Costs of a Self-Selected, Health-Promoting Diet Among the Participants of the Finnish Diabetes Prevention Study

Ottelin, Anne-Mari; Lindström, Jaana; Peltonen, Markku; Martikainen, Janne; Uusitupa, Matti; Gylling, Helena; Poutanen, Kaisa; Louheranta, Anne; Mannelin, Marjo; Paturi, Merja; Salminen, Virpi; Tuomilehto, Jaakko

doi:10.2337/dc06-2444

Cited by 19 publications

(23 citation statements)

References 14 publications

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“…Previous support for a positive association of diet quality and cost has come from cross-sectional research, much of which assesses energy cost rather than daily diet cost, and for which the overall effect attributable to diet quality is small 20 . Only a small body of intervention research has examined the effect on cost of changes in diet quality 32–35 ; these studies and the current analysis all find no increase in diet cost in association with improved diet quality. Additionally, we observed an inverse association of change in diet cost with change in WPFD among parents.…”

Section: Discussionmentioning

confidence: 47%

“…Diet cost was estimated using methods consistent with previous research 32–35 . Price information from two online national supermarkets common to the study location was recorded and averaged for each food component reported (approximately 1600 items), except that prices for items reported from a named store or restaurant were obtained from these retail outlets.…”

Section: Methodsmentioning

confidence: 99%

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Can Families Eat Better Without Spending More? Improving Diet Quality Does Not Increase Diet Cost in a Randomized Clinical Trial among Youth with Type 1 Diabetes and Their Parents

Nansel¹,

Lipsky²,

Eisenberg³

et al. 2016

Journal of the Academy of Nutrition and Dietetics

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Background Although cost is a frequently cited barrier to healthful eating, limited prospective data exist. Objective This study examined the association of diet cost with diet quality change. Design An 18-month randomized clinical trial evaluated a dietary intervention. Participants/setting Youth with type 1 diabetes duration ≥1 year, age 8.0 to 16.9 years (N=136), receiving care at an outpatient tertiary diabetes center in Boston, Massachusetts participated along with a parent from 2010 to 2013. Eighty-two percent of participants were from middle to upper income households. Intervention The family-based behavioral intervention targeted intake of whole plant foods. Main outcome measures Diet quality as indicated by the Healthy Eating Index-2005 (HEI-2005, measures conformance to 2005 Dietary Guidelines for Americans) and whole plant food density (WPFD, cup/oz equivalents per 1000 kcal of target food groups) were calculated from three-day food records of youth and parent dietary intake at six and four time points, respectively. Food prices were obtained from two online supermarkets common to the study location; daily diet cost was calculated by summing prices of reported foods. Statistical analyses performed Random effects models estimated treatment group differences in time-varying diet cost. Separate models for youth and parent adjusted for covariates examined associations of time-varying change in diet quality with change in diet cost. Results There was no treatment effect on time-varying diet cost for either youth [β (95%CI) = −0.49 (−1.07, 0.08), p=.10] or parents [β=0.24 (−1.61, 2.08) p=.80]. Additionally, time-varying change in diet quality indicators was not associated with time-varying change in diet cost for youth. Among parents, a 1 cup/oz-equivalent increase in whole plant food density was associated with a $.63/day lower diet cost [β=−0.63 (−1.20, −0.05), p=0.03]. Conclusions Improved diet quality was not accompanied by greater cost for youth with type 1 diabetes and their parents participating in a randomized clinical trial. Findings challenge the prevailing assumption that improving diet quality necessitates greater cost.

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Section: Discussionmentioning

confidence: 47%

Section: Methodsmentioning

confidence: 99%

Can Families Eat Better Without Spending More? Improving Diet Quality Does Not Increase Diet Cost in a Randomized Clinical Trial among Youth with Type 1 Diabetes and Their Parents

Nansel¹,

Lipsky²,

Eisenberg³

et al. 2016

Journal of the Academy of Nutrition and Dietetics

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“…Finally, several (35)(36)(37)(38)(39) although not all (40) intervention studies have reported that nutrient-dense diets consumed as a result of nutrition interventions were not more expensive than lower-quality diets. These intervention studies provided individual instructions on how to identify nutritious low-cost foods, how and where to make food purchases, and how to store and prepare the foods, possibly facilitating the consumption of a healthier diet at lower cost.…”

Section: Discussionmentioning

confidence: 99%

Monetary cost of self-reported diet in relation to biomarker-based estimates of nutrient intake in young Japanese women

Murakami

Sasaki

Takahashi

et al. 2009

Public Health Nutr.

