which entails a greater expenditure for equal adherence to the MD.

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Alessia Rubini ◽  
Cristina Vilaplana-Prieto ◽  
Marta Flor-Alemany ◽  
Lorena Yeguas-Rosa ◽  
Miriam Hernández-González ◽  
...  

Abstract Background The Mediterranean Diet (MD) is recognized as heart-healthy, but the economic cost associated with this type of diet has scarcely been studied. The objective of the present study is to explore the cost and adherence of a low-income region population to the MD and its relationship with income. Methods A population-based study was carried out on 2,833 subjects between 25 and 79 years of age, 54% women, selected at random from the municipalities of Vegas Altas, La Siberia and La Serena in the province of Badajoz, Extremadura (Spain). Average monthly cost of each product included in the MD was computed and related to adherence to the MD using the Panagiotakos Index and average disposable income. Results The monthly median cost was 203.6€ (IQR: 154.04-265.37). Food-related expenditure was higher for men (p<0.001), age cohort between 45 and 54 years (p<0.013) and those living in urban areas (p<0.001). A positive correlation between food-related expenditure and the MD adherence was found. Monthly median cost represents 15% of average disposable income, ranging between 11% for the group with low MD adherence and 17% for the group with high MD adherence. Conclusions The monthly cost of the MD was positively correlated with the degree of adherence to this dietary pattern. Given that the estimated monthly cost is similar to that of other Spanish regions with a higher income level, the economic effort required to be able to afford the Mediterranean diet is higher. This may represent a barrier to access, which should be analyzed in detail by public decision-makers.


2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
A Rubini ◽  
C Vilaplana Prieto ◽  
L Yeguas Rosa ◽  
M Flor-Alemany ◽  
J Felix Garcia ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Carlos III Health Institute - Spain Background Cardiovascular diseases are the leading cause of death in developed countries. In this context, the Mediterranean diet (MD) is widely recognized as cardioprotective, although its implementation cost has been little studied and rarely employed as an argument for debate. Although previous Spanish studies have corroborated a higher monetary cost associated with increased adherence to the MD, there exist large disparities among studies, and none of them has related the cost of MD to available income, which is highly relevant for assessing the degree of affordability by families. Purpose The aim of this study is twofold. First, to estimate the cost and degree of adherence of the MD in a population of Extremadura. Second, to provide evidence on the cost of the MD in relation to available incomes. Methods A population study including 2.833 subjects between 25 and 79 years old (54% women), randomly selected from Don Benito-Villanueva de la Serena (Badajoz, Spain). Diet questionnaire contained 175 food items and 7 items related to alcoholic beverages. Consumption frequencies were translated in terms of grams or millilitres. Price for each item was obtained using price supermarket comparators from the same geographical area. Total monthly cost was obtained using monthly quantities consumed and the price of each category.  Final cost was related to Panagiotakos adherence degree and to available income. Data of available income was obtained from the Income Tax Statistics by municipality. Results Median monthly cost was EUR 203.63 (IQR 154.04-265.37): 216.91 for men and 191.22 for women. Median monthly cost per age cohort showed an inverted U-shape, with a maximum in the 45-54 years-old cohort (EUR 212.1; IQR 155.47-274.63) and a minimum for the 75-79 years-old cohort (EUR 179; IQR 130.21-224.99). Median monthly cost was very similar for primary, secondary and higher educational levels (208.18, 206.57 and 205.70, respectively), but 14% lower for those without primary studies. MD cost was lower in rural compared with urban areas (188 versus 223 euros, respectively) The percentage of population showing a high MD adherence was 59% whereas the percentage with a low adherence was 12%. The cost associated with a high MD adherence was EUR 228.38. The average cost represents 14% of the available income, ranging from 10.5% for the group with low MD adherence, to 15.72% for the group with a high adherence. Conclusions Higher adherence to the MD can reach almost 20% of the available income. This can lead to low-income families opting for cheaper, energy-dense, and consequently, less healthy dietary patterns. Emphasis should be placed on education strategies to recreate the MD at an affordable price or to introduce changes to consumer taxes (VAT) that favor DM pattern.


