The Economic Cost of Diet and Its Association with Adherence to the Mediterranean Diet in a Cohort of Spanish Primary Schoolchildren

Abstract

Background: Adoption of a certain dietary pattern is determined by different factors such as taste, cost, convenience, and nutritional value of food. Objective: To assess the association between the daily cost of a diet and its overall quality in a cohort of 6–12-year-old Spanish schoolchildren. Methods: A cross-sectional survey was conducted on a cohort (n = 130; 47% female) of 6–12-year-old children schooled in primary education in the central region of Spain. Three-day 24 h records were administered, and the nutritional quality of the diet was also determined by means of Mediterranean Adequacy Index (MAI). A questionnaire on sociodemographic data, frequency of eating in fast-food restaurants, and supplement intake were also recorded. The person responsible for the child’s diet and the schooler himself completed the questionnaires, and homemade measures were used to estimate the size of the portions. Food prices were obtained from the Household Consumption Database of the Spanish Ministry of Agriculture, Fisheries and Food. The economic cost of the diet was calculated by multiplying the amount in grams of the food consumed by each child by the corresponding price in grams and adding up the total amount for each participant. The total economic cost of the diet was calculated in €/day and in €/1000 kcal/day. Results: The area under the curve (AUC) for €/day and €/1000 kcal/day represent 62.6% and 65.6%, respectively. According to AUC values, adherence to Mediterranean diet (MD) is a moderate predictor of the monetary cost of the diet. A direct relationship between the cost of the diet and the adherence to MD was observed [OR (€/1000 kcal/day) = 3.012; CI (95%): 1.291; 7.026; p = 0.011]. Conclusions: In a cohort of Spanish schoolchildren with low adherence to the MD, a higher cost of the diet standardized to 1000 kcal was associated with above-average MAI values.

The Role of Socioeconomic Status in Adherence to the Mediterranean Diet and Body Mass Index Change: A Follow-Up Study in the General Population of Southern Croatia

“…A cross-sectional study from Greece showed that parents who reported that the financial crisis affected their food spending also reported lower consumption of fruits, carbohydrate foods, and legumes, and increased intake of nutrient-poor/energy-dense foods, while their children had reduced weekly consumption of vegetables and increased weekly consumption of nutrient-poor/energy-dense foods [89]. These and other recent evidence show a possible involvement of the economic crisis, and material resources as strong determinants of adherence to the MD in the period after the recession started [90], given that a direct positive association between the cost of the diet and adherence to the MD has been established [36]. However, it is hard to distinguish the contribution of recession due to the economic crisis from the impact of the steady process of westernization of traditional dietary habits, including MD.…”

“…Indeed, the question of a monetary cost behind the Mediterranean dietary pattern has been previously investigated. Some of these previous studies have shown that greater adherence to the MD was associated with a higher dietary cost [35][36][37], especially if it is compared to a Western dietary pattern [38]. Therefore, it is not surprising to consistently find that the lowest-income households had the lowest adherence to the MD and the highest obesity prevalence [39].…”

Mediterranean diet and structural neuroimaging biomarkers of Alzheimer’s and cerebrovascular disease: a systematic review

“…None of the studies included considered this, although all included education which may in part serve as a proxy. Previous studies have identified potentially higher costs of adhering to a MedDiet in the UK and Spain (Tong et al, 2018;Pastor et al, 2021). Higher income has been identified as one of the predictors of adherence to the MedDiet (Bonaccio et al, 2012).…”

Factors associated with adherence to the Mediterranean diet among medical students at a private university in Lima, Peru

“…Since fruits and vegetable intake is a distinctive element of healthy eating patterns, such as that of the Mediterranean, not having available options that promote a varied and balanced diet makes it difficult to achieve high levels of AMedD. Furthermore, eating mainly away from home implies not always being able to choose the ingredients with which the food dishes are prepared [52], in addition to the high cost that their ingredients may have [53].…”