(P17-042-23) Evaluating the Association Between the Cost of Diets and Dietary Intake: Assessing Diet Cost Indicators in 161 Countries

Objectives: This study aimed to analyze secondary data from global databases to reveal the associations between multiple diet cost indicators, and dietary intakes, and to compare the indicators in terms of sensitivity to the dietary outcomes.

Methods: We computed the weighted population-level nutrient adequacy levels and food intakes for 9 nutrients and 13 food groups for 8 adult sex-age groups in 156 countries, with estimated daily nutrient and food intake data retrieved from the Global Dietary Database. We then tested the association between dietary outcomes in 2018 and the diet cost and food price indicators in 2017 (Cost of a Health Diet, Cost of a Nutritious Adequate Diet, Cost of a Calories Adequate Diet, and Food Price Level Index), using mixed-effects models adjusted for country-specific population structure and log GDP per capita and log daily food expenditure per capita as covariates.

Results: For nutrient intakes, we found negative associations between intakes for riboflavin, vitamin C, zinc, and magnesium, while positive association for carbohydrates, and diet cost indicators. For food group intakes, we found negative associations between starchy vegetables, whole grain intakes, and unsaturated fats, while positive associations between refined grain intakes and non-starchy vegetables, and diet cost indicators. Among three diet costs indicators, the Cost of a Healthy Diet is the most sensitive indicator to dietary outcomes, while the Cost of a Calories Adequate Diet is the least sensitive one. Results remain insignificant and inconsistent for price level index for all dietary outcomes.

Conclusions: This overview of population-stratified intakes for selected nutrients and food groups indicated that increased diet cost indicators are associated with higher intakes of carbohydrates and refined grains, but lower intakes of certain essential nutrients and healthy food groups, potentially signaling lower dietary quality. The least costs of diets meeting nutrition and health goals are generally more sensitive to changes in dietary intakes compared to the least cost diet indicator focused on energy only, and traditional price level index for food. Therefore, the cost of a healthy diet could be used as a nutrition-sensitive diet cost indicator providing evidence for policymakers to guide agriculture, food and nutrition interventions and policies.

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