2014 ◽  
Vol 33 ◽  
pp. S102
Author(s):  
M. Torres ◽  
C. Féart ◽  
V. Ginder Coupez ◽  
N. Gausserès ◽  
P. Barberger-Gateau ◽  
...  

2021 ◽  
pp. 1-24
Author(s):  
Ricardo Alves ◽  
Carla Lopes ◽  
Sara Rodrigues ◽  
Julian Perelman

Abstract Background: Adherence to the Mediterranean diet has been decreasing in southern Europe, which could be linked to several cultural or educational factors. Our aim is to evaluate the extent to which economic aspects may also play a role, exploring the relationship between food prices in Portugal and adherence to the Mediterranean diet. Methods: We evaluated data from the Portuguese National Food, Nutrition, and Physical Activity Survey (IAN-AF 2015-2016) (n=3,591). Diet expenditures were estimated by attributing a retail price to each food group and the diet was transposed into the Mediterranean Diet Score used in the literature. Prices were gathered from five supermarket chains (65% of the Portuguese market share). Linear regression models were used to assess the association between different adherence levels to the MD levels and dietary costs. Results: Greater adherence to the MD was associated with a 21.2% (p< 0.05) rise in total dietary cost, which accounts for more 0.59€ in mean daily costs when compared with low adherence. High adherence individuals (vs. low adherence) had higher absolute mean daily costs with fish (0.62€/+285.8%; p< 0.05), fruits (0.26€/+115.8%; p< 0.05), and vegetables (0.10€/+100.9%; p< 0.05). The analysis stratified by education and income level showed significantly higher mean daily diet cost only amongst higher income groups. Conclusions: Our findings suggest that greater adherence to the MD was positively and significantly associated with higher total dietary cost. Policies to improve population’s diet should take into consideration the cost of healthy foods, especially for large low- and middle-income families.


2019 ◽  
Vol 34 (4) ◽  
pp. 282-288 ◽  
Author(s):  
Manuela De Allegri ◽  
Chris Makwero ◽  
Aleksandra Torbica

Abstract Our study estimated the full economic cost of implementing performance-based financing [PBF, the Support for Service Delivery Integration Performance-Based Incentives (SSDI-PBI) programme], as a means of first introducing strategic purchasing in a low-income setting, Malawi. Our analysis distinguished design from implementation costs and traces costs across personnel and non-personnel cost categories over the 2012–15 period. The full cost of the SSDI-PBI programme amounted to USD 3 402 187, equivalent to USD 6.46 per targeted beneficiary. The design phase accounted for about one-third (USD 1 161 332) of the total costs, while the incentives (USD 1 140 436) represented about one-third of the total cost of the intervention and about half the cost of the implementation phase. With a cost of USD 1 605 178, personnel costs represented the dominant cost category. Our study indicated that the introduction of PBF entailed consumption of a substantial amount of resources, hence representing an important opportunity cost for the health system.


2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
F Scazzina

Abstract More than five years since the global commitment to the 2030 Agenda for Sustainable Development, 690 million people lack sufficient food and economic projections suggest that the COVID-19 pandemic may add an additional 83 to 132 million people to the ranks of the undernourished. Meanwhile, 1.3 billion tons of food are wasted globally each year, utilizing 38% of total energy consumption in the global food system. Child and adult overweight and obesity are increasing in almost all countries, and on a global level the cost of a healthy diet is 60% higher than the cost of a nutrient adequate diet, and almost 5 times the cost of an energy sufficient diet. The Mediterranean Diet is one of the recognized models of healthy and sustainable diets. This model has proven to promote longevity and well-being, not only by considering specific food items and dietary patterns, but also taking into account the culture and the history of populations living in that region, as well as social aspects such as tradition and conviviality. Moreover, it is strongly tied to a gastronomic background that links health with enjoyment. This may be extremely important for the implementation of feasible programs for the prevention of chronic non communicable diseases. In fact, long lasting lifestyle changes are difficult to achieve and, although health motivations may lead to satisfactory dietary compliance in the short term, pleasure remains an important determinant of any dietary change that is intended to last. While keeping traditional dietary habits at European level, the main principles of the Mediterranean diet could be taken into account to identify key features that ensure both health benefits and sustainable impact on environment. Assessing the sustainability of these products can be an effective operational approach for preserving and promoting a Mediterranean-type dietary pattern in the European region.


BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e036566
Author(s):  
Clément Ferrier ◽  
Babak Khoshnood ◽  
Ferdinand Dhombres ◽  
Hanitra Randrianaivo ◽  
Isabelle Perthus ◽  
...  

ObjectiveTo assess trends in the average costs and effectiveness of the French ultrasound screening programme for birth defects.DesignA population-based study.SettingNational Public Health Insurance claim database.ParticipantsAll pregnant women in the ‘Echantillon Généraliste des Bénéficiaires’, a permanent representative sample of 1/97 of the individuals covered by the French Health Insurance System.Main outcomes measuresTrends in the costs and in the average cost-effectiveness ratio (ACER) of the screening programme (in € per case detected antenatally), per year, between 2006 and 2014. incremental cost-effectiveness ratio (ICER) from 1 year to another were also estimated. We assessed costs related to the ultrasound screening programme of birth defects excluding the specific screening of Down’s syndrome. The outcome for effectiveness was the prenatal detection rate of birth defects, assessed in a previous study. Linear and logistic regressions were used to analyse time trends.ResultsDuring the study period, there was a slight decrease in prenatal detection rates (from 58.2% in 2006 to 55.2% in 2014; p=0.015). The cost of ultrasound screening increased from €168 in 2006 to €258 per pregnancy in 2014 (p=0.001). We found a 61% increase in the ACER for ultrasound screening during the study period. ACERs increased from €9050 per case detected in 2006 to €14 580 per case detected in 2014 (p=0.001). ICERs had an erratic pattern, with a strong tendency to show that any increment in the cost of screening was highly cost ineffective.ConclusionEven if the increase in costs may be partly justified, we observed a diminishing returns for costs associated with the prenatal ultrasound screening of birth defects, in France, between 2006 and 2014.


2019 ◽  
Vol 22 (8) ◽  
pp. 1444-1450 ◽  
Author(s):  
Ayako Sezaki ◽  
Tomoko Imai ◽  
Keiko Miyamoto ◽  
Fumiya Kawase ◽  
Hiroshi Shimokata

AbstractObjectiveThe aim of the present study was to clarify the global relationship between Mediterranean diet score (MDS) and the incidence of IHD by country using international statistics.DesignThe incidence of IHD by country was derived from the Global Burden of Disease (GBD) database. Average supplies of food (g/d per capita) and energy (kcal/d per capita) by country, excluding loss between production and household, were obtained from the FAOSTAT database. MDS was evaluated based on the total score of nine food items that characterize the Mediterranean diet. The association between MDS and the incidence of IHD was examined in countries with a population of 1 million or greater using a general linear model controlled for socio-economic and lifestyle variables.SettingPopulation data from global international databases.ParticipantsOne hundred and thirty-two countries with a population of over 1 million.ResultsMDS was inversely correlated with obesity rate, ageing rate, years of education and IHD incidence; however, no associations were found with gross domestic product, life expectancy, smoking rate, energy supply or health expenditure. In the general linear model of IHD incidence by MDS controlled for socio-economic and lifestyle variables, the β of the MDS was –26·4 (se 8·6; P<0·01).ConclusionsThe results of this global international comparative study confirmed that the Mediterranean diet is inversely associated with the incidence of IHD.


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