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Objective: All previous studies on monetary diet cost have examined the relationship of monetary cost of self-reported diet to self-reported, rather than biomarker-based, estimates of dietary intake. The present cross-sectional study examined the association between monetary costs of self-reported diet and biomarker-based estimates of nutrient intake. Design: Monetary diet cost (Japanese yen/1000 kJ) was calculated based on dietary intake information from a self-administered, comprehensive diet history questionnaire using retail food prices. Biomarker-based estimates of nutrient intake (percentage of energy for protein and mg/1000 kJ for K and Na) were estimated based on 24 h urinary excretion and estimated energy expenditure. Setting: A total of fifteen universities and colleges in Japan. Subjects: A total of 1046 female Japanese dietetic students aged 18-22 years. Results: Total monetary diet cost showed a significant positive association with biomarker-based estimates of protein, K and Na. Vegetables and fish were not only the main contributors to total monetary diet cost (16?4 % and 15?5 %, respectively) but also were relatively strongly correlated with total monetary diet cost (Pearson's correlation coefficient: 0?70 and 0?68, respectively). Monetary cost of vegetables was significantly positively associated with all three nutrients, while that of fish showed a significant and positive association only with protein.Conclusions: Total monetary cost of self-reported diet was positively associated with biomarker-based estimates of protein, K and Na intake in young Japanese women, and appeared mainly to be explained by the monetary costs of vegetables and fish. Keywords Monetary diet cost 24 h urine EpidemiologyWhile food choice is influenced by a large number of factors (1) , the price of food is clearly an important determinant (2,3) . Generally, energy-dense and nutrientdilute foods such as cereals, fats and oils, and sugar and sweets provide dietary energy at lowest cost. Conversely, the cost per kilojoule of energy-dilute and nutrient-dense foods, including vegetables, fish and fruit, is much higher. If healthier foods cost more then so too will healthier diets. In fact, several (4)(5)(6)(7)(8)(9) although not all (10) observational studies have shown that healthful diets are more expensive than less healthful diets.However, all of these previous studies have estimated both monetary diet costs and dietary intake based on selfreported dietary intake obtained by the same dietary assessment method, resulting in an inevitable overestimation of the association between monetary diet cost and dietary intake due to errors shared by monetary diet costs and dietary intake. Given the difficulty in estimating y The members of the Japan Dietetic Students' Study for Nutrition and Biomarkers Group (in addition to the authors) are as follows:

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“…216 Dietary fibre and fat contents were strong predictors of success, even after adjustment for weight loss. 213 Results: primary outcomes Progression to diabetes Tuomilehto et al (2001) 183 assessed the incidence of T2DM (WHO 1985 criteria) by annual oral glucose tolerance testing for up to 6 years (mean follow-up 3.2 years).…”

Section: Interventionmentioning

confidence: 95%

“…[205][206][207][208][209][210][211][212][213][214][215][216][217][218][219] Description and quality of trial This RCT of 523 participants with IGT in Finland compared intensive lifestyle intervention with a control group. Participants were recruited by screening high-risk individuals (e.g.…”

Section: The Finnish Diabetes Prevention Studymentioning

confidence: 99%

Non-pharmacological interventions to reduce the risk of diabetes in people with impaired glucose regulation: a systematic review and economic evaluation.

Gillett

Royle²,

Snaith³

et al. 2012

Health Technol Assess

118

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Costs of a Self-Selected, Health-Promoting Diet Among the Participants of the Finnish Diabetes Prevention Study

Cited by 19 publications

References 14 publications

Can Families Eat Better Without Spending More? Improving Diet Quality Does Not Increase Diet Cost in a Randomized Clinical Trial among Youth with Type 1 Diabetes and Their Parents

Can Families Eat Better Without Spending More? Improving Diet Quality Does Not Increase Diet Cost in a Randomized Clinical Trial among Youth with Type 1 Diabetes and Their Parents

Monetary cost of self-reported diet in relation to biomarker-based estimates of nutrient intake in young Japanese women

Non-pharmacological interventions to reduce the risk of diabetes in people with impaired glucose regulation: a systematic review and economic evaluation.

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