New study confirms that eating healthy does indeed cost more

On average, eating healthy costs about $1.50 more per day than the least healthy diets, a new study finds. The extra cost seems insignificant at first — a small cup of coffee often costs more — but it all adds up to be a considerable barrier for many low-income families.

Researchers with the Harvard School of Public Health set out to find the evidence behind the conventional wisdom that healthier foods cost more, conducting the most comprehensive meta-analysis to date of price differences between healthy and unhealthy foods. In examining data from 10 high-income nations, researchers found that among food groups, meats and proteins had the largest cost difference, with healthier options costing 29 cents more per serving and 47 cents more per 200 calories than less healthy options. Overall, diets rich in healthy options — fruits, veggies, fish and nuts — cost significantly more than diets based on processed foods, meats and refined grains.

“It’s less than what we might have expected, but it’s important to think about what $1.50 means to some people,” lead study author Mayuree Rao told me. “It translates to about $550 a year for one person, so that’s a lot for many low-income families, especially when you multiply it by three or four family members.”

So, why the price gap? Rao and her colleagues said differences in manufacturing could explain some of it. For example, producing skinless chicken and leaner meats requires more work at the processing plant. They also gave a nod to arguments that years of agricultural policies and subsidies that favor the production of less healthy foods — “inexpensive, high volume” commodities like corn — have contributed to cheaper prices. Overall, they called for more research into the reasons underlying the price differences.

While the study, which was published last week in the journal BMJ, does emphasize that the collective cost of healthier eating is a real barrier for many families, Rao said it’s still a “drop in the bucket” compared to what we spend on diet-related chronic disease. For instance, obesity is estimated to have cost the country as much as $147 billion in medical costs in 2008 alone, according to the Centers for Disease Control and Prevention. And many of the same low-income populations that have difficulty affording healthier foods also suffer disproportionately from diet-related chronic disease, such as obesity and diabetes. Rao and study authors Ashkan Afshin, Gitanjali Singh and Dariush Mozaffarian wrote:

A daily price difference of $1.50 translates to $550 higher annual food costs per person. For many low-income families, this additional cost represents a genuine barrier to healthier eating. Yet, this daily price difference is trivial in comparison with the lifetime personal and societal financial burdens of diet-related chronic diseases. For example, suboptimal diet quality was recently estimated to account for 14% of all disability-adjusted life years in 2010 in the USA; if translated to a proportion of national health expenditures in 2012, this corresponds to diet-related healthcare costs of $393 billion/year or more than $1200/year for every American.

Rao, who is also a junior research fellow within Harvard’s Department of Epidemiology, hopes the study will inform policy discussions, especially at a time when issues of food security and chronic disease are making headlines. She said policies that favor healthy foods — such as taxing unhealthy choices and subsidizing healthy ones — is “one way to nudge people toward a healthier diet.” Another example is the Supplemental Nutrition Assistance Program (SNAP), formerly known as food stamps, which is expected to experience a cut of $5 billion in fiscal year 2014 alone. Right now, SNAP benefits average out to about $1.40 per person per meal.

“You hear a lot about how difficult it is to eat healthy on the minimal amount of assistance provided by SNAP and these findings shed some light on exactly what that barrier might be,” Rao told me. “Thinking about how to design those programs more effectively to help people buy healthier foods will only help contribute to long-term health.”

The Harvard study made a big media splash last week and Rao told me that it’s quite gratifying to see the study resonate with so many people — “it speaks to the fact that it’s very much a part of people’s everyday lives.” But even though $1.50 may not be much to some, public health practitioners still face a challenge in changing people’s behaviors.

“It’s part of that age-old problem in public health,” Rao said. “How do we persuade people to make an immediate investment in preventing (disease) that seems so distant in the future?”

For a copy of the full study, click here.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.