Affordability of Different Isocaloric Healthy Diets in Germany—An Assessment of Food Prices for Seven Distinct Food Patterns

Abstract

Affordability of different isocaloric healthy diets in Germany—an assessment of food prices for seven distinct food patterns Background: For decades, low-fat diets were recommended as the ideal food pattern to prevent obesity, type 2 diabetes and their long-term complications. Nowadays, several alternatives considering sources and quantity of protein, fat and carbohydrates have arisen and clinical evidence supports all of them for at least some metabolic outcomes. Given this variety in diets and the lack of a single ideal diet, one must evaluate if patients at risk, many of which having a lower income, can actually afford these diets. Aim: We modelled four-week food plans for a typical family of two adults and two school children based on seven different dietary patterns: highly processed standard omnivore diet (HPSD), freshly cooked standard omnivore diet (FCSD), both with German average dietary composition, low-protein vegan diet (VeganD), low-fat vegetarian diet (VegetD), low-fat omnivore diet (LFD), Mediterranean diet (MedD) and high-fat moderate-carb diet (MCD). The isocaloric diets were designed with typical menu variation for all meal times. We then assessed the lowest possible prices for all necessary grocery items in 12 different supermarket chains, avoiding organic foods, special offers, advertised exotic super foods and luxury articles. Prices for dietary patterns were compared in total, stratified by meal time and by food groups. Results: Among all seven dietary patterns, price dispersion by supermarket chains was 12–16%. Lowest average costs were calculated for the VegetD and the FCSD, followed by HPSD, LFD, VeganD, MedD and—on top—MCD. VeganD, MedD and MCD were about 16%, 23% and 67% more expensive compared to the FCSD. Major food groups determining prices for all diets are vegetables, salads and animal-derived products. Calculations for social welfare severely underestimate expenses for any kind of diet. Conclusions: Food prices are a relevant factor for healthy food choices. Food purchasing is financially challenging for persons with very low income in Germany. Fresh-cooked plant-based diets are less pricy than the unhealthy HPSD. Diets with reduced carbohydrate content are considerably more expensive, limiting their use for people with low income. Minimum wage and financial support for long-term unemployed people in Germany are insufficient to assure a healthy lifestyle.

Management of Lipedema with Ketogenic Diet: 22-Month Follow-Up

“…We think that the ketogenic diet could be a very useful tool to consider in the management of lipedema; certainly this was a particularly favorable case, as in other situations, there are different aspects, but also less compliance (this aspect could be moderated by alternating periods of a ketogenic diet with periods of a low-carb diet; i.e., with an intake of carbohydrates around 100-150 g per day-we in fact are working on a program of this type on a large scale). The cost of the program, as pointed out by Kabisch et al [38], was not a secondary factor, even in the specific case; perhaps also thanks to the good results, it was not a problem.…”

Food Costs of Children and Adolescents Consuming Vegetarian, Vegan or Omnivore Diets: Results of the Cross-Sectional VeChi Youth Study

“…Similar to our findings, a recent study in Germany which investigated the food costs of four week sample menus using minimum retail prices estimated food costs per day of 5.17 EUR/day (2.59 EUR/1000 kcal) and 5.69 EUR/day (2.85 EUR/1000 kcal) for 10–13 year old girls and boys on a vegetarian diet, respectively. In this study, the food costs of a vegan diet were about 1 EUR/day higher (6.17 EUR/day for girls, 6.97 EUR/day for boys) [ 33 ]. This higher estimated total daily food costs may be due to a higher assumed energy requirement (PAL 1.6, i.e., 2000 kcal/day for girls, 2200 kcal for boys).…”

“…Energy requirements and thus the amount of food needed is the most important determinant of total food costs [ 5 ]. Therefore, daily food costs increase with age and are higher for boys than for girls [ 5 , 33 ]. That is why the present evaluation considered both daily food costs and food costs, standardised to energy intake.…”

Health and sustainability co-benefits of eating behaviors: Towards a science of dietary eco-wellness

“…( Rubini et al, 2021 ) A German study compared monetary costs of seven reasonably healthy dietary patterns and found that the low fat vegetarian diet was the most affordable, with the other dietary patterns ranging from 10% to 70% more costly. ( Kabisch et al, 2021 ) An analysis from the U.K. found that healthy-and-sustainable diets could be affordable among all income quintiles, but that some adjustments might be needed. ( Reynolds et al, 2019 ) Economic savings from transitioning towards a plant-based diet may go beyond the purchase costs of foods.…”