(P17-028-23) Developing a Standard for Global Monitoring of the Cost and Affordability of Healthy Diets

Objectives: The cost and affordability of a healthy diet is crucial to understanding whether people can access healthy diets, such as those recommended in national food-based dietary guidelines (FBDG). The objective of this work was to develop a comparable standard of a healthy diet, for the purpose of calculating and comparing the cost and affordability of healthy diets across countries.

Methods: ±Recent and quantifiable national FBDG were identified in all regions of the world. These were quantified in terms the range and average amount in dietary energy (kcal) of each food group recommended per day per person, proportionally standardized to meet a total dietary energy value of 2329 kcal (the requirement for an average 30-year-old woman). Average amounts of each food group across guidelines were determined and used to construct a Healthy Diet Basket (HDB). The cost of the HDB and each of the originally quantified FBDG was found by analyzing food price data from 177 countries globally from the World Bank International Comparison Program (2017). The macro- and micronutrient content was calculated for the resulting least-cost set of items in each country. Carbon and water footprints of least-cost diets were also calculated to assess sustainability of healthy diets.

Results: The Healthy Diet Basket is proportionally similar to the national FBDGs from which it was derived, as well as additional non-quantified national food guides. The cost of the HDB was slightly less than $3.50 on average across countries. Based on analysis of least-cost baskets of foods meeting each guideline, the mean adequacy ratio (MAR) of the HDB was 94%, identical to the average MAR across national FBDG. The carbon and water footprints of least-cost diets meeting the HDB were very similar to those of the EAT-Lancet reference diet.

Conclusions: The Healthy Diet Basket (HDB) is a transparent, global standard set of criteria that represents commonalities across most FBDG globally and satisfies nutrient needs. Diets meeting the HDB criteria are healthy and environmentally sustainable. It is appropriate to use for comparing the cost and affordability of healthy diets across countries. Even least-cost diets meeting this standard are unaffordable for many people in the world, pointing to the need for accelerated action to make healthy diets accessible for all.

Funding Sources: BMGF and UK FCDO