Affordability of the EAT–Lancet reference diet: a global analysis

Abstract

Background The EAT-Lancet Commission drew on all available nutritional and environmental evidence to construct the first global benchmark diet capable of sustaining health and protecting the planet, but it did not assess dietary affordability. We used food price and household income data to estimate affordability of EAT-Lancet benchmark diets, as a first step to guiding interventions to improve diets around the world. Methods We obtained retail prices from 2011 for 744 foods in 159 countries, collected under the International Comparison Program. We used these data to identify the most affordable foods to meet EAT-Lancet targets. We compared total diet cost per day to each country's mean per capita household income, calculated the proportion of people for whom the most affordable EAT-Lancet diet exceeds total income, and also measured affordability relative to a least-cost diet that meets essential nutrient requirements. Findings The most affordable EAT-Lancet diets cost a global median of US$2•84 per day (IQR 2•41-3•16) in 2011, of which the largest share was the cost of fruits and vegetables (31•2%), followed by legumes and nuts (18•7%), meat, eggs, and fish (15•2%), and dairy (13•2%). This diet costs a small fraction of average incomes in high-income countries but is not affordable for the world's poor. We estimated that the cost of an EAT-Lancet diet exceeded household per capita income for at least 1•58 billion people. The EAT-Lancet diet is also more expensive than the minimum cost of nutrient adequacy, on average, by a mean factor of 1•60 (IQR 1•41-1•78). Interpretation Current diets differ greatly from EAT-Lancet targets. Improving diets is affordable in many countries but for many people would require some combination of higher income, nutritional assistance, and lower prices. Data and analysis for the cost of healthier foods are needed to inform both local interventions and systemic changes. Funding Bill & Melinda Gates Foundation.

Transitioning European Protein-Rich Food Consumption and Production towards More Sustainable Patterns—Strategies and Policy Suggestions

“…This could contribute to overcoming a major barrier identified by the stakeholders-the high price of protein-rich processed products. This barrier follows that of previous studies [47], who identified that healthier foods are likely unaffordable for low income populations. A shift to healthier diets may therefore require higher incomes, nutritional assistance and lower prices, representing considerable social and economic transformations.…”

The affordability of a healthy and sustainable diet: An Australian case study.

“…65 Additionally, Hirvonen et al also concluded that the PHD was affordable in high-income countries such as Australia, also consistent with the present study's ndings. 67 A 2013 global review on food prices and affordability showed that for some consumers price is more of a purchasing determinant than taste, and that consumers generally purchase more food when prices fall and less food when prices rise. 54 Although the affordability of the PHD for metropolitandwelling Australians shopping at major supermarkets has now been demonstrated, it remains unclear if, and to what extent, the cost of uctuating food prices could affect consumer adoption of this diet, particularly lower-income consumers who are more price sensitive than higher-income consumers.…”

“…65,66 Since the present study was completed, other research on the affordability of the PHD throughout the world has since been published, nding that the PHD was affordable for high-income countries such as Australia, but unaffordable for low-income countries. 67 The aims of this study were to: (a) Determine the affordability of the PHD food basket for low, middle and high socio-economic groups in metropolitan Australia; (b) Determine if the PHD food basket is more or less affordable than the Typical Australian Diet (TAD) food basket for low, middle and high socio-economic groups in metropolitan Australia.…”

“…This cost and affordability analysis of the PHD basket lls a gap left by the EAT-Lancet Commission, which did not address the diet's economic viability for consumers in Australia 3 (global affordability has been analysed in other studies). 67 Further research is needed to ascertain the nancial feasibility of the PHD diet in rural and remote areas of Australia where food baskets cost more than in metropolitan areas, 72,90,92,96 as well as constructing and costing PHD food baskets for particular dietary habits such as gluten free and vegetarian and perhaps sub-population groups such as varying employment status, family structure and cultural ancestry. This study suggests that price may not be a major hurdle to shift towards sustainable and nutritious diets, and therefore attention on other consumer behaviours and levers for change is required.…”

The public health rationale for promoting plant protein as an important part of a sustainable and healthy diet

“…Despite the controversies regarding the affordability and effectiveness of the new ‘planetary diet’ (Hirvonen et al . 2019), the recent approach presented in the EAT‐Lancet report (Willett et al . 2019) has received much attention as a blueprint for feeding 10 billion people by 2050 while retaining planetary health.…”